On average, most people will have walked about 50,000 miles by the time they reach age 50. Active people will have walked or run even more. So it’s not surprising that up to 25% of older adults complain of assorted types of chronic foot pain. Here are six common problems and the simple things you can do to keep your feet healthy…
Problem: Thinning of the fat pads in the ball of the foot. The fatty padding under your feet naturally wears away over time, which can lead to pain and inflammation in the soles of the feet, a condition known as metatarsalgia. By age 50, many people have lost half of their natural padding. Fat pad atrophy (FPA) affects men and women equally.
What to do: To prevent the fat pads from thinning, wear comfortable walking shoes. Frequent use of high-heeled shoes can cause FPA as well as conditions such as rheumatoid arthritis. If you must wear heels for an event, limit the distance you walk in them. Excess weight also can have an impact on FPA. Staying within a normal body mass index (BMI) range can help maintain your foot padding. Once thinning has begun, you can add gel pads or inserts into shoes to substitute for the loss of your natural padding. If that doesn’t do the trick, remove the shoe’s existing insert and replace it with a cushioned orthotic insert.
Alternate solution: If the pain persists or gets worse, ask your podiatrist about injections of steroids or, in more extreme cases, a nerve block to relieve the pain.
Not recommended: Injections of fat or synthetic products to repad the sole. These treatments offer only temporary relief and are unproven.
Problem: Corns and calluses. Corns are areas of thickened skin that develop on the tops or sides of the toes, usually due to friction or pressure from wearing shoes that are too tight. Calluses are broader areas of thickening that develop on the bottom of the feet. They’re also usually due to friction or pressure, or they can occur in areas where there isn’t a lot of fat padding.
What to do: You’ve probably already tried the corn and callus cushion pads at your local drugstore—possibly with limited success—but the best thing you can do is simply buy new shoes. Corns and calluses often go away on their own if you stop the offending friction and pressure caused by wearing a shoe that squeezes your toes or a shoe that’s too small. You may not realize this, but there’s a chance you need a larger size shoe at age 60 than you did at 30, as the ligaments and tendons in your feet lose their elasticity, making your feet expand. Choose shoes with soft uppers and wide toe boxes, so your feet don’t rub against the shoe. Tip: Go shoe-shopping late in the day when your feet will be at their widest. Bring the socks with you that you intend to wear with those shoes to make sure they don’t rub.
Alternate solution: Rub a pumice stone over the hardened area after taking a shower. Moisturize afterward. And be patient—these types of skin issues can take several months to heal.
Note: Avoid over-the-counter products that contain salicylic acid to eat away corns and calluses—they often take healthy tissue with them. Likewise, don’t shave corns and calluses yourself. See a podiatrist if you think the area needs to be exfoliated.
Important: Don’t manage corns and calluses or other foot problems yourself if you have diabetes, rheumatoid arthritis or cancer. That can lead to infection.
Problem: Bunions and hammertoes. You usually inherit bunions and hammertoes. Poor shoe choice, however, can increase the speed that the deformity develops. Rheumatological conditions or injury also can contribute to bunion or hammertoe deformities. Despite its appearance, a bunion is not a growth on the joint—rather, it reflects movement of the big toe toward—or over or under, in severe cases—the second toe.
What to do: Ditch the high heels and pointy-toed shoes. You can buy gel and silicone toe separators, splints, wraps or guards for both bunions and hammertoes. Splints are better for bunions at night. Guards, toe separators or pads are helpful for bunions when people are wearing shoes. Pads cushion the deformities, while splints attempt to delay the progression. Avoid overwearing flip-flops and clogs, which increase the risk for hammertoes because they encourage curling of the toe to grip the shoe.
Alternate solution: Use paper tape to gently push down your hammertoe. Apply the tape around the toe to pull it down, and tape it to the bottom of the foot so that it doesn’t rub against your shoe. You may be able to get some relief with products such as Yoga Toe Gems that spread toes apart to stretch weak ligaments. Surgery is a last-resort option, done to correct a deformity that causes you severe pain and functional limitations and that cannot be relieved by other treatments.
Problem: Toenail thickening. Toenails tend to become thicker with age, which can make them difficult to cut. It doesn’t help that, for many elderly people, bending down to reach the nails becomes increasingly difficult.
What to do: It seems obvious, but many people don’t do this—go to a podiatrist or have regular professional pedicures if you are too stiff or inflexible to easily cut your toenails yourself. Using nail softeners also may help make it easier to cut your nails. Cut nails straight across or take small snips in them to prevent painful ingrown toenails. Smooth the ends with an emery board. Clean under the toenails regularly with a nail file.
Problem: Nail fungus. Age can make toenails more prone to nail fungus, an unsightly nail infection that is caused by dampness and spread in gyms, pools and public showers. Three-quarters of people over age 60 have had nail fungus at some point in their lives. It is very difficult to treat successfully once you have a fungus—the available drugs and lasers take a long time to work and aren’t effective for everybody.
What to do: The best defense is a good offense—wear rubber sandals in public showers, pools and gyms to prevent picking up fungus. If you have machine-washable shoes, wash them with bleach and water to disinfect them. Change to fresh socks every day (or multiple times a day if your feet sweat). Wear acrylic socks that wick away moisture instead of cotton socks. A home remedy to treat nail fungus that you can try is to apply Vicks VapoRub to the affected nail daily for six to 12 months.
Problem: Dry skin. The skin on the feet gets drier as you age. When severe, skin fissures can occur.
What to do: Keep things simple. Just wash feet daily, and pat dry. Showering is best. Soaks in the tub are too drying. Regular twice-a-day moisturizing is essential. Apply a moisturizer that contains urea, which helps slough off the dead skin and keeps skin hydrated. Apply at night, and then sleep with socks on. If severe, you can also wrap the foot in plastic wrap at night to increase penetration of the lotion.
Important:Don’t apply moisturizer between toes where fungus or bacteria might grow.
Easy Exercises for Foot Health
The right exercises can help keep your toes and feet limber and strong.
Exercise #1: Pick up marbles. This will strengthen muscles in the bottom of your feet and may help prevent plantar fasciitis. Place marbles on the floor. Pick up one marble at a time with your toes, and drop it into a nearby bowl or cup. Repeat with your other foot.
Exercise #2: Grasp a towel with your toes. This exercise encourages you to do toe curls that will strengthen the tops of your feet. Sit in a straight-back chair with a small towel at your feet. Use the toes of one foot to scrunch the towel and pull it toward you. Repeat with the other foot.
Exercise #3: Trace the alphabet. This exercise helps ankle mobility. Sit down and extend your leg. Trace the alphabet in the air with your big toe. Repeat with the other foot.
Exercise #4: Do toe raises. This exercise helps to strengthen the Achilles tendon and the arch of the foot. Stand with your hands resting on the back of a sturdy chair, and slowly rise up on your toes and come back down. Toe raises can be done in three sets of 10. Repeat two to three times a week. Note: Toe raises are not recommended for people suffering with plantar fasciitis. Instead, you want to stretch the calf by bringing the toes and feet upward toward the shin.