Healthy Edge
Want to stay active? Baby those tootsies!
Particularly common in Seniors, foot problems are often accompanied by painful, distressing symptoms that can limit mobility and quash independence. Studies show that foot problems and pain are key fall risk factors. So, if you want to stay active, baby those tootsies!
As we age, our feet follow suit. According to the American Geriatrics Association, Seniors can experience foot changes such as:
* Shape changes
* Degeneration of the soles' fat pads
* Thinning skin
* Muscle loss
* Bone density loss
* Nail malformation development
* Reduced range of motion
* Sub-optimal circulation
* Sensation loss/numbness (a fall risk, predominantly for Senior men)
These changes lessen feet's stress tolerance, allowing inflammation and pain to set in.
Here are some details about the more common pain-causing foot problems Seniors -- especially Senior women -- encounter.
FOOT PAIN
Senior women are four times more likely than Senior men to experience foot pain. They're at least two times as likely to fall.
According to a December 2008 scientific Gerontology publication, Seniors' foot pain is most commonly caused by:
PLANTAR FASCIITIS. Prompted by stress on the foot arch's connective tissue, this inflammatory condition is a major fall risk factor. Inappropriate shoes and excessive weight are often to blame. Typically, the pain emanates from the heel, especially during the first steps of the day.
Recommendations:
Have a little pain? Stretch your plantar fascia and your Achilles heel.
- Before leaving bed, flex and point each foot 10 times, holding for ten seconds. When you flex, mentally focus on touching your toes to your knees.
- Do "the golf ball roll." For two minutes, roll a golf ball under your foot, giving it a good massage.
- Stretch your Achilles. Position yourself in a gentle forward lunge against a wall. Keep the heel of the straight knee grounded. Hold for 10 seconds then relax. Repeat 20 times for each heel.
- Have a lot of pain or chronic pain? See your podiatrist. Orthotics may help, especially if your arch or walking style is to blame.
HALLUX VALGUS (BUNION). When your big toe (hallux) migrates toward your little toe, a bump, or bunion, develops at the big toe's base. Bunions can be very painful and can substantially reduce Seniors' ability to walk.
Recommendation:
Outside of surgery, there is no long-term treatment for bunions. However, orthotics fitted by your podiatrist may help.
HYPERKERATOSIS (CORNS AND CALLUSES). In response to excessive pressure and friction, our feet's skin thickens to protect us, forming corns and calluses. (Hammertoes are a common forefoot condition where painful calluses jut from the toes' middle joints.) As they grow, corns and calluses become more painful. Corns in particular are prone to infection, leading to serious complications particularly if you have poor circulation, peripheral neuropathy or conditions such as diabetes.
Recommendation:
To treat corns and calluses, see your podiatrist. Self-management is limited at best and potentially dangerous. Corns and calluses only go away if the underlying problem is treated.
METATARSALGIA. This inflammatory condition manifests as pain in the ball of your foot.
Recommendation:
Getting the right shoes is sometimes treatment enough for metatarsalgia. In other cases, your podiatrist can prescribe orthotics.
INAPPROPRIATE FOOTWEAR. Need I say more?
Recommendation:
FIND THE RIGHT SHOES. There's no one-shoe style that works for all foot types. Just because shoes look comfortable or are pricey doesn't mean they're right for your feet. Often Seniors need a wider and sometimes a bigger size than they were accustomed to in their forties.
If you haven't done it recently, have your size rechecked. Then, find shoes with:
* high, wide toe boxes
* soft uppers
* soft, cushioned outer soles.
Shoes should be longer to promote proper standing toe alignment. Also, lower heels afford you greater ankle stability.
WANT BETTER BALANCE? KEEP YOUR TOES HEALTHY!
Strong toes are important for good balance. SIT AND BE FIT(tm), a non-profit organization committed to healthy aging, suggests the following exercises:
1. Toe strengtheners: Sitting in a chair with feet flat on the floor, lengthen your toes and press them into the floor. Don't let them curl! Hold five seconds and release for 10 reps.
2. Hallux pulls: Place a thick rubber band around both big toes and laterally pull them away from each other. Do 10 reps, holding for five seconds.
3. Toe spreads: Spread your toes on each foot, holding for five seconds. Do ten reps each.
OTHER FOOT CONDITIONS TO AVOID
Stress fractures. These little bone breaks generally cannot be detected by your doctor without imaging equipment. Stress fractures that do not heal properly leave scar tissue. You're most at-risk if you're overweight, have metabolic disease, a woman with low estrogen levels, and have had foot traumas. Traumas that cause stress fractures can be large, small, severe or repetitive -- just wearing inappropriate shoes can cause trauma.
Ingrown toenails (often caused by improper self-care). When the nail penetrates the skin, painful infections can result. For those with diabetes, infections can lead to amputations. Even for healthy Seniors, mobility may be temporarily lost.
SYSTEMIC DISEASES THAT AFFECT FOOT HEALTH
Perhaps the most important disease affecting Seniors' foot health is diabetes. Up to 75 percent of amputations in those with diabetes can be avoided with daily assessment, early treatment and foot health education.
Because diabetes can affect eyesight, diabetics may have a harder time adequately monitoring your feet for changes. Borrow the eyes of a loved one and/or caregiver!
Peripheral Vascular Disease (PAD) and metabolic syndrome -- a cluster of factors that raise your heart disease, stroke and diabetes risk -- can also result in foot complications similar to those caused by diabetes.
If you have medical conditions that may affect your feet, please inspect your feet daily and report any changes (e.g., pain, swelling, stiffness, limited movement, deformity and wounds that don't heal) to your doctor right away. See your podiatrist at least once a year.
WANT MORE EXERCISES?
Visit the SIT AND BE FIT(tm): www.sitandbefit.org or contact them at 509-448-9438.
Many PBS stations air SIT AND BE FIT(tm) but ours doesn't. If you want SIT AND BE FIT(tm) aired, call PBS at (352) 392-5551 ext. 1100. §
Kendra Siler-Marsiglio, Ph.D. is the Director of the Rural Health Partnership at WellFlorida Council.
