Foot and Ankle Care for Older Adults: Special Considerations After 65

Medically reviewed by Dr. Tom Biernacki, DPM — Board-Certified Podiatric Surgeon — Balance Foot & Ankle, Howell & Bloomfield Hills, MI. Last updated April 2026.

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Foot Care After 65: Different Needs, Different Priorities

Podiatric care for adults over 65 involves clinical considerations that are distinct from younger patient management — different healing characteristics, different risk profiles, different goals of care, and different treatment constraints shape how foot and ankle conditions are evaluated and treated in older adults. At Balance Foot & Ankle in Howell and Bloomfield Township, Michigan, a significant proportion of our patients are older adults, and we provide age-appropriate care that balances effective treatment with the realities of geriatric physiology.

Age-Related Foot Changes That Affect Management

Normal aging produces foot changes that alter clinical presentation and treatment response. Heel fat pad atrophy: the cushioning layer beneath the heel thins with age, making the heel more vulnerable to pressure pain and bruising. Skin changes: thinner, more fragile skin with reduced elasticity heals more slowly and is more vulnerable to breakdown from friction, pressure, and callus removal. Nail changes: slower-growing, thicker, more brittle nails that are harder to trim safely — particularly important in patients on blood thinners or with diabetes. Reduced proprioception: declining sensory feedback from foot and ankle mechanoreceptors increases fall risk. Circulatory changes: reduced arterial elasticity impairs peripheral circulation and wound healing capacity.

Fall Prevention: A Critical Foot Care Goal

Falls are the leading cause of injury-related hospitalization and death in adults over 65, and foot and ankle health is directly linked to fall risk. Factors that podiatry addresses to reduce fall risk: painful feet that alter gait and reduce confidence walking, toenails that catch on carpeting and cause trips, footwear that is inadequate for stability (slippers, unsupportive shoes), peripheral neuropathy reducing sensory feedback, ankle weakness and instability, and deformities that impair stable stance. Comprehensive geriatric foot evaluation includes fall risk assessment and specific recommendations to reduce modifiable foot-related fall risk factors.

Surgical Decision-Making in Older Adults

Surgery in older adults requires balancing the benefits of correction against the risks of anesthesia, slower healing, and prolonged recovery. For older patients with serious comorbidities, conservative management that manages symptoms may be preferred over corrective surgery with lengthy non-weight-bearing requirements. For healthy, active older adults, surgery can provide significant functional improvement and is absolutely appropriate when conservative measures are inadequate. The risk-benefit analysis is individualized based on overall health status, activity goals, and the specific condition. Contact Balance Foot & Ankle at (810) 206-1402 for a comprehensive geriatric foot evaluation tailored to your health status, activity goals, and priorities.

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Balance Foot & Ankle — Howell & Bloomfield Township, MI

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When to See a Podiatrist for Foot Care After 65

Foot problems increase significantly after age 65 due to fat pad thinning, circulation changes, arthritis, and balance decline. At Balance Foot & Ankle, Dr. Tom Biernacki provides comprehensive geriatric foot care including fall prevention assessment, nail care, diabetic foot monitoring, and custom footwear guidance.

Learn About Our Senior Foot Care Options | Book Your Appointment | Call (810) 206-1402

Clinical References

1. Menz HB, Morris ME, Lord SR. Foot and ankle characteristics associated with impaired balance and functional ability in older people. J Gerontol A Biol Sci Med Sci. 2005;60(12):1546-1552.
2. Dunn JE, Link CL, Felson DT, et al. Prevalence of foot and ankle conditions in a multiethnic community sample of older adults. Am J Epidemiol. 2004;159(5):491-498.
3. Menz HB, Lord SR. The contribution of foot problems to mobility impairment and falls in community-dwelling older people. J Am Geriatr Soc. 2001;49(12):1651-1656.

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Dr. Tom Biernacki, DPM

Dr. Tom Biernacki, DPM is a double board-certified podiatrist and foot & ankle surgeon at Balance Foot & Ankle Specialists in Southeast Michigan. With over a decade of clinical experience, he specializes in heel pain, bunions, diabetic foot care, sports injuries, and minimally invasive surgery. Dr. Biernacki is a member of the APMA and ACFAS, and his patient education content on MichiganFootDoctors.com and YouTube has reached over one million views.