Death and taxes may be the only certainties in life for some, but parents know that you can add a third in September: queues in shoe shops, as hundreds of thousands of children wait with their patient parents to be shod for the new school year. Clarks does a quarter of its annual business in this month alone. Yet according to a report published today, the money that parents save by buying their children cheap shoes is a fraction of the cost of treating the foot problems that will inevitably follow.

    A YouGov survey for the Society of Chiropodists and Podiatrists （SCP） suggests that more than three quarters of women and two thirds of men suffer from foot problems, yet nearly half fail to see a doctor or specialist about them. An estimated 70 per cent of these problems began in school - and with so many cheap fashion imports available, plus the popularity of off-the-shelf and mail-order shoes, "logic dictates that it is going to get worse," says Gordon Watt, a paediatric podiatrist.

    Is Britain facing a national foot problem? Three years ago, a study at Glasgow Caledonian University indicated that foot troubles often begin because of children's excess weight, which can cause conditions such as fallen arches and arthritis in the major leg joints. When Clarks introduced its first 'H' fitting in the early Nineties, childhood obesity was only beginning to be recognised. According to Bob Harvey, who has worked at the company for 40 years, "we have been selling an increasing number of wider fittings ever since".

    Inactivity in the school holidays does not help, either, says Mike O'Neill, vice-president of the SCP. "A lot of children now spend much of their time in front of a screen, so the muscles in their feet and lower legs are not exercised. Trainers and light slip-on shoes without good shock absorption add to the problem, leaving their feet susceptible to strain and injury."

    Experts agree that, while some foot problems are caused by obesity, inactivity or inherited conditions, most can be blamed on inappropriate shoes. Lack of support in children's shoes often leads to long-term joint and postural problems - and with Britain's annual bill for foot problems alone （not including other conditions that these cause or aggravate） among the over-50s currently at ￡30 million, the overall cost is extremely high.

    So what is wrong with our children's shoes? Most people know that high heels and pointed toes are not good for feet, but other apparently innocuous style features can also be harmful. The flat, round-toed shoes currently in vogue for older children can be disastrous, says Watt: "Slip-on shoes without adequate heel support and no strap or lace, such as 'dolly' shoes and ballet pumps, can create problems that become impossible to treat."

    A common consequence is fallen arches, where the foot becomes flattened and starts to lose flexibility. "Claw toes" can result from flat slip-ons that make children grip with their toes to keep the shoe in place. The toe bones, which are still developing, develop an irreversible deformity.

    死亡和交稅可能是某些人一生中唯一一成不變的事情，但是父母們知道，你可能在 9 月 份添加第三件事情：在鞋店排隊。因為有成千上萬的孩子們和他們有耐心的父母一起等待去買新學年所用的鞋子。英國其樂公司僅僅在這個月就做了它的年度生意的四分之一。然而根據今天公布的一份報告顯示，父母們為他們的孩子購買廉價鞋所省下來的錢，正是治療不可避免地跟隨發生的足部毛病的費用的一小部分。

    手足病醫生和腳病醫生學會（SCP）的一份 YouGov 調查提出，在英國超過四分之三的女性和超過三分之二的男人患有足部毛病，但是有近一半沒去看醫生或者這方面的專家。估計約有 70% 的這類毛病是在學校開始的--而且隨著那么多便宜服裝的進口，加上即用產品和郵購鞋的普及，"邏輯上表明，情況將會變得更糟，"兒童腳病醫生戈登 瓦特說。

    英國面臨全國性的足部毛病嗎？ 三年前，在格拉斯哥大學所做的一項研究表明，足部毛病通常是因為兒童體重超標而引起的，這可能會導致例如足弓下陷和主要腿關節的關節炎等情況。當英國其樂公司在上世紀 90 年代初介紹它的第一個"H"適配的時候，兒童肥胖癥剛剛開始被認識。根據已經在這家公司工作了 40 年的鮑勃·哈維的說法，"從那時到現在，我們已經銷售了越來越多的較寬適配的規格號碼".

    SCP 的副主任麥克 阿尼爾說，孩子們在學校放假的時候活動不多，或者也是對事情沒有幫助的。"很多孩子現在花大量的時間坐在屏幕前面，所以他們足部和小腿的肌肉沒有受到鍛煉。沒有好的減震的運動鞋和輕的套入式便鞋加劇了這個問題，讓他們的腳容易勞累和受傷。"

    專家們認為，雖然某些足部毛病是由肥胖癥、不活動或者遺傳條件所引起的，但是大多數可以歸咎于不適當的鞋子。在兒童的鞋子里缺少支撐往往會導致長期的關節動作與姿勢問題--而且按英國的年度帳單，在 50 歲以上的人中，僅僅因為足部毛病（不包括由此引起的或者使其惡化的其它情況）目前每年就花掉 3000 萬英鎊，這樣的總費用是極其高的。

    那么，我們孩子的鞋錯在什么地方呢？ 大多數人都知道，高跟鞋和尖頭鞋都是不利于腳的，但是其它似乎無害的款式特點也可能是有害的。目前正在較大一些孩子中流行的平的圓頭鞋可能會是災難性的，瓦特說："沒有適當的后跟支持的以及不帶搭扣或鞋帶的套入式便鞋，諸如'多莉'鞋和芭蕾舞輕舞鞋，可能引起毛病，變成不可能治療。"

    通常的后果是足弓下陷，腳變得扁平并且開始失去柔韌性。"爪狀腳趾"可能起因于平的便鞋，它讓孩子們通過腳趾緊抓來把鞋子保持在適當的位置。使得仍然正在生長中的腳趾骨產生不可逆轉的變形。