Do our feet change in middle age: Common foot problems in adults and how to treat foot pain

As you enter middle age, are you noticing changes in your feet? For example, have you gone up a shoe size? Are you wondering if your feet shrink or grow with age? Experiencing more foot pain? Or can’t comfortably wear certain types of shoes anymore?

These are common questions patients ask me, and I know it is natural to wonder about the health of your feet over time. I wanted to explain what you might expect with middle-aged feet and if there’s something you can do to stave off foot problems and pain, or if you need to ditch your flip-flops and high heels.

When do your feet stop growing?

Your feet stop growing longer when you stop growing in height. Though your feet are not technically growing as you age, your foot can reposition or may get wider, which would require you to change your shoe size to a more comfortable size. Feet elasticity is the same as other body parts – tissue can loosen, causing the increased width and sagging of the arch.

What causes foot pain in older adults?

As you reach middle age, there are several things that can cause foot pain, with common conditions including:

• Plantar Fasciitis, the number one cause of foot pain as you age, is inflammation and pain from the tissue under the heel.
• Achilles Tendinitis is a very common wear-and-tear condition that causes pain at the back of the heel.
• Adult-Acquired Flat Foot occurs when the foot starts turning out as the tendons become weaker and can no longer hold up the arch, causing the foot to be flat.
• Bunions are caused by a gradual change in the position of the bones that make up the big toe. This positioning makes the bones stick out more on the inside part of the big toe.
• Foot Arthritis, such as osteoarthritis and rheumatoid arthritis, is deterioration and/or inflammation of the joints in your foot that causes pain, stiffness and decreased mobility/flexibility.

How to prevent foot problems in older adults

While some people are more prone to foot problems than others, you should still pay attention to your body and make a proactive effort to prevent foot pain early, such as:

• Wear reasonable shoes for all occasions. Ensure you are wearing comfortable shoes for work, exercise, events and more to make sure that you are not creating unnecessary stress and pain to your feet.
• Stretch your calf muscles. Foot problems often develop because calf muscles are very tight, which sends more force through the joints of the foot and ankle, ultimately causing pain. Doing 2-3 minutes of calf stretching in the morning and before bed can help avoid injury. The more ankle motion you have, the less stress you have through the small joints of the foot. 

Foot Pain Treatment for Older Adults

While wearing less supportive shoes can create foot problems, this doesn’t necessarily mean that everybody has to give up flip flops, high heels and unsupportive shoes. However, I would recommend that people who notice that they’re getting foot pain, experience feelings that their foot is not stable, or there’s a lot of pain in the bottom of their foot, should first and foremost look at more supportive shoes.

Age-related foot changes are normal and are likely to happen. As long as you recognize it and, when you feel pain, make the needed adjustments to the support in your shoes, you should feel better. Common shoe recommendations include:

Arch support shoes for foot pain relief
While a decrease in elasticity can lead to injuries, it depends on how much you’ve used your feet in your life. As the tissues start to collapse a little bit, you can get arthritis and pain in the foot, so your feet needs more support, which usually means a change in footwear.

Buy shoes that are comfortable, with a solid sole and a stiffer arch support. For many foot conditions, you want a shoe that doesn’t bend, so if you try to bend it, it shouldn’t be easy to fold in half. You also want to look at thickness of the sole. If it’s only a few millimeters thick, then it’s probably not thick enough to give you support.

Orthotics
Orthotics can be a great tool to manage foot pain, but not everyone needs orthotics. There are some foot and ankle conditions that require orthotics, but they are not a default treatment for all people with foot pain at a certain age.

When is foot surgery necessary?

Most of these middle-aged foot problems are not surgical problems, but occasionally surgery is the best solution. For example:

• If arthritis in the foot hasn’t improved after stretching, shoe changes or injections, surgery can help manage the pain.
• If Adult Acquired Flat Foot continues to worsen, where the foot’s position has changed quite a lot and physical therapy and orthotics haven’t worked, surgery can correct the issue.

Our orthopaedic foot and ankle team will always work with you to design a treatment plan that works best for you and your unique foot condition.