It’s normal for feet to change as you get older, but that doesn’t mean all changes should be ignored. Knowing how and why your feet might change can help when you’re faced with foot problems or pain — and alert you to when you should seek advice from your doctor.
There are many factors affecting foot health with age. Many occur naturally, such as the flattening of the feet, reduced cushioning, and skin changes. But there are also some chronic conditions and lifestyle habits that may contribute to age-related foot problems, such as wearing shoes without support, like high heels and flip-flops.
Here are six ways feet change with age:
1. Feet Flatten and Stretch
It’s common for shoes to feel tighter as you age, even if your shoes once fit comfortably. Your feet can increase a half-size (or more) as you get older. This happens because the arch of your foot (the curved portion on the underside of each foot) tends to flatten as the ligaments and tendons in the foot lose strength, which ends up lengthening the rest of the foot and toes. It can also be the result of carrying extra weight, says Hylton Menz, PhD, a professor of podiatry at La Trobe University in Melbourne, Australia, who has conducted research on aging feet.
2. Fat on the Soles Deteriorates
The fatty pads on the soles of the feet thin as part of the aging process. In fact, about half of the fatty padding may be gone by age 50. This is known as heel fat pad syndrome, fat pad atrophy, fat pad syndrome, or heel fat pad atrophy.
Fat pads typically cushion your heel, and the loss of the cushion can make it painful to run, walk, or jump.
3. Skin Becomes Drier and Thinner
The skin on the feet tends to thin and become dry with age. This happens when the deepest layer of skin loses fat and the oil glands become less productive over the years.
There’s also a reduction in collagen (a protein that provides strength), elastin (a protein that provides elasticity), skin-cell turnover (the process of shedding dead skin cells and replacing them with new ones), and blood supply, Dr. Menz says. “The end result is that our skin becomes drier and more likely to develop calluses, takes longer to heal, and is more likely to develop infection,” he says.
4. Joints in the Foot Stiffen
It’s common for the joints in your feet to become stiff with age, mainly due to the cartilage (a connective tissue) that protects joints and bones wearing down and the decrease in the synovial fluid that lubricates the joints, says Michael Lacey, doctor of podiatric medicine, a board-certified foot and ankle surgeon with Northern Illinois Foot & Ankle Specialists in Hoffman Estates, Illinois.
Ultimately, stiffer joints can lead to a reduced range of motion, pain while walking, an altered gait or balance, and an increased fall risk, Dr. Lacey says.
5. Muscles Weaken
It’s natural for the muscles in the foot to weaken over time. One study found that the thickness and area of the foot muscles were reduced by up to 45 percent in people ages 60 or older compared with those ages 18 to 50.
The reduction in muscle could change how weight is distributed to the foot, leading to changes with the way the foot moves, a decrease in arch stability, changes in bone structure, and an increased risk of falls.
6. Nerves Lose Sensation
The nerves in the legs and feet become less sensitive over time. As you age, the nerve cells gradually shrink and stop working properly, which makes the feet less able to detect pressure and vibration, Menz says. This loss of nerve sensation tends to happen around age 60, and you might experience it as numbness or tingling in the feet, Lacey says.
The risk of developing conditions and health issues that affect the feet also increases with age. Here are several of those:
Osteoarthritis
Osteoarthritis (OA) commonly develops around age 50 and occurs more often in women than men. It occurs as the joints deteriorate or become inflamed, leading to pain, stiffness, and mobility issues. OA happens as a result of wear and tear of the joints over time and typically occurs in the midfoot, big toe, and ankle, Lacey says. And while it can happen to anyone, the risk of developing arthritis in the feet increases for people with a family history, smokers, those with previous foot and ankle injuries, and athletes or people who stand a lot.
Bunions
Bunions are prominent, sometimes painful bony bumps that extend from the bottom of the big toe. They develop over time as the bones shift and the foot spreads out.Bunions typically develop between the ages of 40 and 60, Lacey says.
Plantar Fasciitis
This is one of the most common reasons for heel pain as you age, and commonly appears between ages 40 and 60.Plantar fasciitis is characterized by inflammation of the plantar fascia, the connective tissue that runs along the bottom of your foot. It can be caused by the structure of the foot (such as high arches or flat feet), spending a lot of time on your feet every day, or wearing unsupportive shoes.
Bone Spurs
Also known as osteophytes, bone spurs are bony growths commonly associated with osteoarthritis. However, they typically don’t come with any symptoms or need to be treated. They can also affect the knee, spine, hips, shoulders, or fingers. Nearly all adults (up to 95 percent) have them by age 70.
Hammertoes
A hammertoe is when the second, third, or fourth toe bends at the middle joint, resembling the shape of a hammer. It happens when a muscle imbalance (commonly caused by wearing shoes that push the toes against the shoe and force them into a bent position) in the affected toe causes the joint to tighten. “Hammertoes tend to appear in middle age and worsen with time,” Lacey says.
Gout
Gout is a form of arthritis that occurs when urate crystals (which form from high levels of a natural waste product known as uric acid) accumulate in the joint, leading to pain, inflammation, and redness of the big toe. For men, gout tends to occur between ages 30 and 50, while women tend to develop gout after menopause. The risk of gout increases with age due to declining kidney function (which affects the body’s ability to get rid of uric acid), more frequent use of diuretic medications, and a higher prevalence of conditions like high blood pressure (hypertension) and diabetes, Lacey says.
Adult-Acquired Flat Foot
When the foot’s arch flattens as a result of weakening tendons, many people are left with flat feet. Flat feet can lead to pain and arthritis, which can make it difficult to walk on uneven surfaces. It affects adults over age 40 and occurs more often in women than men.
Though it’s natural for feet to change over time, there are things you can do to keep yours as healthy as possible. Here’s how to care for aging feet:
1. Choose Appropriate Footwear
Ill-fitting footwear can lead to foot problems, impaired balance, and falls, Menz says, adding that supportive footwear also makes it easier and safer to stay active. Look for shoes with sufficient room in the toe box, a supportive but flexible sole that bends with the foot, a textured outsole to prevent slipping, and a low, sturdy heel, Menz suggests. Inserts can also help address a flattening arch and make it more comfortable to stand for extended periods.
2. Stretch Calves Daily
If your calves are tight, the force is passed onto the joints in your feet and ankles, which can be painful. Stretching the calf muscles for just a few minutes at the beginning and end of the day can help, especially if you stand on your feet all day long. Try holding the back of a chair and standing with one leg straight and back, heel on the floor, and your other foot close to the leg of the chair. With your front knee slightly bent, lean forward until you feel a stretch. Hold for 30 to 60 seconds and repeat on the other leg.
3. Care for Nails and Skin
Moisturize regularly to combat thinning and drying skin. Moisturizing can prevent cracks in the skin, which leave you prone to infection. Pay special attention to the heels, which have a tendency to get dry, and avoid the space between the toes, where bacteria can grow. Your nails will likely become more brittle as you get older, too, and they may turn yellow if you often wear nail polish. Try to remove polish for a day or two to let them “breathe” between polish changes.
4. Eat Anti-Inflammatory Foods
Your diet can have an impact on the health of your feet. Eating an anti-inflammatory diet can reduce arthritis pain and swelling, help manage gout by lowering uric acid, and improve circulation and skin integrity, Lacey says. Anti-inflammatory foods include tomatoes, olive oil, green leafy vegetables, nuts, fatty fish, and fruit.
5. Check Feet Regularly
Lacey suggests examining your feet weekly and looking for sores, blisters, or cuts; color changes; swelling; thickened or discolored nails; cracks between toes; and fungal infections or calluses. This is especially important for individuals over the age of 60 and those with diabetes.
6. Maintain a Healthy Weight
“The most effective lifestyle habit in relation to the foot is regular exercise and maintaining a healthy body weight,” Menz says, adding that being overweight can lead to persistent foot pain. It can also increase the risk of plantar fasciitis, arthritis, and flat feet, Lacey says.
Many foot changes come naturally with age, but that doesn’t mean you have to live with foot pain. Pain is a signal that something is wrong, and most causes of foot pain can be treated effectively.
Seek out a healthcare provider for any foot pain, swelling, numbness or tingling, changes in foot shape, wounds that haven’t healed after a week, ingrown toenails, or fungal infections, Lacey says. “A podiatrist is usually the best first step, though your primary care doctor can help refer you if needed,” he adds.
Age-related foot changes include changes in size, weaker muscles, thinning soles, stiffening joints, and dry skin.
There are a number of age-related foot conditions that become more common with age, including hammertoes, bunions, and osteoarthritis.
Consult a healthcare provider if you experience foot pain, swelling, or numbness or tingling. Also, seek help if you notice changes in foot shape, wounds that won’t heal, ingrown toenails, or fungal infections.
