03 May 2005

Feet don't fail me now - or later

If you're getting a little long in the tooth, you're probably also getting wide - and flat - in the foot as decades of pounding the pavement take their toll.

If you're getting a little long in the tooth, you're probably also getting wide - and flat - in the foot as decades of pounding the pavement take their toll.

But experts say a little common shoe sense can go a long way in taking the pain out of the process.

According to the American Orthopaedic Foot and Ankle Society, many of the more than 4.8 million visits to doctors made each year for foot and ankle problems are problems that could have been prevented with better footwear and foot care.

Don't only blame Father Time
At a meeting of the American Academy of Orthopaedic Surgeons in Orlando recently, experts with the Foot and Ankle Society described the variety of foot problems that emerge with age and how to tell which can probably not be blamed on Father Time.

"There are five things that occur naturally with ageing," explains Dr Cherise M. Dyal, chief of the foot and ankle division of orthopaedic surgery at the Montessori Medical Centre in New York.

"The size increases as your feet get longer and wider; you lose some of the padding on the bottom of your foot, so you thin out your fat pad and tend to lose some of the spring in your step; your foot tends to become a little stiffer, so you lose some of the range of motion in your foot and ankle; you tend to have some problems with balance; and there is a very mild settling of the arch that's seen as a flattening of the foot. Those are the natural changes," she says.

And the unnatural changes?
"They can include bunions, hammer toes, claw toes, bunionettes, pinched nerves, calluses and arthritis, and all can be exacerbated by ill-fitting shoes," she says.

Shoes may come in all shapes and sizes, but experts say people often pay much more attention to size than shape. And shape can be important.

While many believe that oddly shaped shoes will adapt to the form of their feet, your feet actually try to adapt to fit the shoe, the experts say. So the longer you wear such shoes, the longer you may experience the consequences.

What to do
Dyal says the best bet is to consider not only shape and size, but also material and height of heel in buying shoes.

"The key is to choose shoes that have a wide enough toe box with room for all your toes to lie comfortably flat. You also want shoes that are shaped like your foot, shoes that are made of soft, breathable material like leather or suede, which mould and breathe and give, and you want shoes with heels that are under an inch in height," she says.

You can also improve the condition of your feet with various exercises.

"There are a series of exercises using marbles and golf balls and towels that allow you to strengthen the small muscles in the feet and the toes," explains Dr Carol Frey, director of the Orthopaedic Foot and Ankle Centre in California.

Don't forget about the toes
"The toes are really necessary for balance, but most people don't really think about that. They act like little tripods when you're walking," she says.

"Toes can get very weak in time, especially if you wear tight shoes, but if you strengthen them, you can really improve your balance, especially if you're over 50," she adds.

Flexing the Achilles tendon is also beneficial to foot health, says Frey. "The Achilles is usually exceptionally tight, especially in women, and when it's tight, you put yourself in the position for having injuries to the ankle, such as ankle sprains," she says.

"The more flexible you are in that tendon, the more you absorb forces when you're walking, and the more you can put your bones in the position of stability," she says.

While a majority of those who require medical treatment are over 65 years of age, increases in foot problems are now being seen in people who are much younger.


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