Falls are a major concern as we age - it is estimated that 1 in 3 people over the age of 65 experience a fall at least once a year.
There are numerous medical causes that can lead to falls such as medication, poor sensory input, neurological conditions and cognitive decline. However, lower limb problems remain a large contributor and can be minimised with regular visits to your podiatrist. The main contributing factors that we assess and treat are:
In older people this is most commonly caused by arthritis, fat pad thinning, ingrown toenails, highly calloused regions or corns, and deformities of the foot. In such cases, a podiatrist can help you by providing specialist nail care, proper footwear advice or should it be required, referral to another health care practitioner.
NEUROLOGICAL OR VASCULAR PROBLEMS
Nerve damage, such as diabetic polyneuropathy, may cause falls due to the inability to feel the ground due to loss of sensation. Vascular disease can impact your ability to find properly fitted shoes due to symptoms such as swelling. Non-invasive testing can be performed by your podiatrist to determine your neurovascular status and a referral for further investigation given if required.
MUSCULAR WEAKNESS AND IMBALANCES
Muscular imbalances may have a profound impact on balance and walking speed which may often lead to loss of confidence. A podiatrist can guide you to improved muscular strength and stability after specific lower limb testing.
Often compensatory mechanisms are the cause of injury and musculoskeletal damage leading to poor lower limb function. Common structural issues such as heavy pronation or supination, flat foot or high arch respectively, can affect the way you walk which may in turn affect other joints and muscles higher in the lower limbs and back. Poor foot posture may be the reason for early fatigue in daily life and can be easily treated through exercise regimes and orthotic therapy when required.
Key footwear advice that may help to reduce your risk of falls:
- It is best not to buy backless shoes such as slide on slippers. The heel counter should be high and firm enough to support the entire ankle.
- Buy for FIT, not for size. A shoe should accommodate protruding bony areas by being wide and deep. Your longest toe should be approximately 1cm from the end of the shoe (and this may not always be your first toe!)
- When trying on shoes, put on both and go for a walk to make sure your heels are not slipping out of the back of the shoe.
- Fit shoes with your usual socks/stockings/orthotics - and please ensure you try them towards the END of the day as your feet will most likely have swollen a little after your daily activities.
- Choose a quality sole! Pick one that is not too thick - as it makes the ground harder to feel, but also not too thin - as there won't be enough cushioning.
- Make sure the sole isn't slippery, but also not too sticky as both can increase the risk of falls
- Shoes should only flex where the toes flex!
- If wanting to wear a heel choose low, broad square heels
- So you don't have to worry about your shoes slipping off (and your feet having to overwork), buy shoes with a fastening mechanism eg. velcro, laces, buckle
- Shoes should not be too heavy - excess weight will increase fatigue in the legs
- Little to no stitching in the upper material can help to prevent pressure points
- Shoes must be replaced, repaired and cleaned regularly (ask your Podiatrist for some tips)
- Wearing shoes around the house is proven to minimise the risk of falls
If you or someone you know is at risk or prone to falling, make an appointment with one of our friendly podiatrists today!