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.

    死亡和交税可能是某些人一生中唯一一成不变的事情，但是父母们知道，你可能在 9 月 份添加第三件事情：在鞋店排队。因为有成千上万的孩子们和他们有耐心的父母一起等待去买新学年所用的鞋子。英国其乐公司仅仅在这个月就做了它的年度生意的四分之一。然而根据今天公布的一份报告显示，父母们为他们的孩子购买廉价鞋所省下来的钱，正是治疗不可避免地跟随发生的足部毛病的费用的一小部分。

    手足病医生和脚病医生学会（SCP）的一份 YouGov 调查提出，在英国超过四分之三的女性和超过三分之二的男人患有足部毛病，但是有近一半没去看医生或者这方面的专家。估计约有 70% 的这类毛病是在学校开始的--而且随着那么多便宜服装的进口，加上即用产品和邮购鞋的普及，"逻辑上表明，情况将会变得更糟，"儿童脚病医生戈登 瓦特说。

    英国面临全国性的足部毛病吗？ 三年前，在格拉斯哥大学所做的一项研究表明，足部毛病通常是因为儿童体重超标而引起的，这可能会导致例如足弓下陷和主要腿关节的关节炎等情况。当英国其乐公司在上世纪 90 年代初介绍它的第一个"H"适配的时候，儿童肥胖症刚刚开始被认识。根据已经在这家公司工作了 40 年的鲍勃·哈维的说法，"从那时到现在，我们已经销售了越来越多的较宽适配的规格号码".

    SCP 的副主任麦克 阿尼尔说，孩子们在学校放假的时候活动不多，或者也是对事情没有帮助的。"很多孩子现在花大量的时间坐在屏幕前面，所以他们足部和小腿的肌肉没有受到锻炼。没有好的减震的运动鞋和轻的套入式便鞋加剧了这个问题，让他们的脚容易劳累和受伤。"

    专家们认为，虽然某些足部毛病是由肥胖症、不活动或者遗传条件所引起的，但是大多数可以归咎于不适当的鞋子。在儿童的鞋子里缺少支撑往往会导致长期的关节动作与姿势问题--而且按英国的年度帐单，在 50 岁以上的人中，仅仅因为足部毛病（不包括由此引起的或者使其恶化的其它情况）目前每年就花掉 3000 万英镑，这样的总费用是极其高的。

    那么，我们孩子的鞋错在什么地方呢？ 大多数人都知道，高跟鞋和尖头鞋都是不利于脚的，但是其它似乎无害的款式特点也可能是有害的。目前正在较大一些孩子中流行的平的圆头鞋可能会是灾难性的，瓦特说："没有适当的后跟支持的以及不带搭扣或鞋带的套入式便鞋，诸如'多莉'鞋和芭蕾舞轻舞鞋，可能引起毛病，变成不可能治疗。"

    通常的后果是足弓下陷，脚变得扁平并且开始失去柔韧性。"爪状脚趾"可能起因于平的便鞋，它让孩子们通过脚趾紧抓来把鞋子保持在适当的位置。使得仍然正在生长中的脚趾骨产生不可逆转的变形。