Thursday, February 22, 2018

Are you at risk for falls?


Mark Fraser

Is your gait (the way you walk), unsteady? For most of our lives, we take it for granted that once we’re upright and on our feet, we’ll stay that way. But starting in about our mid-60s to 70s, falls start occurring. Fortunately, most of these result in only minor scrapes and bruises, if anything at all. But they can be frightening; and even if there’s little physical harm, people sometimes develop a strong fear of falling. Besides, a significant minority (between 5 per cent and 10 per cent) of falls among older people, do result in major physical injuries such as broken bones, serious cuts, or bad bangs to the head. Some of those injuries (hip fractures especially), could lead to disability or worse, as some seniors die of complications or depression after hip replacement surgery.

Everything from slippery throw rugs, to poor lighting, to poor eyesight, to side effects from multiple medications, has been implicated as a risk factor for falling. Foot problems and pain get mentioned in the roll-call of risk factors, but usually near the end, and frequently as an afterthought.

The aging foot

The lowly feet have to be capable of handling high-pressure situations. When you’re standing still, the force from your body weight is spread fairly evenly. But when you walk, the force on the heel when it hits the ground is up to about one times your body weight. Walk fast, and the force of that impact is even greater.

As the foot rolls forward, the pressure shifts to the outside edge, and then as you start to push off, to the ball of the foot and the toes. Young feet can repeat this thousands of times a day, and feel no pain. Older feet may not be so lucky.

The feet, like the rest of the body, feel the effects of age. Muscle tissue thins out. The long nerves that supply them don’t send electrical messages as efficiently as they once did, so there may be some loss of sensation. Blood is more likely to pool in veins, which causes feet and ankles to swell.

Age also tends to bring on structural changes. Arches falter, so there’s a tendency for the feet to flatten out. Older toes have a propensity toward curling into “claw (hammer) toes” because of muscle imbalance. And older people, especially older women are prone to developing bunions. This is a misalignment of the bones in the big toe, which causes the end of the metatarsal bone at the base of the toe, to angle out.

Making the connection

But change is on the horizon. Over the past several years, there has been a surge of research connecting falls to foot pain, and perhaps also to common foot problems like bunions and clawed toes. Other researchers have linked foot pain to a slow gait and poor balance, which is perhaps just what you’d expect. So here are some tips to deal with your situation:

• Choose your shoes wisely and wear them. Older people may want to be especially careful about width. Even if you don’t have a full-fledged bunion, the base of the big toe may bulge out somewhat with age, therefore the front of your foot needs more room than it used to. If you have clawed toes, or the beginning of them, you also need to make sure that the front of the shoe (the toe box) is deep enough; otherwise, you’ll run the risk of developing calluses on the knuckles of your toes from friction against your shoes.

• Lose weight. Studies have linked being overweight or obese to foot pain and other foot problems. If you’re heavy, dropping a few pounds could literally take a load off your feet, spare you some pain, and possibly (this hasn’t been proven) reduce your chances of falling.

• Try prefabricated orthotics first. Orthotics do prevent some falls by stabilising the feet. They help to redistribute pressure, and provide additional tactile input, so there is a little bit of extra information about where the feet are.

• Give your feet a little bit of a workout. Exercises for the feet and ankles can help offset the muscle loss and stiffness that naturally set in with age. Some of the exercises may seem silly, but they serve a purpose. For example, picking up marbles or small stones with your toes, helps to strengthen muscles that may counteract the tendency of toes to curl.

Many people are in denial about what’s happening to them; do take note and heed the tips provided to not only enhance your quality of life, but to ensure that your life isn’t curtailed because of inaction.

Your feet mirror your general health . . . cherish them!

Leana Huntley is an English trained foot health

practitioner attached to ALMAWI Limited The Holistic Clinic. E-mail or visit the website: