Studies suggest that about one in four older adults suffer from some form of foot pain. We don’t often give our feet much thought, until they start to hurt. But they are a complex arrangement of bones (26) and joints (33), which are held together by more than 100 muscles, ligaments, and tendons. They also have more than 7,000 nerve endings. All of these components work together to support the weight and impact of an average 8,000 to 10,000 steps per day (most of us walk about 115,000 miles during our lifetime).
Older feet are vulnerable to pain and injury because as we age, the soft tissues in the feet become less flexible, and the arches drop, causing “flat feet.” This often causes the feet to roll inward as you walk (called “overpronation”). Research has suggested that this may result in mobility limitations in older adults. As we age we also lose a lot of the fat that pads the ball and heel of the feet. Without this protective cushion, our feet are subject to the stress of repeated impacts with the ground as we walk. The feet also lengthen and widen in older age, meaning that shoes you’ve worn for years with no ill effects might now be too short and narrow for your feet. About three-quarters of people ages 65 and older wear shoes that are too small and this raises their risk of conditions such as bunions (swollen, tender joints at the base of the big toes), hammertoes (in which toes develop abnormal bends due to shortened tendons), and corns and calluses: thickened areas of skin that typically develop over pressure points like the tips and tops of the toes.
Osteoarthritis is common in older feet, and may occur in the toes, midfoot area, and ankles. It develops when the cartilage that coats the ends of the bones in a joint wears away. With less cartilage, joints are not able to work smoothly and you may feel as if your bones are grating against each other as you flex your feet and ankles. People with diabetes are vulnerable to foot pain arising from neuropathy: a type of nerve damage caused by high blood sugar. Neuropathy can cause sharp pain, a tingling, burning sensation in the feet, and numbness that means you may not be aware of minor injuries to your feet. Because diabetes also affects blood circulation, these injuries may not heal, raising the risk of infection. Plantar fasciitis is an inflammation of the band of tissue that runs the length of the bottom of the foot, linking your toes to your heelbone and supporting the arch. It causes stabbing ‘start up’ pain in the heel area, especially first thing in the morning or after a period of rest. This improves with time, but can worsen again with prolonged weight bearing.
Perhaps the best thing you can do to ensure your feet don’t hurt as you get older is to wear comfortable shoes that fit you properly. When shopping for shoes, do so late in the day, when your feet will have swelled to their largest, and get your feet professionally measured if possible. Try both shoes on, and make sure you have enough space to wiggle your toes. Walk about in the shoes for five to 10 minutes to make sure they are supportive and don’t slip up and down against your heel. Other foot-friendly strategies include trimming or filing your toenails straight across to prevent the corners from growing inwards and causing ingrown nails, and inspecting your feet weekly for calluses, redness, swelling, cracks in the skin, or sores. If you have diabetes, I recommend you have your doctor examine your feet at each appointment and get an annual checkup from a podiatrist once a year. If arthritis or another health issue is affecting your ability to reach your feet to check them and trim your toenails, see a podiatrist on a more regular basis to ensure that these routine footcare tasks are done. With a bit of care and attention to apart of the body that often is overlooked, you’ll be footloose instead of footsore!
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