“I have plantar fasciitis and Doctor was very patient, providing exercises and answers. I'm seeing improvement for the first time in months.”Google · Sean Murray · Jun 2023
“He finally freed me from my plantar fasciitis! Orthotics he casted are exceptional.”Google · Gleb Kartsev · Nov 2021
“Best orthotics ever! Before — horrible pain from plantar fasciitis heel spurs. Best arch support ever!”Google · Weilian Tang · Nov 2021
“Dr Patish and his staff are great! Ingrown nail and plantar fasciitis — he helped immensely with both!”Google · Polly Trump · Mar 2023
“Doctor took very good care of my plantar fasciitis problem — quick and effective.”Google · Judy Wahl Talley · Apr 2019
“Dr. Patish's orthotics have changed my life! I can walk for hours with no pain.”Google · Sarah Tang · Mar 2022
“For fifteen years I saw countless doctors for pain in the ball of my foot. Dr. Patish's diagnosis was dead on.”Google · A. Holston · Jan 2023
“I wish I could give Dr. Patish 10 stars!!! He has literally been a life changer.”Yelp · Troy E. · Aug 2019
“I have plantar fasciitis and Doctor was very patient, providing exercises and answers. I'm seeing improvement for the first time in months.”Google · Sean Murray · Jun 2023
“He finally freed me from my plantar fasciitis! Orthotics he casted are exceptional.”Google · Gleb Kartsev · Nov 2021
“Best orthotics ever! Before — horrible pain from plantar fasciitis heel spurs. Best arch support ever!”Google · Weilian Tang · Nov 2021
“Dr Patish and his staff are great! Ingrown nail and plantar fasciitis — he helped immensely with both!”Google · Polly Trump · Mar 2023
“Doctor took very good care of my plantar fasciitis problem — quick and effective.”Google · Judy Wahl Talley · Apr 2019
“Dr. Patish's orthotics have changed my life! I can walk for hours with no pain.”Google · Sarah Tang · Mar 2022
“For fifteen years I saw countless doctors for pain in the ball of my foot. Dr. Patish's diagnosis was dead on.”Google · A. Holston · Jan 2023
“I wish I could give Dr. Patish 10 stars!!! He has literally been a life changer.”Yelp · Troy E. · Aug 2019
Fall Prevention: How Your Feet Play a Bigger Role Than You Think
Falls are the leading cause of injury for seniors, and foot problems are a major contributor. Learn how podiatric care can help reduce your fall risk.
Falls are common as we get older. In a CDC survey, about 1 in 4 adults 65 and older reported a fall in the past year (Kakara and colleagues, 2023). Falls are also the leading cause of injury and injury death in that age group. What many people don't realize is how much the feet have to do with it.
Before you read on. This article is general information, not medical advice. After a fall, get medical care right away if you hit your head, if you take a blood thinner, or if you have new pain, swelling or trouble walking. Sudden dizziness, weakness, numbness on one side or trouble speaking is an emergency: call 911. Falls often have more than one cause, so tell your primary doctor about any fall. We handle the foot side and will refer you for the rest.
Your feet are your body's base and a key source of balance information. When foot problems affect feeling, strength or stability, a fall becomes more likely. The CDC agrees. Its fall prevention program lists foot-related fall risks: foot pain, stiff ankles, weak calf muscles, numb feet, and bunions or toe deformities. It also recommends sturdy, well-fitted shoes (CDC feet and footwear fact sheet).
How Foot Problems Increase Fall Risk
One study followed 176 older adults in a retirement village for a year. Compared with people who didn't fall, the people who fell had stiffer ankles and more severe bunions (Menz and colleagues, 2006). They also had less feeling on their soles, weaker toes and more disabling foot pain. Weak toes and disabling foot pain stood out even after the researchers accounted for other fall risks.
Nerve damage (peripheral neuropathy), common with diabetes, dulls the feeling in your feet. Your brain gets less information about the ground under you, and balance suffers. Learn about our diabetic foot care.
Bunions, hammertoes and painful feet change the way you walk. When walking hurts, it's natural to change how you step, and that can make you less steady.
Weak ankles and toes make it harder to catch yourself when you trip on uneven ground. The good news is that strength and balance can improve with the right exercises, even later in life.
The Footwear Factor
What's on your feet matters. In a study of older adults, falls were least likely in sneakers, meaning athletic and canvas shoes (Koepsell and colleagues, 2004). They were much more likely when people were barefoot or in socks. A steadier shoe usually has these features.
- A firm heel counter that holds your heel in place
- A low, broad heel
- A non-slip sole with some tread
- A fairly thin, firm midsole, so you can feel the ground
- Laces or hook-and-loop straps that keep the shoe on your foot
Skip loose slippers, backless shoes and worn-out soles, and don't walk around in socks on smooth floors. If your feet swell or you wear a brace, look for shoes that open wide and adjust. If a dropped foot catches on the ground, an ankle-foot orthosis can hold the foot up as you walk.
Exercises That Help
Exercise is a well-studied tool for fall prevention. A Cochrane review of many trials found high-certainty evidence that exercise programs reduce falls in older people living at home (Sherrington and colleagues, 2019). Overall, falls dropped by about a quarter. The programs that clearly worked focused mainly on balance and everyday movements, often with strength training added. Our balance and strengthening exercises are a good place to start. A physical therapist can build a program that's safe for you.
What a Podiatrist Can Do
A foot check for fall risk looks at feeling, circulation, strength, joint motion, the way you walk and your shoes. From there, treatment targets what we find. That can mean custom orthotics or better shoes. It can also mean care for painful problems like bunions and ingrown nails, plus foot and ankle exercises.
Two trials have tested this kind of podiatry program. In Australia, older adults with disabling foot pain received orthoses, footwear advice and help buying shoes. They also did home foot and ankle exercises and got a falls-prevention booklet. They had 36% fewer falls than a comparison group (Spink and colleagues, 2011). A larger UK trial of a similar program found a smaller drop in falls that could have been due to chance (Cockayne and colleagues, 2017). Fewer people in that program fell more than once, though. So a podiatry program can help, and it makes sense as one part of a broader plan with your primary doctor.
Falls often have more than one cause. Foot care is one piece, along with vision, medicines, blood pressure, home safety and exercise. If you've fallen or feel unsteady, tell your primary doctor, and let us check your feet and shoes.
The Bottom Line
Falls aren't a normal part of aging that you simply have to accept. Many of the foot-related factors behind them can be treated. If you or someone you love has fallen or feels unsteady, a foot exam is a good step.
Frequently Asked Questions
How do foot problems cause falls in seniors?
Nerve damage dulls the feeling in the feet, painful feet change how you walk, and weak toes and stiff ankles make it harder to catch yourself. In a study of older adults, weak toes and disabling foot pain were linked to falls even after other risks were accounted for (Menz and colleagues, 2006).
What shoes are best for fall prevention?
In a study of older adults, athletic and canvas shoes were linked to the lowest fall risk, and going barefoot or in socks to a much higher risk (Koepsell and colleagues, 2004). Look for a firm heel counter, a low heel, a non-slip sole and laces or hook-and-loop straps. Avoid loose slippers and worn-out soles.
Can a podiatrist help prevent falls?
Yes, as part of a broader plan. In one trial, a podiatry program of orthoses, footwear advice and foot and ankle exercises led to 36% fewer falls (Spink and colleagues, 2011). A larger trial found a smaller effect that could have been due to chance (Cockayne and colleagues, 2017). We check your feet, shoes and balance and treat what we find.
Are slippers safe for older adults?
Loose or backless slippers can slip off or catch on things. If you wear slippers, choose ones with a closed back, a firm sole and non-slip tread. Walking barefoot or in socks was linked to a much higher fall risk in a study of older adults (Koepsell and colleagues, 2004).
What exercises help prevent falls?
Balance and everyday-movement exercises have the strongest evidence. A Cochrane review found that exercise programs reduce falls in older people living at home by about a quarter (Sherrington and colleagues, 2019). Tai chi may help too. Start gently, and ask your doctor or a physical therapist what's safe for you.
What should I do after a fall?
Get medical care right away if you hit your head, if you take a blood thinner, or if you can't bear weight or have new pain or swelling. Even a fall without injury is worth telling your primary doctor about, since falls often have more than one cause. If your feet, shoes or balance played a part, see us.
Can foot drop cause falls?
Yes. A foot that drops or drags can catch on the ground and trip you. An ankle-foot orthosis can hold the foot up as you walk. Foot drop has several possible causes, so it needs its own exam.
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