Don’t forget your feet

Women sometimes neglect their feet until they start to experience foot pain and other problems.

Most women get their teeth cleaned at least once a year, keep tabs on their heart, and may even have an annual eye exam. While they might clip and paint their toenails on a regular basis, women often neglect the health of their feet.

That lack of attention can lead to pain and other foot problems, which are common and — for some people — life-altering.

How your feet change over time

Over time, natural changes in your feet can make it more likely that you will experience pain. Below are some of the changes you might see in your feet through the decades. For more detailed information on this topic and for other tips on how to care for your feet, see the Harvard Special Health Report Healthy Feet: Preventing and treating common foot problems (www.health.harvard.edu/fcb).

In your 30s. At this stage of life, the muscles, tendons, and ligaments in your foot may start to weaken or lose resilience.

In your 40s. This is the time when many people start to experience foot pain and problems caused by the weakening of foot structures that began in your 30s. Many people in this age group start to notice their feet are sore at the end of a long day and often begin to experience foot problems. Common conditions include bunions, which are caused by a misalignment of the foot bone that causes a bony bump to jut out at the base of your big toe; or hammertoes, toes that permanently curl downward; and nail fungus.

In your 50s, 60s, and beyond. The fat pads in the bottom of your feet become thinner. By the time people reach their 50s typically half of the fatty padding in the soles of their feet is gone. A loss of estrogen after menopause may lead to lower bone density in the feet and consequently a higher risk of stress fractures in the foot. People in this age group are also more prone to calluses and corns. Foot problems related to chronic conditions are also more common in this age group.

A widespread problem

A 2018 survey of nearly 1,300 adults conducted by the American Podiatric Medical Association (APMA) found that as many as 75% of those surveyed had some issue with their feet, ranging from the troublesome (such as excess sweating, odor, or nail problems) to the painful (such as bunions or stress fractures). And half of those surveyed said they have foot problems that are severe enough to limit their activity in some way.

"I think the biggest problem when it comes to foot pain is that no one knows what to do or who to talk to about it," says Marian T. Hannan, a professor of medicine at Harvard Medical School and co-director of the Musculoskeletal Research Center at the Marcus Institute for Aging Research, Hebrew SeniorLife. Doctors don't typically receive specific training on foot problems in medical school, says Hannan. "And most people don't think to go to a podiatrist unless they have diabetes or rheumatoid arthritis," says Hannan.

While women surveyed by the AMPA reported taking better care of their feet than men, fewer than half of the people who participated in the survey did anything more than clip their nails when it came to foot care. And women were more likely than men to have pain — not surprising when you consider that the APMA found that high heels are the No. 1 cause of foot pain.

But taking some simple steps to protect your feet can help you avoid pain and other problems. Below are some strategies you should follow.

Pay attention to your footwear. Many instances of foot pain are caused by shoes that are too pointy, too tight, or too high in the heel. So, changing them makes sense, says Hannan. Look for shoes that fit well, provide enough cushioning, and are comfortable. Also, don't wear the same shoes every day. It's healthy to swap shoes and avoid keeping the same pair on all the time, says Hannan. As for high heels, you may want to rethink them. But that's often easier said than done. The APMA survey found that even though people said high heels hurt their feet, users still reported owning more than six pairs.

Give your feet a good soak. Keeping feet clean and soaking them regularly reduces problems caused by harmful bacteria and can ward off fungal infections such as athlete's foot, says Hannan. "Foot baths are really helpful," says Hannan. If you have shoes that are rubbing your feet the wrong way, a good foot bath can soften up calloused skin and help keep feet smooth. Make sure you dry your feet thoroughly after washing, especially between your toes. Bacteria and fungi can thrive in a wet environment.

Don't forget to exercise. You can prevent problems by doing exercises that stretch and strengthen your feet. (See sample stretches.)

Foot stretches

Limber up. To limber up your foot, try this:

Sit in a chair with your feet flat on the floor. Lift your left leg so your foot is off the floor and use your big toe to make circles in the air, moving in a clockwise direction, for 15 to 20 rotations. Reverse direction and make another 15 to 20 circles, this time in a counterclockwise direction. Repeat with your right foot.

Bottom-of-foot stretch. To stretch the muscles on the bottom of your feet and your toes:

Stand with feet together. Step back with your left leg so your heel is raised and your toes press against the ground. You should feel the muscles on the bottom of your feet pull gently. Hold for 20 to 30 seconds. Repeat with your right foot.

Top-of-foot stretch. To stretch the muscles on top of your feet and your toes:

Stand with feet together. Working with one foot at a time, raise your heel and curl your toes under, pressing the tops of your toes against the floor. You should feel the muscles on the top of your feet and the front of your ankle gently stretch. Hold for 20 to 30 seconds. Repeat with the other foot.

Maintain a healthy weight. Weight gain and foot pain are often linked. In the APMA survey, 74% of individuals who were overweight and 81% of people with obesity reported foot problems. People with obesity were more likely to experience heel pain and plantar fasciitis (inflammation of a band of tissue that runs along the bottom of the foot). Their feet were also more likely to have tendinitis (inflammation of the tendons), bone spurs (abnormal bony growths), and stress fractures (cracks in the bones caused by repetitive pressure).

Moisturize and soften. Smoothing skin with lotion or a podiatric cream keeps your feet moisturized and keeps skin from drying and cracking, says Hannan. But avoid the area between your toes, where moisture can collect and cause problems.

Change your socks. Wearing clean socks every day can also cut down on bacteria. Take your socks off periodically to let your feet air out, says Hannan.

Trim your toenails correctly. Cutting your toenails straight across, instead of rounding them at the edges, can help prevent ingrown toenails, a condition in which the nail digs in and grows into the adjacent skin.

Pay a visit to the pros. An occasional pedicure can help keep feet in top shape, particularly if you have trouble reaching your feet — for instance, if you are older or pregnant, says Hannan. But be certain to pick a nail salon that is clean and follows stringent sterilization practices to avoid infection, or the service could end up doing more harm than good.

Nix the bad habits. Smoking or excess alcohol consumption affects not only your overall health, but your feet as well.

Look for signs of trouble. Examine your feet regularly for worrisome changes. This is particularly important if you have diabetes or rheumatoid arthritis. Things to look for are red spots, bruises, calluses, or patches of thickened yellow skin, called corns.

Seek out an expert. If you are experiencing foot pain that is persistent or severe, it's best not to try to treat it yourself, but rather to turn to an expert such as a podiatrist, orthopedist, or physical therapist to diagnose and treat the problem, says Hannan. For example, some cases of foot pain may be caused by gait problems. Tight ligaments or arthritis in the hip may cause an unsteady walk that puts uneven pressure on your feet. Orthotic inserts for your shoes or physical therapy could help, says Hannan. Pain that affects your daily life shouldn't be tolerated. If you've given up your daily walk because your foot hurts, it's time to see a doctor. "Pain isn't normal. It's a signal to pay attention," says Hannan.

Consider surgery. If your foot hurts because of a more serious problem, such as a bunion, you might want to consider a surgical solution to relieve the pain.

Image: © spukkato/Getty Images

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