Ask the Expert: Kirsten Levens-Spiliotou – Why we all need Happy Feet

Did you know that the human foot is composed of 26 bones? Where you aware that, with every step we take, the heels of our feet hit the ground with a force equal to twice our body weight? That in our lifetime, we will walk up to 185,000 km? That’s roughly 5 times around the world! No wonder it’s so important to have happy feet! In our #AskTheExpert interview of the month we sit down with Kirsten Levens-Spiliotou of The Podiatry Centre.


Kirsten, hi! What does a Podiatrist do?

In podiatry we aim to prevent deformity in the foot and maintain normal function and mobility. If abnormalities are observed, we provide an initial diagnosis and suggest ways to manage the condition. We also treat infections and skin issues, and provide nail care.

What kind of abnormalities can occur in children’s feet?

Because a child’s foot is constantly changing, it is at risk from a variety of problems at different ages as the feet and lower limbs develop. These issues can be associated with growth or with activities that the children are involved in, such as dance, gymnastics, martial arts etc. In the case of growth, the main cause of trouble is often a badly fitting shoe, or even an outgrown shoe. In the case of activities, excessive unaccustomed exercise can lead to painful foot and lower limb issues. Weight gain and postural changes also affect the feet.

How can these problems be addressed?

Some foot changes can look like serious problems to the untrained eye but may just be appearing during the period of developmental change. Often these will not require any major correctional measures and can be solved with footwear advice alone. More serious conditions can be helped with the provision of orthoses, which are special tailor-made insoles that address the positioning of the foot.

What about skin and nail issues?

These are common and not a cause for serious concern, but they need to be appropriately cared for. Proper hygiene goes a long way towards preventing most issues such as sweaty feet (very prevalent in puberty), smelly feet, athlete’s foot (the fungus that affects the skin and nails) and infected blisters.

When should a baby get their first pair of shoes?

Ideally not until they can actually walk outdoors. The child should be barefoot for as long as possible in the first year for the feet to develop naturally and normally. Remember that the age at which a baby starts to walk unaided varies from child to child.

Is there a trick to knowing the perfect shoe size and fit?

Yes, you can have your child stand on a piece of paper and trace around the shape of their foot. Measure the distance between the longest toe and the heel. A newly fitted shoe will need to be approximately 12-16 mm longer than that distance in order to allow for growth and the foot elongating when walking. This can help guide you in the shoe shop, where you can then measure the inside of the shoe you are considering buying.

Should children wear the same shoes every day?

In the best-case scenario, different shoes should be worn on alternate days in order to allow the shoe to dry out, as children’s feet can get very sweaty. Damp shoes and socks make our skin more prone to athlete’s foot and verrucae.

What about trainers as a daily shoe? Are they unhealthy for children’s and teenagers’ feet?

As long as hygiene and good foot health is followed, sports and running shoes are fine. Allow for adequate room, depth and width in the toe area, ensure the fastening is tight and the heel is well fitting and firm, with shock absorbing heel and sole. Fashion trends should not take priority over the sensible choice, especially as some trainers are designed for a particular sporting activity. Either way, here too, it’s best to take shoes off inside the house to allow for the foot to breathe and the show to dry out.

Is there anything to look out for in socks?

The importance of proper socks is often underestimated. It should be the same size as the shoe and made from 100% cotton, especially if the child has skin problems. Avoid nylon socks, as that material will make the foot sweat and it does not absorb moisture.

How often should children’s toe nails be cut, and what is the best way to do this?

The rate of nail growth varies from child to child, but it’s best to do a weekly check. If they are left too long, they can split and become ingrown. Use proper nail clippers instead of scissors, as they are safer. Always follow the shape of the nail, keep the corners free, and leave approximately 1 mm of growing nail.

What is a ‘gaitscan’ and would you recommend every child has one?

A gaitscan system records the timing sequence as a person stands and walks across a pressure plate. This plate is linked to a software programme that produces data, which allows the podiatrist to accurately detect abnormal foot function and suggest appropriate measures to correct any developmental problem. It’s an amazing technology, and you know what they say: a picture is worth a thousand words!

Not every child has to have one. Check their feet regularly and ask your podiatrist for advice if any foot problems occur. Don’t rely on your child telling you if they have a problem. Take an interest in your child’s foot health especially if they are involved in activities that may damage the feet. My children are teenagers now and I still inspect their feet every now and then, it’s never too late to get involved.

Most issues can be addressed with special custom-made orthotic insoles, which the child will need to wear for about two years. While children will not feel pain in legs and feet at this stage due to the softness of their bones, any posture problems caused by the foot deformities will become more apparent in later life.

Here at The Podiatry Centre we can help you identify and correct any issues early on. Come and see us for a no-obligation evaluation of your child’s feet. We are delighted to provide a 15% discount on the consultation fee as an exclusive offer for Mums in Cyprus members !


Kirsten is a member of both the Cyprus society of chiropodists & podiatrists, the UK society of chiropodists and podiatrists, and is also a registered member of the health professions council, UK. After graduating from Brighton university Kirsten worked for 7 years in the UK for the NHS ‘National Health Service’ in both hospitals, health centres and the community settings. She then worked 1 year in the private sector before moving to Cyprus in 2002 where she established her own private practice comprising of all elements of podiatry.



The Podiatry Centre

Gropious 43

Evangelos Court 205

Limassol 3076

Tel 25 878708



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