July 2019 - Taking Care of our Feet
The foot is a complicated body part – home to 26 bones. 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. 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," 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 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 made worse 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, frequently accompanied by a painful corn that rubs on the inside of the 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.
If you're not having specific problems with your feet, seeing a podiatrist once a year is probably adequate. However, if you're having foot pain or have a systemic disease such as diabetes or vascular diseases that increase your risk of developing foot problems, it's important that you see a podiatrist regularly to prevent small problems from developing into bigger issues.
Lastly, for anyone with foot pain, it's important to realize that's not just a normal part of aging. There are treatments that can help you get back to your more active self with less pain. You should have your feet evaluated so your podiatrist can help you find a solution to get you back on your feet, literally.
Source: Elaine K. Howley, US News & World Report