In her younger days, Chicago resident Barbara Longworth liked to wear fancy shoes with high heels on special occasions, such as receptions, weddings and dinners at nice restaurants. But through the years, her feet changed shape and seemed to get bigger. “I was about a 7 AAA, now I’m a 7 1/2 EEE — eek!” says Longworth, 88.
For the past 15 years, Longworth has exclusively worn sturdy New Balance sneakers because, she says, that brand has more room in the toe box and wider sizes. “There are no silver sequined dancing shoes for me anymore,” Longworth says. “I still walk past shoe stores with beautiful designer women’s shoes, pointy shoes with 4-inch heels, and admire them. Those are definitely out of my range now. They wouldn’t fit, and the pain would be absolutely awful.”
As our bodies shrink with age, our feet often seem to get bigger. Feet do not literally grow, orthopedists agree. Rather, over the years, tissue in our feet degenerates and ligaments become looser, which causes strain on joints and can lead to arthritis, says Dr. Megan Leahy, Longworth’s orthopedist. The degeneration of ligaments can cause feet to flatten and become wider, Leahy continues. Arthritis also takes a toll on feet. For instance, Longworth, a retired teacher and former charitable fundraiser, has suffered from rheumatoid arthritis for more than 40 years. “My feet are constantly changing because of the arthritis,” Longworth says. “All the tissue has been eaten away by the rheumatoid arthritis. The bones in my feet shift and move positions.”
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When ligaments in the feet spread out, feet can get not just wider, but also longer, Leahy says. “When you lose the integrity of the arch, the foot can widen out. As the arch goes down, it can cause an increase in the length of the foot.” Pregnant women are particularly prone to having their feet widen, Leahy says. During pregnancy, women’s bodies produce the hormone relaxin, which helps childbirth by relaxing ligaments in the pelvis and softening and widening the cervix. The hormone also causes foot ligaments to spread out, which can cause feet to widen and elongate, Leahy says.
Cobblers and shoe salespeople see the effects of feet becoming wider and longer in their businesses. Though he is not a medical professional, Nelson Ramos, 54, the owner of Corrective Shoe Repair in the District of Columbia, knows a fair amount about why some people outgrow their shoe size over time. As much as 10 percent of his business is from men and women whose feet have changed shape to the point their shoes no longer fit comfortably, Ramos says. Some of his clients are referrals from orthopedists, Ramos says. “[The orthopedists] tell us what the dilemma is.” In many cases, stretching a pair of shoes to make them wider will solve the problem, the cobbler says, adding, “We’re 90-percent effective.”
One recent day, three people went to Alamo Shoes in Chicago because their shoes had become too tight, says salesman Carlos Salas. “Three customers came in because their shoes no longer fit, and they had to go up from half a size to a full size,” Salas says. “It’s pretty common. On most days, one to five customers come in who need new shoes because their usual size no longer fits.”
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Conditions like diabetes can create other foot problems, says Dr. Andrew Shapiro, an orthopedist in Long Island, New York. For example, patients with diabetes could develop diabetic neuropathy, in which they lose sensation on the soles of their feet. That increases the chances of infection, because people with that condition could break the skin on the soles of their feet and not realize it. “I had a patient who walked a whole day with his eyeglasses in his shoe,” Shapiro says.
People can take a number of steps to lessen their foot pain or mitigate the effects of diabetes, arthritis and deteriorating ligaments, Leahy and Shapiro say. Here are five:
Do not minimize or ignore foot pain. Many people live with foot pain and do not seek medical attention until the discomfort is too great for them to endure, Leahy and Shapiro say. “Foot pain is never normal. If you have it, always see your podiatrist,” Leahy says. Shapiro adds: “Use your head when it comes to your feet. If you have pain, get it looked at right away.”
See your podiatrist if you notice a sudden loss of arch height. The collapse of one’s arches could signal a deterioration of ligaments. “Oftentimes, an outside support in the form of an orthotic or foot insert can help augment loosened ligaments and avoid spreading of the foot structure,” Leahy says. Orthotics, also known as inserts, can be used to replace the insoles that come with each pair of shoes. Podiatrists can create molds of a patient’s feet to produce custom-made insoles, which range from $200 to $800 a pair. Non-custom insoles range from about $20 to $180 a pair. These orthotics are typically sturdier than the insoles that come with a new pair of shoes or sneakers and provide additional arch support and padding for the soles of the feet.
[See: Got Diabetes? Why You Must Protect Your Feet.]
If shoes are not comfortable when you try them on, don’t buy them in the hopes you will break them in. A pair of shoes may look great, but if they do not fit correctly the first time you try them on, they won’t fit any better with time, Leahy says. When shopping for shoes, it’s best to try them on at the end of the day, when your feet are slightly swollen, Shapiro says. When purchasing shoes, “slightly loose is better than slightly tight,” he adds. Leahy agrees: “It is not a good idea to wear shoes that are painful from the start,” Leahy says. “The more steps you take, the more problems can develop.”
Monitor your feet for changes in nails, the loss of hair growth and numbness, burning or tingling in the feet. These can be the signs of a circulation problem, which could be symptoms of diabetes, Leahy says. People experiencing these changes should see a podiatrist for an assessment. People with diabetes who haven’t experienced foot issues can prevent them by taking their medications as directed by their doctor, maintaining regular checkups with their primary care doctor or podiatrist, keeping track of their blood glucose levels and eating a healthy, balanced diet, Leahy says.
Don’t feel you have to keep wearing the same shoe size you’ve used for years. Because of ligament deterioration, diabetes and arthritis, some people may go up a half shoe size every 10 years, Leahy says. “A lot of people feel they are married to their shoe size, and that’s problematical,” the podiatrist explains. “Even within the same brand, there can be inconsistencies in sizes.”
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Coping With the Changes Your Feet Undergo With Age originally appeared on usnews.com
