Foot Care for Seniors: Common Problems, Fall Prevention & When to See a Podiatrist

Quick answer: Senior Foot Care Guide affects roughly 1 in 4 adults in our practice. Effective treatment starts with a targeted diagnosis, conservative-first treatment, and escalation only when needed. We treat this regularly at our Howell and Bloomfield Township practices. Call (810) 206-1402.

Related Conditions

✅ Medically reviewed by Dr. Tom Biernacki, DPM — Board-Certified Podiatrist · Last updated April 6, 2026

Foot health becomes increasingly important as we age — and increasingly neglected. Over 80% of adults 65 and older have at least one foot problem, yet foot pain is often dismissed as an inevitable part of aging. It isn’t. Healthy, comfortable feet support independence, mobility, balance, and overall quality of life.

At Balance Foot & Ankle in Howell and Bloomfield Township, MI, we provide specialized foot care for older adults and work with patients’ broader medical teams to address the foot-related implications of diabetes, vascular disease, arthritis, and other conditions common in this population.

How Aging Changes Your Feet

Change	Effect on the Foot	Common Result
Loss of fat pad thickness	The natural cushioning under the heel and metatarsal heads thins, reducing shock absorption	Metatarsalgia, heel pain, increased bone stress
Reduced collagen quality	Tendons, ligaments, and fascia become stiffer and less resilient	Plantar fasciitis, Achilles tendinopathy, reduced flexibility
Decreased muscle mass	Intrinsic foot muscles weaken, reducing arch support and toe control	Progressive flat feet, hammertoes, balance problems
Skin changes	Skin becomes thinner, drier, and more fragile; reduced sweating	Cracked heels, increased wound risk, slower healing
Nail changes	Nails become thicker, more brittle, harder to trim	Onychomycosis (fungal nails), ingrown nails, subungual pain
Reduced proprioception	Fewer sensory nerve endings; slower nerve conduction	Balance impairment, fall risk
Circulatory changes	Reduced arterial flow and venous return efficiency	Swelling, slower healing, increased cold sensitivity
Foot widening and lengthening	Ligament laxity allows the foot to spread and flatten	Ill-fitting shoes that were once comfortable; bunion progression

Common Foot Conditions in Older Adults

Toenail Fungus (Onychomycosis)

Affects over 50% of adults over 70. Thickened, discolored, brittle nails are caused by dermatophyte fungi and are notoriously difficult to treat. Oral antifungals have meaningful success rates but drug interactions (especially with statins and blood thinners) limit their use in older adults. Laser treatment offers a safer alternative. Professional nail debridement is important to prevent ingrown nails and painful pressure on the nail bed. Read our guide on toenail health.

Bunions and Hammertoes

Progressive deformities that worsen with age and accumulating years of footwear wear. In older adults, the primary goal shifts from correction to accommodation — ensuring adequate footwear and padding to prevent complications. Surgical correction remains an option for those who are medically fit and have sufficient functional limitations to warrant it.

Ankle and Foot Arthritis

Post-traumatic ankle arthritis, hallux rigidus (big toe joint arthritis), and midfoot arthritis become more prevalent with age. Conservative management — custom orthotics, rocker-sole footwear, intra-articular injections — can maintain comfortable function for many years before surgical intervention is considered. See our foot arthritis guide.

Peripheral Arterial Disease

PAD affects 12-20% of adults over 65. Foot symptoms — coldness, color changes, leg cramping with walking, slow wound healing — may be the first signs of significant vascular disease. Podiatric evaluation can identify PAD before it causes serious complications. See our guide on PAD foot symptoms.

Heel Pain

Plantar fasciitis, heel bursitis, and fat pad atrophy all cause heel pain in older adults but have different treatment approaches. Thinning of the heel fat pad is a common contributor in adults over 60 — orthotics with gel heel cups or extra cushioning address this. See our plantar fasciitis treatment guide.

Venous Insufficiency and Edema

Chronic leg and foot swelling from venous insufficiency is extremely common in older adults. Compression therapy (graduated compression stockings) and leg elevation remain the cornerstone of management. More advanced venous disease may benefit from procedural treatment. See our guide on venous insufficiency and foot swelling.

Fall Prevention: The Foot’s Role

Falls are the leading cause of injury in adults 65 and older. Foot and ankle problems are a significant and underappreciated contributor to fall risk:

• Peripheral neuropathy impairs proprioception — the ankle’s ability to sense its position and react to instability
• Bunions, hammertoes, and deformities alter how the foot contacts the ground, destabilizing balance
• Reduced ankle range of motion limits the ability to recover from balance perturbations
• Inappropriate footwear — slippers without backs, worn-out athletic shoes, non-slip soles missing — is implicated in a large proportion of home falls
• Pain causes protective compensations that actually increase fall risk

Evidence-based interventions for fall risk reduction that involve the foot:

• Custom orthotics with proprioceptive enhancement (textured materials)
• Ankle strengthening and balance exercises (proven to reduce fall rates by 35-40%)
• Appropriate footwear — enclosed, non-slip sole, low heel, adequate toe box, secure fastening
• Vitamin D supplementation (reduces fall and fracture risk)
• Addressing neuropathy causes (B12 deficiency, thyroid disease, medication review)

Footwear for Older Adults: Evidence-Based Guidance

Footwear for seniors deserves more attention than it typically gets:

• Enclosed heel: Slippers and open-back footwear require constant toe gripping to stay on — this disrupts normal gait and increases fall risk significantly
• Non-slip sole: Textured rubber outsole appropriate for indoor and outdoor surfaces
• Velcro or wide opening: For those with dexterity limitations or significant swelling
• Wide toe box: Accommodates bunions, hammertoes, and the natural widening of aging feet
• Firm heel counter: Provides rearfoot stability for those with balance impairment
• Diabetic-certified for diabetic patients: Extra-depth shoes with seamless interiors protect insensate feet

How Often Should Seniors See a Podiatrist?

Situation	Recommended Frequency	What’s Covered
Healthy older adult, no complicating conditions	Annual foot exam	Nail care, skin check, circulation/sensation assessment, footwear evaluation
Diabetes without neuropathy	Every 3-6 months	Monofilament testing, circulation check, nail care, ulcer risk assessment
Diabetes with neuropathy or vascular disease	Every 1-3 months	Comprehensive diabetic foot care; wound prevention
Active foot condition (arthritis, chronic pain)	As needed (typically 2-4 times/year)	Treatment, monitoring, orthotic adjustment

Medicare covers annual foot exams and nail care for diabetic patients. Call Balance Foot & Ankle at (810) 206-1402 to schedule your appointment in Howell or Bloomfield Township.

Frequently Asked Questions

Q: Is foot pain normal as you get older?
A: Foot problems become more common with age, but pain is not a normal or inevitable part of aging that should simply be accepted. Most foot pain in older adults has a specific, treatable cause. Evaluation by a podiatrist often reveals conditions that respond well to treatment.

Q: My feet have gotten wider and longer as I’ve aged — do I need to remeasure?
A: Yes, absolutely. Foot size and shape can change significantly with age due to ligament laxity and structural changes. Many older adults are wearing shoes that are too narrow or too short because they haven’t been measured in years. This is a major driver of foot pain and deformity progression.

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Related Patient Guides

• Diabetic Foot Care: Daily Routine & Warning Signs
• Foot Arthritis: Types, Symptoms & Treatment Options
• Peripheral Arterial Disease: Foot Symptoms Guide
• Venous Insufficiency & Foot Swelling
• Peripheral Neuropathy in the Feet: Symptoms & Care
• Toenail Health: What Your Nails Reveal
• How to Choose the Right Shoes for Your Foot Type
• Medicare Diabetic Shoe Benefit: What You Get & How to Qualify
• Michigan Podiatrist Home Visit: Who Qualifies & How to Request

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