Hallux valgus in pre-school-aged children: the effects of too-short shoes on the hallux angle and the effects of going barefoot on podiatric health

Abstract

Wearing shoes of insufficient length leads to the development of bunions (hallux valgus). We inspected the feet and the fit of shoes worn by pre-school-aged children in Japan and compared the results with those of children who went only barefoot at pre-school. The hallux angles of 1238 feet were recorded. Only 12.3% of the children presented with a straight position of the great toe and 19.1% of the children’s feet presented with a valgus angle of over 10°. 75.5% of 620 children were wearing outdoor shoes of insufficient length, 84.6% of 381 children had indoor shoes that were too short. A significant correlation between the fit of the shoes and the hallux angle was observed: the shorter the shoe, relative to foot length, the greater the hallux angle. The relative risk of a lateral hallux deviation, higher than the background risk, increases up to 30% if outdoor shoes are two sizes too short. The hallux angle in children who went barefoot was significantly smaller compared to those who habitually wore indoor shoes. Going barefoot can possibly help to counteract the increased hallux angle caused by regularly wearing shoes of insufficient length.