Our feet are powerful organs. They allow us to walk. As we walk, about 600 pounds of force passes through the bones at the middle and end of our foot.  When we run, even more force goes into the bottom of our heel and through our ankle when our heel hits the ground.  Just standing and moving around on hard floors at work puts a big load on our feet.

Our feet are made for walking. They are not made for standing on hard surfaces for long periods of time. Even under the best conditions our feet begin to wear out in our forties.  Since we tend to live much longer than that, there are common problems which bother people’s feet as they get into their fifties, sixties, and seventies.

Our Feet Change Over Time

As time goes by our feet, on the average, get wider and even a little bit longer.  We may resist getting larger or wider shoes, but our feet will be happier in shoes that fit.

In most people, just as the foot is changing with time, other structures start to change too.  Our calves get too tight, our toes may curl, our crosswise or transverse arch falls, and we may notice more pressure on the balls of our feet.

Since our feet change with time, there are things we can learn to do with our feet that can help protect them from damage and us from discomfort.  Most people need more cushioning under their feet as time goes by.  This is because so many of us stand on hard surfaces all day and because the normal aging process causes the fat pads under the ball of the foot to squeeze out onto the end of the foot, where they do us little good, or they begin to thin out entirely.

At the same time the joints that connect our toes to our feet drop down closer to the floor and our calves get tighter. This can lever our forefoot against the floor more of the time and with more force.  The net result is that we may get calluses on the ball of the foot, neuromas between the joints that make up the ball  of the foot, or clawing of the lesser toes as a result of tendons getting out of balance in the forefoot.

How Can We Protect Our Feet?

The best way to protect our feet is to use supportive shoes and insoles to cushion the heel, to support the longitudinal and transverse arches, to get pressure off the balls of the feet, and to have enough room for the toes to move without rubbing. The more flat and flexible a foot is, the more it needs to be held in position and kept from moving out of position. This requires shoes that control motion and control pronation.

If the forefoot becomes overloaded, and a person has pain under the ball of the foot, more cushioning in the forefoot and more support of the transverse arch are necessary. The idea is to get pressure off the bottom of the joints where the toes join the foot.

If a person has claw toes, shoes with a high toe box are necessary. The high toe box allows room for the bent toes and keeps the knuckles of the toes from rubbing on the inside of the shoe.

How Can We Strengthen Our Feet?

In addition to protecting our feet, we can strengthen them to help them work better. First, we can stretch out our calf muscles so that they work better as shock absorbers for our feet. Second, we can keep our feet flexible so that they work better. This is especially true for people who have a stiff high arch. Third, we can keep our legs and feet in good condition. Walking, dancing, yoga, and bicycling are among the best exercises for our legs and feet. Wearing sandals that are contoured to fit the shape of our foot and which have enough cushioning is actually good exercise for the feet. Such sandals are much more widely available than they used to be.

If you are doing all these suggestions for your feet but you are experiencing pain, you may need to visit an orthopedic foot and ankle specialist or a podiatrist for evaluation and treatment.

Richard Atwater, MD
Surgery of the Foot and Ankle
Member of the American Orthopedic Foot and Ankle Society
Northwest Hand and Orthopedics
www.nwhandortho.com