Fall Prevention: Out with the Old Shoes, Old Habits

Monday, June 20, 2011

ROCHESTER, Minn. — The right choice of indoor and outdoor shoes can help keep older adults on their feet, according to the June issue of Mayo Clinic Health Letter. Surveys show that old shoes and old habits can contribute to falls in older adults.

Older adults who wear athletic shoes around the house are much less likely to fall than those who go barefoot, wear socks alone or wear slippers. Outside of the home, older adults often opt for slip-on shoes without snug fasteners or laces. Lace-up or strap-on shoes with a snug fit offer the most support.

Surveys have shown that older adults often wear shoes that are worn out and have lost their cushioning or even have flopping parts. Or, some people persist in wearing shoes that are too small or narrow. Feet tend to elongate with age, and a bigger shoe size may be necessary. Poor-fitting or worn-out shoes increase the risk of falls and can contribute to foot problems such as bunions, corns, or pain under the base of the toe joints (metatarsalgia).

Older adults have many shoe choices, including the traditional rocker bottom shoes with a mostly flat sole and upward curve at the toes. There are many newer trends, including double rocker bottom shoes, foot gloves and shoes with negative heels.

Double rocker bottom shoes feature a sole that curves up at the toes and the heel. The sole looks like the bottom of a rocking chair. They can be effective for people with a fused ankle joint or advanced arthritis of the foot or ankle. Mayo Clinic doctors urge caution with this choice, as they require a level of balance that many older adults don't have, increasing the risk of falling.

Foot gloves fit the foot like a glove and imitate aspects of going barefoot, but with protection from stepping on sharp objects. Originally designed for runners, they are increasingly popular for casual or around-the-house wear. Again, Mayo Clinic doctors urge caution for older adults. Natural foot cushioning diminishes with age, and it's possible these products could raise the risk of injury in older adults.

Negative heels feature a heel lower than the toe box. For most people, this shoe design stretches the Achilles tendon more than normal with every step, potentially leading to discomfort and injury. Mayo Clinic doctors say the risk of injury from a negative heel shoe outweighs any potential benefits.

Good shoes that fit well aren't the only factor in preventing falls, but selecting the right footwear can make a difference.

Mayo Clinic Health Letter is an eight-page monthly newsletter of reliable, accurate and practical information on today's health and medical news. To subscribe, please call 800-333-9037 (toll-free), extension 9771, or visit Mayo Clinic Health Letter Online.

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