4.7 In conclusion
5.1.2 Naming the chronicles
5.1.2.5 Chronicle 5: If the shoe fits
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was nearly impossible. There were no outlets that catered for flat feet with no arch; it had to be purpose-made.
Childhood-valgus flat foot with marked pronation of the foot created problems of stable gait.
In early years Tiara’s walking was affected and her balance on her feet compromised by this condition of her feet which required various specialists’ advice. The first was an orthopedic surgeon who recommended we visit an orthotist to have a mould made of her foot and a purpose made shoe created to offer more support with a detachable in-sole to create an arch for the flat feet and help stabilise her walk. (Her walk until then was a swaying and
imbalanced with a tendency of swaying from side to side.) Year after year, and at great cost, Tiara had to be taken to the orthotist to have a new mould made each time she outgrew her shoes. Specific height, weight, material and strapping had to be carefully deliberated.
There is not much research available to me on suitable shoes for school children. Illingworth (1978) appealed to the medical profession, if they could, to put pressure on shoe
manufacturers to design and manufacture suitable shoes, emphasising the risk of
disfigurements in children wearing unsuitable footwear. Beyond this comment I struggled to find research on design and manufacturing of suitable walking and running shoes for CWDS.
I accessed information on children’s footwear from a website promoting their range of shoes, which offered the following information: Children spend hours of their school lives in shoes, it is important for them to fit properly. I took particular notice of a website promoting a particular brand of school shoes which, in its marketing statement, state that “in the first eleven years of a typical child’s life, feet will grow through around 17 shoe sizes, up until they are 18 years of age, and ill-fitting shoes can lead to problems in adulthood, such as ingrown toenails, corns and bunions, which may even require surgery later in life”.30
To ensure we were obtaining the appropriate fitting school shoes, both feet were measured and it was found that one foot was slightly longer and broader. To avoid injuries by wearing shoes larger than the feet, Tiara’s shoes had to be purchased twice a year. Velcro fastening on genuine soft leather uppers was considered an appropriate choice. The orthotist took into
30 www.kidspot.com.au
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account the following aspects in the design of the custom-made shoes: a comfortable fit offers the wearer’s thumb-width space at the back of the shoe and at the front of the longest toe; the widest part in the shape of the foot should match with the width in the shoe; the clasp on the shoe must allow for the heel to be firmly positioned at back of the shoe and made of velcro as she could not do lace-up; the sole needed to be non-slip in case of inclement weather, and thick enough to give stability; the shoe heel needed to be comfortable and secure whilst the rear, durable and offering a steady balance when walking; insoles had to be designed to be inserted into the shoes to compensate for the flat feet and create an artificial arch; the light weight of the shoes had to be comfortable and genuine leather material was chosen to meet this requirement.
I was mindful that her feet had bones in continual growth. We were advised by the orthotist that if she wore shoes larger than her feet, it would cause damage to her bones and balance.
Having flat feet meant that only custom-made shoes designed uniquely for her feet would do.
Her shoes needed to be stable when she set on the floor to avoid a swaying gait, with sufficient cushioning, whilst offering all-round support. If her shoe wore off unevenly, it could lead to superficial irritation of the skin so it had to be inspected intermittently. One style of shoes did not suit all purposes and therein lay our next challenge. Extra-mural activities required children to wear takkies. This battle we could not win. We compromised by buying takkies off the store shelf of a reputable store and inserted the purpose made insoles into them.
This is the starting point that prompted me to think of schooling access as not just entrance through the front gate but the issue of navigating the geographical spaces within the school.
According to Calvo (2013) “shoes can allow children to spend more time performing more recreation activities, such as playing” (p. 2). Guzian, Bensoussan, Viton, De Bovis, Ramon, Azulay and Delarque (2006) add that shoes can prevent foot diseases and improve walking speed and gait when worn. In a study conducted by Terrier, Lithi and Deriaz (2013) on 25 patients in a rehabilitation facility in Switzerland to analyse their gait and foot stability, on account of their chronic pain through ankle or foot injury, noted that foot orthotics or purpose- made footwear are commissioned to address malformations. In the design these individualities have to be accommodated in order to reduce or remove discomfort caused by factors each
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person experiences. We observed that orthotic insoles in custom made footwear improved Tiara’s gait symmetry, and hence ambulation.