Johanna Youner
Johanna S. Youner, DPM, board-certified foot surgeon in private practice in New York, an attending physician at New York Downtown Hospital, and a Fellow of the American College of Foot and Ankle Surgeons.
Virtually all of us experience foot pain at some point in our lives. Feet are like car tires—but unlike tires, feet are not replaceable. Even simple foot discomfort can have far-reaching consequences—when our feet hurt, we become more sedentary, which can increase our risk for life-altering health problems such as obesity, heart disease and diabetes.
With 33 joints and 26 bones in each foot, there’s a lot that can go wrong. Good news: Foot pain sometimes has surprisingly simple solutions, says podiatric surgeon Johanna S. Youner, DPM. Here are her suggestions for things you can do to avoid and solve foot pain…when to see a podiatrist…and simple solutions to a few common foot issues.
Wearing supportive, properly sized footwear will reduce the odds of developing foot pain in the first place and solve many foot problems that do occur.
Get sized properly. Unfortunately, most shoe stores don’t provide sizing these days. Best: Look for a shoe store that specializes in running shoes or orthopedic shoes. Salespeople at these specialty stores usually understand that providing a proper fit is essential, and they are trained to help you with that.
Contrary to what you might think, supportive, comfortable shoes can be attractive. The best brands that combine support and style…
Cole Haan for men’s and women’s shoes (ColeHaan.com)
Allen Edmonds for upscale men’s shoes (AllenEdmonds.com)
Vionic for women’s and some men’s shoes (VionicShoes.com)
Dansko, best known for its women’s clogs but it offers other shoes for women and men as well (Dansko.com).
Alternative: Wear sneakers rather than more formal footwear. Seniors may fear that giving up on formal or stylish shoes will make them seem even older—but what really makes people seem older is hobbling around in painful footwear. Wearing sneakers that help you move more often, more rapidly and more steadily will help you maintain your youthfulness. Besides, sneakers are increasingly fashionable these days. Sneaker brands that do an excellent job of providing support…
Asics (Asics.com) for people who have narrow feet.
Hoka (Hoka.com) for people who have somewhat wider feet.
Helpful: If you have unusually low or high arches, slip orthotic insoles into your shoes. Insoles made by Superfeet are excellent and affordably priced—often less than $30 per pair. Check the “Insole Finder” tool at Superfeet.com to select appropriate insoles. It is best to have a separate pair in each of your shoes. Also: You may need to go up a half size in shoes to accommodate your orthotic.
For athletic shoes: PowerSteps (PowerStep.com) are orthotic support options for athletic shoes. Replace the liner in the sneaker with the Powerstep.
If these don’t help, a podiatrist can have custom orthotics made, typically for $300 or more. Medicare or health insurance might pay part of the bill.
Doing a few very easy foot and ankle flexibility exercises dramatically reduces the odds of a wide range of foot problems. You don’t have to join a gym or buy expensive workout gear to do these exercises—you don’t even have to get off your couch. Do each of the following every day with both feet…
Ankle circles. While seated, extend one leg out in front of you with no part of the foot touching any surface. You could do this by extending the foot beyond the edge of an ottoman or by placing a rolled-up towel on a coffee table under your lower calf/upper ankle. Without moving your leg, rotate your foot and ankle in the largest circles you can manage. Do at least a few clockwise and then counterclockwise.
Foot alphabet. While seated, extend one leg out in front of you—as above, no part of that foot should be resting on a surface. Use this foot to spell out the alphabet, letter by letter.
Towel stretch. While seated, extend one leg out in front of you—the heel of this foot can be resting on a surface. Fold or roll a towel so that it’s relatively narrow in width…grip one end of the towel in each of your hands…then loop this towel under the toes and ball of your outstretched foot. Gently pull the towel while keeping your leg straight, so that the foot points somewhat back toward your head.
If you experience acute foot pain and/or pain that persists for more than a week, it’s time to see a podiatrist. Foot pain that lasts longer than a week may cause you to alter your stride in a way that leads to more foot, leg, knee, hip and/or back problems.
Caution: If a podiatrist recommends surgery, be extremely wary…and get a second, even a third, opinion. There is no such thing as minor foot surgery—virtually any foot operation has the potential to cause lifelong mobility problems.
It’s distressingly common for podiatrists and orthopedic foot surgeons to recommend surgery for issues that could have been solved with better footwear choices, physical therapy, exercise or other treatment options—surgery generates significantly more revenue for surgical practices.
Best: Try all other options before resorting to foot surgery, and never get foot surgery for purely cosmetic reasons. I know a professional dancer who thought she was having minor surgery on her pinky toe and ended up never being able to dance again.
Here are some common foot problems and what to do about each…
Plantar fasciitis is essentially inflammation of the band of connective tissue that runs along the sole of the foot, providing support for the arch. This condition can be extremely painful—the pain is typically felt near the heel. It often can be successfully treated without seeing a doctor, but you have to act quickly—the longer plantar fasciitis lingers, the longer it’s likely to take to resolve.
What to do: Ice the painful area at night before bed—at least two cycles of 10 minutes with the ice on, five minutes with it off. Also ice it during the day as needed. Gently stretch the foot and the back of the lower leg—the towel stretch mentioned earlier is a good choice here. Wear only supportive, cushioned footwear.
Calluses can form where our feet rub against our shoes. Over time, callouses can start to feel like pebbles inside the shoe, and that can affect our stride in ways that sometimes lead to foot, knee, hip, leg and/or back pain. This is increasingly likely to occur as we get older—young adults shed old skin cells every 20 or 30 days, but by the time we’re in our 70s, it can take 75 days or longer, dramatically increasing the odds that calluses will develop.
What to do: To remove calluses, soak the foot…dry it…gently rub a pumice stone over the callus. Then apply a urea cream or lactic acid callus-removal cream. Over-the-counter creams are available, or a doctor can prescribe a cream with a higher acid content for especially stubborn calluses.
Warning: A “Morton’s neuroma” could be confused with a callus. Like a callus, it can feel like a pebble in the shoe. But a neuroma is overgrown nerve tissue inside the foot, not excess skin cells. Morton’s neuromas typically occur in the forefoot, often between the third and fourth toes. They’re usually painful. Sometimes placing a pad on the bottom of the foot between the metatarsal heads can alleviate discomfort. Shoes that are wider across the forefoot may help as well. A podiatrist can offer nonsurgical treatment options, such as “radiofrequency ablation”—high-frequency radio waves delivered via a needle that destroy the problematic nerve tissue.
Verrucae are a type of wart that typically appears on the bottoms of the feet. Like other warts, these are caused by a virus and should be treated promptly—they’ll spread if allowed to linger, both around the body and to other members of the household. Verrucae often are contracted by walking barefoot in hotel rooms or gym showers that have not been properly cleaned.
What to do: Over-the-counter salicylic acid–based wart-removal products are less effective than the stronger products a doctor can prescribe. Your primary care physician might recommend applying liquid nitrogen to freeze warts as well as salicylic acid. Avoid walking barefoot until the problem is resolved to reduce the odds of transmitting the virus to other household members.
