My Mother/Father just won’t pick up his/her feet!

It’s a tough situation, your mother or father begins to trip because they can’t pick up their feet and you know sooner or later they are going to break a hip or worse. What makes the matter worse is that they won’t listen to reason because their worried about losing their independence. What to do? Tripping is often caused by the shoes that they wear. Dr. Carol Frey, director of the Foot and Ankle Center at Orthopedic Hospital in Los Angeles, conducted a year-long study regarding safe footwear for seniors. Her research showed that in many cases shoes that are generally considered “safer footwear” were often to blame for falls that caused injuries. Dr. Frey studied 185 men and women over 55 who had fallen and injured themselves during a one-year period. Among those 65 and older, shoes were frequently at fault for the falls that resulted in the injuries. Your parent’s shoes could be contributing to their stumbling.  Athletic shoes are mainly to blame. Sixty percent of those wearing sneakers when they fell said they fell because their shoes “caught or dragged” on the floor and 40 percent said their athletic shoes were “too slippery.” What shoes should older people wear? Doctors recommend:

Never wear shoes with slippery or worn outer soles. Also avoid shoes with smooth leather or plastic soles, which can be slippery on carpets, wood and tile floors, and wet surfaces. Some athletic shoes made with synthetic soles, which may be ideal for exercising in a gym, can be extremely slippery on a damp or wet surface. Remove any tripping obstacles, even a low lying rug can be tripped on.

Avoid wearing shoes and slippers that are loose or ill-fitting.

When walking on carpets, avoid wearing shoes with heavy rubber lugs that can catch on carpets, especially when they are worn by people who barely pick up their feet when they walk. The rubber tips on the toes of running shoes can also cause a stumble on a carpeted surface.

For an all-around shoe, consider walking shoes, which provide good traction and support but do not have heavy soles or rubber over the toes.

Although shoes with a lot of cushioning can make you feel as if you are walking on air, they can also make an older person unstable and are best avoided unless they are at risk of diabetic foot ulcers.

Shoes that tie are safer than shoes that slip on the feet. Laced shoes can be adjusted to accommodate orthotics, braces and swelling of the feet. For those who lack dexterity, consider replacing cloth laces with elastic ones that hold the shoe firmly on the foot, but stretch enough to allow shoes to be slipped on and off without tying or untying the laces.

The wrong shoes can mean falls for the elderly. Experts recommend shoes that lace up and have light rubber soles, and warn of possible hazards of the ones shown below. Slippers can fall off. Shoes with smooth leather soles can slide. Running shoes with thick rubber soles that extend over the toe area can stick to the carpet and cause falls. If your parent can’t bend over to lace the shoe consider Velcro straps.

Leg muscle weakness, illnesses, medication side effects, vision problems and problems with proprioception (proprioception is the ability to know where your body’s position and movement is in relation to the environment) are common factors that can lead to balancing problem in the elderly. Mary Tinetti, MD says, “The nerves in their feet are not giving their brains the message of where they are.”  “A cane or walking stick gives input to your brain of where your feet are through your hands,” she adds. Balance can be measured by the time patients can stand on both feet in tandem stance (heel to toe) and on one foot (single stance); normal is greater or equal to 5 seconds. A walker may provide similar input to the brain. But those whose balance is compromised enough to require a walker may not experience the same level of effect. But walking devices may be a hard sell to older adults. They’re associated with aging and dependence in an elderly person’s mind. Judy Stevens, Ph.D., epidemiologist at the National Center for Injury Prevention and Control says, “The best way to motivate older adults is to appeal to their desire to remain independent, rather than to talk about the dire risks of falling.” Allways consider physical therapy, strengthing can lead to years of independence for your parent.

Foot Facts

The foot contains 19 muscles, 107 ligaments and tendons, 26 bones with 33 joints.

The foot contains @ 25 % of all the bones in the body. If foot bones are out of alignment, then the whole body is out of alignment.

Most people have one foot that is larger than the other. The average male shoe size is 10. The average women’s shoe size is 8.5, this has gone up two sizes in just four decades. Feet are at their largest in the evening, this is also the best time to get fitted for shoes. A person’s foot will increase two sizes longer when they stand up.

In our lifetime we will walk the equivalent of more than 4 times around the earth. @ 115 thousand miles.

In an average day of walking 8,000 to 10,000 steps, we displace the weight of a fully loaded cement truck on our feet. Each time our heel leaves the ground our toes carry the weight of ½ our body weight. When running the pressure on the feet can be as much as four times the runner’s body weight.

An adult averages 4,000 to 6,000 steps in a day. Walking is the best exercise for your feet. Standing is by far, more taxing, because just a few muscles are under continuous strain. The average woman walks three more miles in a day than the average male.

Problems in the feet are a precursor of things to come, many conditions such as arthritis and diabetes first show their symptoms in the feet. Only a small percentage of the population is born with foot problems, but 75 out of 100 Americans will experience serious foot problems in their lifetime.

90% women wear shoes that are too small for their feet. Because of high heels (a 2½-inch high heel can increase the load on the front pad by 75%) and ill-fitting shoes they are 4 times more likely to experience foot problems than men. Another symptom, more than half the women in America have bunions, a common foot deformity in which the joint that connects the big toe to the foot gets larger and juts out.

Foot fetishes are more popular or profitable than foot health, there are more websites having to do with foot fetishes than with foot health. Heel pain and ingrown toenails are the most common problems searched for on the internet. Approximately 5% of Americans will have ingrown toenails in a given year.

It is normal for a child to take its first steps between 10 to 18 months but the average that it occurs is 13 to 17 months. A child’s feet will grow rapidly for the first year, by the age of 12 their foot will be 90% fully grown.

By the mid thirty’s the padding in the bottom of the foot thins out. This is why foot pain can develop from standing for lengthy periods. Read more – Metatarsal Pain

Corns and calluses will affect approximately 6.5% of the population. Read more – Safe and Effective Ways to Remove Them.

Soles of feet contain more sweat glands and sensory nerve endings per square centimeter than any other part of the body. In a pair of feet, there are 250,000 sweat glands which can excrete up to a half-pint of sweat a day.

When a toenail is torn off, it takes 5 to 6 months for a new one grow back.

According to the Guinness Book of World Records:  Madeline Albrecht was employed at the Hill Top Research Laboratories in Cincinnati, Ohio, USA, a testing lab for products. She worked there for 15 years and had to smell literally thousands of feet and armpits during her career. She has sniffed approximately 5,600 feet.

The record for the world’s largest feet belongs to Matthew McGrory who wears US size 29 1/2 shoes. There is a video showing him putting shoes inside of his shoes.

Akshat Saxena from India, holds the world record for having the most toes with 10 digits one each foot!

About 20-30% of the world’s population have Morton’s Toe, a foot condition in which the second toe is longer than the big toe. Once considered a mark of intelligence and beauty. Read more – Morton’s Toe

Approximately one in four Americans have flat feet.

Plantar Fasciitis (heel pain) Over 2 million Americans seek treatment) each year. Approximately 10 percent of the US population in a lifetime.

During pregnancy, hot weather and teenage years, toenails grow faster.

The Plantar Wart virus can enter cuts in the feet and take hold. The feet can also contract many diseases from communal showers: Planter Wart, Athletes foot, Ring worm. Approximately 5% of the US population has fungal foot infections in a given year.

It is common for the elderly to have foot conditions that cause pain and disability which can lead to loss of mobility and independence.

For @ 7 million Americans arthritis is the number one cause of disability. It limits everyday dressing, climbing stairs, getting in and out of bed or walking. Osteoarthritis is the most common type of arthritis in the United States affecting an estimated 20.7 million, mostly after age 45.

Diabetes usually attacks the foot first with Peripheral Nerve Damage and other complications. Approximately 56,000 people a year lose their foot or leg to diabetes. Read more – Diabetes and the Foot.

Peripheral Vascular Disease a disease of the arteries, affect the feet and legs, when severe leads to ulceration, infection and sometimes amputation.

Most injuries reported from people 17 or older are ankle sprains, @ 60%.

Tarsal Tunnel Syndrome – a pinched nerve going to the foot is a very common reason for feeling pain and burning in the feet. Read more – Tarsal Tunnel

75% of Americans will experience foot problems at one time or another in their lives and @ 19% of the population will have 1.4-foot problems each year.

Stone Age people used animal skins to protect their feet. The ancient Romans were the first to make specific left and right shoes. The first pair of boots were created for Queen Victoria back in 1840.

In Britain shoe size is measured in Barleycorns, this unit of measurement stretches back to King Edward 2nd in Anglo-Saxon times. He declared that the diameter of one barely corn- one third of an inch- would represent one full shoe size.

Tendonitis Recovery

The Achilles tendon is one of the longest tendons in the human body, it connects the calf muscles to the heel bone. This tendon is often referred to as the heel cord. Forces on the Achilles tendon are great, up to 12 times a person’s body weight when sprinting. The Achilles tendon is approximately 6 inches in length and is the thickest tendon in the body, because it is connected to the most powerful muscle group in the body. Tendons as a whole don’t heal well, because there is not much blood flow to them. The heel cord gets its supply from one blood vessel known as the posterior tibial artery which branches out into many smaller vessels that feed the entire tendon. You can feel the tendon work when you stand on your tippy toes.

The Achilles heel has always been a vulnerable part of the body as portrayed in a Greek Myth over 2,000 years ago. The Nymph Thetis wanted her son to be a great warrior that could not be injured, so she held her young son by the ankle and dipped him head first into the River Styx. The magical waters make Achilles body impenetrable, except for the ankle where the water did not touch. This eventually leads to his demise when Paris’s arrow penetrates Achilles’s heel and mortally wounds him. So when someone says, “That’s his Achilles heel.” They mean that is his vulnerable spot.

Achilles Tendinitis:

Over use or over stretching the Achilles tendon can lead to tears in the tendon. Once this happens inflammation and pain set in. High impact sports (jogging, basketball, tennis, etc.) and age will contribute to tendonitis. As we get older, blood flow can decrease to the Achilles tendons making them prone to injury. If an individual is inactive the Achilles tendon becomes weaker and is also prone to Achilles Tendinitis. If you feel pain in the heel area, stop all activities that bring further pain. Rest the Achilles tendon. This is a slow healing injury and may take 3 months or longer. If you wish to continue exercising try bike riding, swimming or other activities that don’t require propulsion by the foot. Icing the tendon will reduce swelling and aid in the healing process. Over the counter medication Advil, Aleve will also reduce swelling and pain. Stretching exercises are recommended once the swelling subsides.

How do I know I have Tendonitis?

Squeeze the tendon on the sides between your finger and thumb, if the pain is more intense than when pressing on the tendon from the back, this is a sign of tendonitis. If pain is felt upon wakening, the pain may improve and then worsen as activity increases, is another sign.

How can I help the healing process?

A walking cast will take the pressure off the Achilles heel, this is used briefly as to avoid weakening of the calf muscles and tendon (cost is @ $40.00). Wearing a Dorsal Night Splint allows the tendon to heal while you sleep, they can be purchased for @ $23.00.

What is a Rupture of the Achilles Tendon?
A rupture occurs when the tendon partially tears or completely tears in two. Often a snapping sound is followed by an intense pain. The pain usually subsides quickly followed by aching in the lower back leg. You may be able to bear weight on the injured leg but will not be able to stand on your toes. Another test “The Thompson Test” requires the person to lie on their stomach then their calf muscle is squeezed. If there is no movement or flexion in the foot, then the Achilles tendon is injured. As a rule of thumb, surgery is recommended for a complete tear and nonsurgical treatment for partial tears.

How will the doctor treat a ruptured Achilles tendon?

If the tendon is completely separated, “tendon transfer” surgery will be performed. This involves a cut just above the heel, the two tendon ends are then sutured together and the cut stitched. This requires @ six weeks of immobilization. There is less than a 5% injury recurrence rate.   A partial tear is usually operated on if you are younger and more active. Older people are often treated with a cast for up to 12 weeks, followed by rehabilitation. Partial tears are sometimes treated like complete tears, with surgery and casting. A heel lift is usually used for 6 months to one year following removal of the cast. Rehabilitation to regain flexibility and then to regain muscle strength are also instituted following removal of the cast.