If you’re older than 45 or 50, chances are you’ve experienced foot pain. With age comes changes in the way feet are structured. Bones and joints stretch out and feet get bigger. The muscles in feet begin to lose flexibility and elasticity. Finally and most commonly, the fat pad underneath the ball of the foot begins to atrophy.
And that fat, says Dr. Frances Faro, a foot and ankle surgeon with Orthopaedic Physicians of Colorado, “takes an enormous amount of stress and pressure off the foot.” Losing it means bad things for the bones in feet, collectively called the metatarsals, because they have less cushion to protect them. “I joke with patients of a certain age that we keep fat where we don’t want it and lose it where we do want it.”
Faro knows, of course, that for many patients, this is anything but a laughing matter. These changes in the foot can cause painful health problems (see sidebar). There are, however, a number of things that foot experts recommend to help keep your feet in shape as you age.
Stretch, Then Stretch Some More
Faro says tight calf muscles are the number one culprit when it comes to chronic foot health issues. Add to that tight hamstrings and a weak core, and it’s an equation for pain.
“A calf muscle that’s very tight causes the forefoot to push down into ground, which can cause things like plantar fasciitis, bunions and hammertoes, stress fractures of the metatarsals and Achilles tendinopathy,” Faro says.
To counter this, Faro suggests that everyone stretch their calf and hamstring muscles while brushing their teeth twice a day. The classic runner’s stretch is a good one for this purpose. (With one foot behind the other, bend the front knee forward while keeping the back leg straight. Keep your back straight and hold.) For those already experiencing foot and ankle pain, add a one-minute calf stretch, for each side, before each meal. This is about 10 minutes of stretching per day — in other words, doable.
Advancing age often means a slower metabolism, which leads to weight gain, which of course, is bad for our feet and their atrophied fat pads. Podiatrist Chad Simmons with the Elite Foot and Ankle Center says advising his patients to stay active is the one pieces of advice he wishes they all would heed.
Be Shoe Smart
For active people, that means buying new athletic shoes often. Faro’s rules of thumb: Serious runners and walkers shouldn’t keep any pair of shoes longer than six months — Faro recommends writing the date you buy them somewhere on your shoe — and all shoes should be replaced after about 450 miles. She also advises that people rotate the types of shoes they wear, from high and low heels to athletic shoes to sandals. “The body likes change and motion and same is true for the kinds of shoes we wear,” Faro says.
It’s also important to wear shoes that fit and are comfortable. People should try on shoes at the end of the day, when the feet are at their flattest and widest. “If the shoe is comfortable during that time, they should be comfortable any time,” Simmons says.
What About Orthotics?
Some problems can be alleviated by an orthotic or shoe insert. Simmons says people should be evaluated by a physician before buying costly prescription orthotics. There are over-the-counter inserts available, like those with metatarsal pads, that can help with less severe issues, Faro notes.
Don’t Wait, See Someone
“If you’re having foot pain that does not go away within a few days, see a health professional,” Simmons says. “I have seen simple issues that could be solved with conservative care become issues that take longer to improve and may need surgical intervention.”
Plantar Fasciitis: Caused by straining the plantar fascia ligament that supports the arch. Recurring strain can cause tiny ligament tears, pain and swelling.
Achilles Tendinopathy: Thought to be caused by repeated tiny injuries to the Achilles tendon and common in very active people.
Bunions and Hammertoes: Bunions happen when the metatarsal bones of the big or pinky toes slide to the side. Hammertoes happen when there is a muscle and ligament imbalance around the toe joint, most commonly in the middle three toes.
Metatarsalgia: A painful and inflamed ball of the foot, usually caused by forefoot overload due to fat pad atrophy.
Ankle Arthritis: Inflammation and stiffness of the ankle joint. Faro notes that ankle replacement surgeries are becoming more common and successful.
Acquired Flatfoot: Happens when the posterior tibial tendon works overtime trying to keep the forefoot up and experiences micro-tears. The foot will start to get flat, resulting in pain on the inner side of the foot.
Tags: Foot Health
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