As we age, foot health can change and impact overall health.
THE FOOT IS A complicated body part – home to 26 bones, says Dr. Neal Houslanger, a podiatrist in private practice at Houslanger & Kassnove Podiatrists in Patchogue, New York. This complexity and the heavy-duty wear-and-tear they endure over the years places a lot of stress and strain on our feet over the years.
“Each bone needs to be in a specific place, but as we age, our bodies are always changing and usually not for the better,” Houslanger says. One aspect of this process is that “the cells hold less water, which affects the collagen, tendons and ligaments in the feet. Tendons get tighter and ligaments get looser.” When the muscles, tendons, ligaments and bones shift, that can lead to pain and bony growths, among other problems.
In addition to less water in the cells, “our circulation diminishes, so our healing ability lessens” as we age, Houslanger says, making older adults “more prone to infections and other issues.” As people are living longer, overuse and joint injuries in the feet are also becoming more common.
After a lifetime of supporting and carrying your weight – while quite possibly encased in ill-fitting shoes – it shouldn’t come as a huge surprise that many older adults develop foot problems. Among the most common issues older adults may experience with their feet are:
- Bunions. Bunions, also called hallux valgus, are painful, bony bumps that develop on the outside of the big toe joint. They tend to develop slowly over time, as pressure on the big toe joint pushes the toe inward, toward the second toe. This effect is often exacerbated by tight footwear or high heels, and over time, the bone structure changes leading to a bunion.
- Corns, callouses and dry skin. Corns and callouses are thickened patches of dead skin that form to protect more sensitive areas and may develop in response to constant rubbing from an ill-fitting pair of shoes or other regular irritation. They’re often accompanied by dry skin, which can also be painful and lead to cracked skin that’s prone to infection.
- Hammertoes. The term “hammertoe” refers to a toe that points upward, rather than lying flat. The Cleveland Clinic reports that “the condition is actually a deformity that happens when one of the toe muscles becomes weak and puts pressure on the toe’s tendons and joints. This pressure forces the toe to become misshapen and stick up at the joint.” Also sometimes called claw toe or mallet toe, these conditions are frequently accompanied by a painful corn that rubs on the inside of the wearer’s shoe.
- Structural changes. As we age, the fat pads on the bottom of our feet thin, which can lead to pain with each step as well as less support for the arch. Achilles tendonitis and pinched nerves can also develop as the foot ages.
- Arthritis. Because the foot has so many joints – 33 in total – osteoarthritis can be a major source of pain and limited mobility for older adults.
- Heel pain. Pain at the back of the foot may result from heel spurs – bony growths that develop along the heel bone – or plantar fasciitis – inflammation of the ligament that runs along the bottom of the foot. Both can make standing and walking very painful.
- Diabetes-related foot problems. Changes in your overall health can also take a toll on your feet and lower extremities. Specifically, diabetics have a higher rate of vascular issues that can lead to major foot problems that may eventually require amputation, and thus diabetics need to carefully monitor foot health.
- Fungal infections, ingrown toenails and other toenail issues. Our bodies are host to many different types of bacteria and fungus, and most of the time, these foreign bodies are in balance and can actually be beneficial to our health. But an overgrowth of fungus, such as may occur when the feet are constantly damp, can lead to painful and unsightly infections of the toenails and between the toes. Toenails can also grow at odd angles, leading to ingrown toenails that can be extremely painful and require surgery to correct. Dry and brittle nails are also more common among older adults, as blood flow to the lower extremities weakens.
- Pain and soreness. Pain and soreness may accompany any of the other problems cited and can be a problem in and of itself that can prevent you from comfortably standing or walking for longer periods of time.
As with anything, no two people are going to have the same experience of aging and foot health. Depending on what shoes you’ve worn your whole life, how active you’ve been and your genetics, you may develop one or more of these problems, or none of them.
Any and all of these conditions may lead you to seek the assistance of a podiatrist, a specialist doctor who focuses on foot health. Dr. Said Atway, a clinical assistant professor of podiatry at The Ohio State University Wexner Medical Center, says that he generally sees two subsets of older patients in his practice, including “the active elderly patient, which we’re seeing more of as the general population ages,” he says. These older adults are still active and healthy and may develop overuse injuries. Keeping their feet healthy will enable them to continue being as active as they want, with less pain.
Experts say older adults should avoid walking barefoot.(GETTY IMAGES)
On the other hand, sedentary older adults may also often experience foot problems. “These adults are not in the workforce or active and they’re more prone to things like diabetes and vascular disease because the blood flow isn’t running as well. They’re not maintaining overall health, and they can develop things like pressure wounds or callouses. They may also not be able to reach their feet, or because of vision impairment, they can’t see their feet,” and this can mean that small problems that could have been corrected early on had they been spotted are allowed to develop into much bigger issues, Atway says.