How do our feet change as we age?
- Katelyn Martens
- Mar 26
- 4 min read
I had the pleasure of taking to a women's group this month about the ways our feet will change as we age and female specific changes that can happen in our feet.
When I sat down to do extra research about this topic, I found myself down the rabbit hole of changes that can happen. These changes can range from a higher prevalence of pain to hormone changes influencing changes in our bodies to higher risks for arthritis and the development of bunions.
One of the first things I talked about was how you could go into your closet, pull out a pair of shoes that you have loved to wear and fit perfectly in the past, but now when you put them on they seem to be too tight or small on your foot. If this has happened to you, you’re not crazy. It is very likely that your feet changed and now your they are not the same size as they were or the same width.
Biggest changes when it comes to aging and our feet:
· Osteoarthritis1
· Fat pad atrophy1
· Lesser toe deformities1
· Lowering of arches in the feet
· Greater prevalence of bunion pain compared to men2
· Higher levels of inflammation causing painful foot conditions such as plantar fasciitis3
What is osteoarthritis?1
Osteoarthritis or OA is characterized by changes to the surfaces of our joints. OA can be caused due to a history or injury to a certain joint or caused by a poor alignment of the joint. OA is 4x more likely to occur after the age of 55 than in younger age groups.
Some treatment options for OA in the feet include a shoe with a stiff rocker to help propel the foot forward during walking and help reduce painful range of motion. Sometimes custom orthotics can be indicated to help with improper loading of certain joints and help to correct movement if indicated.
What is Fat Pad Atrophy?1
Fat pad atrophy is when the fat pads under your heels and the balls of your feet begin to change and shift. The fat pad is there to provide shock absorbency and cushioning to our feet when we walk. As we age, this fat pad can wear down and thin out or break causing them to be unable to perform their intended job of cushioning our feet. This can feel like you are walking on the bones of your feet. This is uncomfortable for walking and can also lead to more serious issues such as ulceration in some cases.
Treatment options include custom made orthotics with extra cushioning in the areas where the fat pad has thinned out or footwear recommendations. Additionally, a custom orthotic with a deeper heel cup could help to contain the existing fat pad in the heel if it is migrating.
What are lesser toe deformities?1
Toe deformities include hammer, mallet and claw toes occurring in the toes 2-5 (not the big toe). Usually these can occur due to muscle imbalances from the muscles responsible for pointing the downs down and the ones responsible for pointing the toes up. Tight fitting footwear can also contribute or exacerbate the occurrence of these toe deformities. Our small or lesser toes are a big part of helping us stay stable as we walk, meaning that when these toes are compromised with deformities, our balance can be off, and we are at a higher fall risk. There is also a higher prevalence of toe deformities in woman vs. men. We can also have calluses form due to areas of extra pressure on the tops of toes or even the tips when we have toe deformities.
The best time for treatment for these toe deformities is early on when there is still flexibility in the toes. Treatment options usually include footwear recommendations usually with extra depth and more flexible materials for the upper of the shoe. Additionally, a custom or over-the-counter toe crest could also be used for treatment.
What is a bunion?2
A bunion occurs when the joint at the base of the big toe (the 1st metatarsal phalangeal joint) moves towards the opposite foot causing the big toe to move inwards towards your lesser toes. This can cause the foot itself to become wider and cause pain in the big toe.
Bunions can occur due to genetic factors as well as environmental factors such as narrow fitting footwear. There is also a risk of bunions when people have joint diseases such as rheumatoid arthritis. Additional risk factors can include tight calf muscles, a short Achilles tendon, or they can develop due to a flatfoot or splaying foot. Bunions can vary in severity ranging from non-existent to mild to moderate to severe.
Women tend to have a higher prevalence of bunions compared to men and tend to experience more pain in their bunions. Bunions are also more common over the age of 40.
Treatment options include footwear recommendations and custom-made orthotics. Additionally, a toe spacer can be used if the bunion is still flexible along with physiotherapy to help strengthen the muscles.
Why can there be a higher prevalence of plantar fasciitis?3
Coming from Dr. Louise Newson, she notes that “Low levels of estradiol can reduce the elasticity of the plantar fascia. Plus, estradiol is also important in creating collagen, a protein which provides structure and flexibility to your skin, bones, muscles and tendons. Degeneration of collagen in the sole of your foot can also lead to plantar fasciitis occurring”.
Changing hormone levels during and after menopause can cause significant changes to our feet due to the change in elasticity of our tendons.
Treatment options can include shoes in the house, footwear recommendations and custom made orthotics depending on the severity and the cause for the platnar fasciitis.
Everyone is different and not every treatment plan will be the same. It is important to consult a healthcare provider if you believe that you are experiencing any of the conditions listed. A pedorthist can complete a biomechanical and gait assessment as well as a footwear assessment and make recommendations based on the findings. They will refer back to your primary care physician when appropriate or you can start with your primary care physician.
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