Everything from slippery throw rugs to poor lighting to side effects from medications has been implicated as contributing to the growing tendency to fall and hurt ourselves as we get older.

Foot pain and problems? They get mentioned but are usually way down the list, according to the November 2011 issue of the Harvard Health Letter.

That may be changing.

Researchers have started to document that older people with foot woes are more likely to fall than those with problem-free feet.

And earlier this year, Australian researchers reported findings from the first-ever randomized clinical trial of foot care as a way to prevent falls. The foot care consisted of several exercises targeting the feet, inexpensive orthotics, and expert advice about shoes and footwear. The results, published in the medical journal BMJ, showed that study volunteers who received the foot care experienced 36% fewer falls than those in the control group.

Health Letter editors spoke with one of the Australian researchers, Hylton Menz, who is a Fulbright Visiting Scholar at the Institute for Aging Research at Harvard-affiliated Hebrew SeniorLife, a long-term care facility based in Boston.

Here are a few practical suggestions for keeping your feet healthy, from Menz and other sources:

Make sure your shoes fit properly. Research has found that a surprising number of people (35% in one study) are wrong about their correct shoe size. Older people should be especially careful about shoe width. Even without a full-fledged bunion (when the joint at the base of the big toe angles out), the front of the foot may tend to widen with age.

Wear your shoes indoors. Harvard researchers have found that people who wore shoes indoors were less likely to suffer a serious injury from a fall than those who wore slippers or socks or went barefoot.

Lose weight. Being heavy puts more force on your feet, so add another item to the ever-growing list of reasons for staying trim — and dropping a few pounds if you haven’t.

Give less expensive, prefabricated orthotics a try before the custom-made ones. Orthotics can help with foot pain. But custom-made orthotics cost several hundred dollars, whereas a good-quality, prefabricated pair costs about $50. They’ve produced similar results when compared in clinical trials and, notes Menz, the orthotics used in his fall prevention study were prefabricated. So, Menz says, research results and cost consideration argue for trying prefabricated orthotics before spending money on custom-made orthotics, unless you have a major foot deformity that clearly needs custom treatment.

Read the full-length article: "Feet and falling"