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Dr Mark Nelson

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Aging and Your Feet

Information From The American Podiatric Medical Association

Foot Health and Aging

Medicine and health awareness have progressed so rapidly since 1900 that life expectancy of the average American has increased by about 30 years. Older persons have become an increasingly significant proportion of our total population -- and their numbers are growing rapidly. In 1900, for example, there were three million Americans aged 65 or older. In the year 2000, older people outnumber children for the first time in history.

If older people are to live useful, satisfying lives, they must be able to move about. Mobility is a vital ingredient of the independence that is cherished by our aging population, and foot ailments make it difficult or impossible for them to work or to participate in social activities.

According to the US National Center for Health Statistics, impairment of the lower extremities is a leading cause of activity limitation in older people. As if foot problems weren't enough of a nuisance, they can also lead to knee, hip, and lower back pain that undermine mobility just as effectively. The NCHS says one-fourth of all nursing home patients cannot walk at all and another one-sixth can walk only with assistance.

Mirror of Health

The human foot has been called the mirror of health. Foot doctors, or doctors of podiatric medicine (DPMs), are often the first doctors to see signs of such systemic conditions as diabetes, arthritis, and circulatory disease in the foot. Among these signs are dry skin, brittle nails, burning and tingling sensations, feelings of cold, numbness, and discoloration. Always seek professional care when these signs appear.

Foot Problems Can Be Prevented

For reasons that are difficult to fathom, many people, including a lot of older people, believe that it is normal for the feet to hurt, and simply resign themselves to enduring foot problems that could be treated.

There are more than 300 different foot ailments. Some can be traced to heredity, but for an aging population, most of these ailments stem from the cumulative effect of years of neglect or abuse. However, even among people in their retirement years, many foot problems can be treated successfully, and the pain of foot ailments relieved.

Whether due to neglect or abuse, the normal wear and tear of the years causes changes in feet. As persons age, their feet tend to spread, and lose the fatty pads that cushion the bottom of the feet. Additional weight can affect the bone and ligament structure. Older people, consequently, should have their feet measured for shoe sizes more frequently, rather than presuming that their shoe sizes remain constant. Dry skin and brittle nails are other conditions older people commonly face. Finally, it's a fact that women, young and old, have four times as many foot problems as men, and high heels are often the culprits.

Observing preventive foot health care has many benefits. Chief among them are that it can increase comfort, limit the possibility of additional medical problems, reduce the chances of hospitalization because of infection, and lessen requirements for other institutional care.

Keep Them Walking

Studies show that care for a bedridden patient costs much more than care for an ambulatory patient. In their private practices and in foot clinics, podiatric physicians are providing services designed to keep older people on their feet, and they serve in hospitals and nursing homes across the country.

Records indicate that amputations and other forms of surgery due to infections of the feet, many brought about by diabetes, have been significantly reduced in recent years because of early diagnosis and treatment. Further reduction in this area is a goal of Healthy People 2010, a US Department of Health and Human Services campaign endorsed by podiatric physicians, to encourage understanding and application of preventive medical practices.

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Foot Health Tips From The APMA
 

Foot Health Tips

bulletProperly fitted shoes are essential; an astonishing number of people wear shoes that don't fit right, and cause serious foot problems.
 
bulletA shoe with a firm sole and soft upper is best for daily activities.
 
bulletShop for shoes in the afternoon; feet tend to swell during the day.
 
bulletWalking is the best exercise for your feet.
 
bulletPantyhose or stockings should be of the correct size and preferably free of seams.
 
bulletDo not wear constricting garters or tie your stockings in knots.
 
bulletNever cut corns and calluses with a razor, pocket knife, or other such instrument; use over-the-counter foot products only with the advice of a podiatrist.
 
bulletBathe your feet daily in lukewarm (not hot) water, using a mild soap, preferably one containing moisturizers, or use a moisturizer separately. Test the water temperature with your hand.
 
bulletTrim or file your toenails straight across.
 
bulletInspect your feet every day or have someone do this for you. If you notice any redness, swelling, cracks in the skin, or sores, consult your podiatrist.
 
bulletHave your feet examined by a DPM at least twice a year.

 

Reprinted with permission from the American Podiatric Medical Association

Which Orthotic / Arch Support Should I Use?

Dr Nelson's comments: 
The best fitting and functioning type of arch support is a custom made prescription orthotic, which can be made by your podiatrist.  Generally, for most people, I recommend trying a pre-made arch support before progressing to an expensive pair of custom made orthotics.  Finding a comfortable and effective pre-made arch support can be difficult.  There are hundreds of varieties on the market and that can make it confusing for customers.  Due to the variations in people's foot shapes, foot problems and style variations in different products, there is no "one type fits all" arch support available.  That's why DrNelsonClinic offers different brands and models like OrthoFeet, SuperFeet, WalkFit and PowerStep to choose among.  Fortunately, for most people, I've found that the OrthoFeet BioSole gel self-molding orthotics work for almost everybody.  Among the hundreds of pre-made arch supports I've seen and used, the OrthoFeet BioSole models give the best support and pain relief for people with plantar fasciitis and heel pain.  It's by far my favorite model for people with heel pain, due in part to the higher arch and shock absorbing gel under the heel.  Be aware that the standard OrthoFeet BioSole "sport" model is rather thick through the arch and it fits into athletic, work boots and walking shoes, but may not fit into a shallow shoe, like a dress shoe.  If you want to use the OrthoFeet in a shallow shoe, like a dress shoe, then use the "thin-line" or "high heel dress" models.  The "sport" model may also be too high in the arch area for people with very flat feet.  For elderly or arthritic people and those that want extra cushioning and softness under the foot, while still getting extra support under the arch, try the OrthoFeet BioSole "soft" model.  If you don't need extra arch support or heel pain relief  and only want shock absorption and cushioning under the foot, try the OrthoFeet "ThermoFit" model.  After you start using the arch supports, remember to break them in gradually, because is will take some time for the orthotic and your feet to adjust to each other.  I personally use the OrthoFeet BioSole sport model in my athletic shoes and have found them to be as effective and comfortable as my expensive custom prescription orthotics.  But, it did take longer to "break-in" the OrthoFeet supports than my custom orthotics.  If you don't have plantar fasciitis or heel pain or if you have a flat foot and can't tolerate an arch support with a higher arch, but still want foot support to relieve foot fatigue and strain, you should also consider the popular SuperFeet Synergizer orthotics.  In general, I highly recommend OrthoFeet BioSole over any other brand of arch support.

 

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Last modified: 10/13/10