The feet are a complicated part of the body. The complexity and the heavy-duty wear and tear they endure over the years, place a lot of stress and strain on them.

Each bone needs to be in a specific place, but as we age, our bodies keep changing. 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. Our circulation diminishes too, so our healing ability lessens with age. Older adults are 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 they may experience are:

• Bunions – Sometimes painful, bony bumps that develop on the outside of the big toe joint.
• Corns, callouses and dry skin – Corns and callouses are thickened patches of dead skin that form to protect more sensitive areas. They may develop due 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 infection prone cracks.
• Hammertoes – The term “hammertoe” refers to a toe that points upward, rather than lying flat. 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.
• Structural changes – As we age, the fat pads on the bottom of our feet thin, leading to pain with each step, as well as less support for the arch. Achilles tendonitis and pinched nerves can also develop.
• Arthritis – Because the foot has so many joints, 33 in total, osteoarthritis can be a major source of pain, along with limited mobility.
• Heel pain – Back of the foot pain 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. Eventually, amputation may be required, so foot health needs careful monitoring.
• Fungal infections, ingrown, and other toenail issues. Our bodies are host to many different types of bacteria and fungus. Usually, 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. Nails can also grow at odd angles, leading to ingrown toenails, that can be extremely painful, requiring corrective surgery. Dry and brittle nails are also more widespread, as blood flow to the lower extremities weakens.
• Pain and soreness. May accompany any of the other problems cited, and can be a problem in and of itself.  You can thus be prevented  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 the shoes you’ve traditionally worn; your activity level and genetics; you may develop one or more of these problems or, none of them.

Generally, we see two subsets of older patients in practice. This includes the active elderly ones, which we’re seeing more of, as the general population ages. These seniors are still energetic 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.

On the other hand, sedentary older adults may frequently experience foot problems too. These adults are not in the workforce or active, and therefore more prone to issues like diabetes, and vascular disease, as the blood flow is compromised. They’re not maintaining overall health, and can contract things like pressure wounds or callouses. They may also not be able to reach their feet; or if visually impaired,  can’t see their feet. The result is that small problems, which could have been corrected earlier, had they been spotted, develop into much bigger issues.

Walking barefoot isn’t a great choice for any of us. It’s also most definitely not for seniors, and those with diabetes or vascular issues, that elevate risk for foot problems. Going barefoot is an issue for a number of reasons, not least of which is the mere possibility of stepping on something. With reduced vascular capacity; neuropathy that often accompanies diabetes; other chronic diseases associated with age, the chances of stepping on something sharp and not feeling it, increase. That can lead to dangerous infections.

Wearing the right shoes can make a big difference in the health of your feet, and prevent problems from developing. Many people don’t realise, that as their feet change, they may need to purchase larger shoe sizes. It’s to accommodate how the bones and ligaments have shifted.

When it’s time to buy new shoes, shop later in the day. Over the course of the day, gravity makes your feet swell, so they may be a bit larger later in the afternoon, than on awaking in the morning. If the shoes fit comfortably in the evening, they’ll probably work well any time. If you’re not having specific problems with your feet, a podiatrist’s visit once a year is probably adequate. However, if you’re having foot pain, or a systemic disease such as diabetes, or vascular issues that increase your risk of developing foot problems, it’s important that you see a podiatrist regularly to curtail them. It’s said that “skin changes or infections, pain or anything you’re not sure about,” are good reasons to visit the podiatrist. A word to the wise…

                                Your feet mirror your general health . . . cherish them!