There have been a number of previous studies in children in African countries that have shown a high correlation between flat foot and the wearing of shoes. This often gets touted as the shoes caused the flat foot and is used by those with an agenda to promote barefoot. However, that is not what those studies showed. All they showed was a correlation. Correlation does not mean causation
The studies could be interpreted several ways:
1. The wearing of the shoes did indeed cause the higher incidence of flat foot
2. Those with a prior flat foot wear shoes more often as the feet feel better wearing them
3. Those that wear shoes more often walk on harder surfaces and it is the harder surface that is responsible for the higher incidence of the flat foot, and not the shoes
Those with an agenda, clearly like to push option one as to what they think the studies have shown. Those without an agenda are open to all the options as an explanation of the results of those studies.
Now we have a new study on a population of children in Nigeria that has taken the analysis of these types of studies to a new level (see discussion: Flatfoot not related to footwear in Nigeria study) in which they used a more sophisticated analysis and controlled for some other variables. They concluded that the footwear was not a factor in the development of flat foot.
Don’t get me wrong, I have no doubt that footwear can and does cause a lot of problems, its just that the studies referred to above cannot be used to imply that wearing shoes in children cause flat feet.
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