Q. My teenage daughter wears soft flat pumps to school and those infamous Australian sheepskin boots at home. Her heels seem to fall inwards in both. Will this affect her posture in later life?
Oh teenagers and footwear! The teenage years are characterised by rapid growth of the musculoskeletal system: just think of the physical difference in height and maturity of a ten year old versus a sixteen year old. In teen growth spurts, bone lengthens first, especially the long bones of the leg, stretching thigh and calf muscles, which play physiological ‘catch-up as more muscle cells are added in response to bone lengthening.
This makes leg muscles temporarily weaker for periods during and after puberty. Whilst muscle length and strength often self correct over time once growth has finished, better choice footwear is advised to prevent long term biomechanical issues.
Most teenagers we see in the clinic wear dreadful footwear: unlaced sneakers, ‘dubes’, flat thin pumps and the afore-mentioned wide boots, all providing minimal support for the feet and legs. With poor footwear, toe muscles have to work excessively in order to hold on the shoes, leading to further muscle strength imbalance both in the foot and up the leg. As you have correctly observed, this presents as the heels falling inwards in walking.
The advice we give to every teenager and parent is simple: choice of school shoes and sneakers should be predicated on presence of a strong heel counter. This means that holding the shoe from the back, the leather at the back of the heel should be fairly rigid. This helps control the position of the foot and leg at heel strike, the most vital phase for good walking pattern.
The shoe, sneaker or boot should grip the foot neatly and tied or laced every time it is put on (no wriggling into the shoe without opening it!). If the shoe is loose, toe muscles will inevitably have to strain to keep the shoe on. For girls, everyday shoes can be flat or have a moderate height heel, preferably wedge type support, no higher than 4-5 centimetres. Flat pumps with a small bar across the instep are better (maryjane type pumps). Really high heels and the infamous boots should be reserved for occasional rather than everyday wear. |
