The Agony of the Feet as You Get Older

Making foot care a priority as you get older is important for maintaining a healthy and active lifestyle.

Article written by Stacey Colino, Contributor to US News on August 9th, 2018

While people often pay attention to how their feet look once sandal season comes around, they give their feet little TLC the rest of the year. Meanwhile, we pound our feet on the pavement or place three to four times our body weight on them when we jog. And we often subject our feet to tight or poorly fitting shoes or precarious heels. Given these stresses and strains, it’s a wonder the human foot – with its 26 bones, 33 joints and complex matrix of ligaments, tendons and muscles – doesn’t launch a full-scale rebellion.

But sometimes it does, especially as we get older. Indeed, a study in a 2016 issue of Maturitas found that foot pain affects 1 in 4 adults after age 45, and it’s at least somewhat disabling in two-thirds of those cases. Even worse, foot pain in older adults is associated with a 62 percent increased risk of recurrent falls, according to a study in a 2017 issue of Gerontology. “As we get older, our muscles and tendons lose elasticity, which can contribute to foot pain,” says Beth Gusenoff, a podiatric surgeon and clinical assistant professor in the department of plastic surgery at the University of Pittsburgh Medical Center.

It’s important to make your foot health a priority, especially as you get older because “a healthy foot is a catalyst for mobility and a healthy lifestyle,” Gusenoff says. “Your feet really are your base of support.”

Here are six things you may not know about your aging feet – but should.

Obesity can increase your risk of suffering from foot pain. study in a 2017 issue of the journal Obesity Research & Clinical Practice found that as people’s body mass index, or BMI, increases from the normal range to obesity, so do the odds that they will have foot pain as they get older; this is true for men and women. With excess weight on the body, “the foot can’t handle the mechanical load that’s being put on it,” Gusenoff says.

Unfortunately, the obesity issue can create a vicious cycle, whereby obesity increases the risk of foot pain, which makes people less likely to engage in weight-bearing physical activities, which can lead to more weight gain, and so on, notes Dr. Clifford Jeng, medical director of the Institute for Foot and Ankle Reconstruction at Mercy Medical Center in Baltimore. Consider this extra incentive to shed excess pounds.

Loss of fat in the feet can make you more susceptible to foot pain. We’re all born with a certain amount of fat under our feet, especially under the heels and the balls of our feet, which allows for shock absorption. “As we age, the fat padding under our feet can atrophy – some people’s gets thinner more rapidly than others,” Jeng explains. Overtraining and getting cortisone injections (to reduce pain and swelling in the feet) can accelerate the fat pad loss in the feet. When this happens, people often complain that it feels like they’re walking on hard rocks or marbles, which can lead to pain and a flattening of the feet. What’s more, “losing the fat pad can make you more susceptible to stress fractures, bruised bones and balance problems as you get older,” Gusenoff notes. Since fat can’t be transplanted from other parts of the body – at least not yet – “the only thing that we can do is to supplement the fat pad with external cushioning like silicone,” Jeng says. However, while it’s not offered routinely, some medical practices, including Gusenoff’s, now offer fat grafting procedures to treat fat pad atrophy, relieve pain and prevent worsening pressure to the foot. You can also buy insoles or gel pads to put in your shoes wherever you need the extra padding – including under your heel, under the ball of your foot or next to a bunion.

Compromised blood flow to the feet can cause or worsen foot pain. Various factors can affect the quality of blood flow to the feet, including whether you smoke or have diabetesperipheral neuropathy or blood clots. Poor circulation to the feet is a problem because “diminished blood flow may manifest itself as frank pain when the soft tissues are not being perfused with enough circulation,” notes Tim Swartz, chief of podiatry at Kaiser Permanente’s Mid-Atlantic region. “Wound and tissue healing can also be a problem if there is compromised blood flow” to the feet. That’s why it’s essential to tell your doctor about any numbness or tingling you have in your feet, as well as any chronic diseases, such as diabetes, arthritis or vascular disorders, that you have.

Different foot ailments become more common with age. Bunions, hammertoes, fungal infections, corns and calluses can occur at any age. Meanwhile, certain foot ailments become more common as people get older. These include plantar fasciitis (pain in the bottom of the heel that occurs when the band of tissue that supports the arch becomes irritated and inflamed), posterior tibial tendonitis (in which the tendon that attaches the calf muscle to the bones on the inside of the foot becomes torn or inflamed), Achilles tendinitis and big toe arthritis, Jeng says. Persistent pain or swelling in the foot, especially when accompanied by compromised mobility, warrant a visit to your doctor.

“Sometimes foot pain in the aging population is dismissed as due to age and tired feet, but there may be a true underlying cause of the pain that can be treated,” Gusenoff says. “Improving pain and keeping a patient mobile and active can be a catalyst for healthier living and a better quality of life.” She recommends doing basic stretches for your Achilles, foot circles and balance exercises, such as toe and heel raises or standing on one foot. In terms of cardio workouts, cycling and swimming are easier on the feet because they’re not weight-bearing activities.

When shopping for new shoes, always have your feet measured. Even if the rest of you stopped growing long ago, it’s important to have your feet measured throughout your life. “Everyone’s feet get larger as they get older – everything else in your body sags as you get older; your feet do, as well,” Jeng says.

When selecting footwear, don’t become a slave to fashion. Instead, “choose your shoes wisely,” Swartz advises. “Make sure they have plenty of room in the toe box to accommodate” your forefoot and any bony protrusions on your feet and offer plenty of cushioning for bony or tender areas.

You should tend to your feet regularly. Wash your feet every day and after exercising, and be sure to dry them thoroughly. Apply a moisturizer to prevent cracking of the skin. Also, “perform daily foot exams – if you cannot see the bottom on your own foot, hold it over a mirror or have someone else check for you,” Swartz suggests. In particular, look for wounds, sores, blisters, calluses and corns. If you find any, wash them with soap and water, apply an antibiotic ointment to sores and wounds and use a bandage to protect corns and calluses from friction.