Benefits of Physical Therapy for Senior Foot Health

Posted by Donna Mae Scheib on August 29, 2017

Benefits of Physical Therapy for Senior Foot Health

It is hard to imagine the total amount of miles one has walked by the age of 65. Our feet help us get from place to place and take on the enormous responsibility of supporting our entire bodies. The intricate design of our feet is comprised of many smaller bones, joints, and tendons that can be susceptible to injury, especially as we age. However, living with foot pain is not something seniors should just accept.  Senior Living Link had the chance to discuss expert advice and benefits of physical therapy with Nicole Weinhold, a licensed physical therapist that has over sixteen years of experience. She holds the credentials of sports certified specialist and has currently been practicing as a physical therapist for the past six years at Foot & Ankle Specialists, a podiatry specialty clinic located in the Omaha, Nebraska metropolitan area.

What are the most common foot injuries you see in patients aged 65+ ?

Nicole Weinhold, PT, CSC : Many foot problems seen in older populations commonly have begun at a much younger age.  I would say the most common types of foot injuries in older people are foot deformities such as hammertoes and bunions.  These injuries can become more painful with time and generally result from abnormal alignment, poor support, weakness, or instability.  Over time, these problems may lead to these types of foot deformities, which eventually may lead to arthritic changes and subsequent pain.  

Also, arthritis is always a concern in older populations. This is commonly again contributed by weakness, instability, or in general, poor alignment that leads to wear and tear of the feet, and eventually causes pain over time.

Fractures can be another concern, as we get older.  Eyesight and general balance capabilities decline, leading to the potential for falls. Fractures are much more common in older populations due to a decrease in bone density.

Other common foot injuries that are seen alongside these in large numbers of frequency in the general population include tendinitis and plantar fasciitis. Again, all of these common foot injuries are often due to poor alignment, weakness, or inflexibility, which all usually become increasingly more frequent problems as we age.

Why do these injuries often occur?  

Nicole Weinhold, PT, CSC: Adding to what I have stated above about these common foot injuries, I would say that in general wear and tear of our feet is always a huge factor. Then, when alignment is bad and muscle control is poor, the injury will continue to be aggravated. Usually strength and balance also decline with age making these types of injuries more prevalent.   

What are common therapeutic practices for these injuries?

Nicole Weinhold, PT, CSC: While there is a variety of therapeutic practices for any bodily injury including foot injuries, as a practicing physical therapist, I recommend physical therapy as a first choice!

• In the case of foot deformities mentioned above like bunions, hammertoes, or other deformities, you can sometimes pad the area, or support the area to help with pain, but once the deformity has become fixed, often surgery is the only true fix.  Following surgery with therapy will help with a multitude of things include improving range of motion, restoring normal gait  (your walking pattern), and improving strength and balance!
• For arthritis, bracing and support are often helpful.  Anti-inflammatory medications, icing, and pain relieving creams are common.  Physical therapy can help to improve flexibility, strength, and balance.  Any time you improve the muscle control around a joint, the less stress is transmitted to the joint – thereby reducing chance of joint related pain.
• Treatment for fractures is usually immobilization for a while – and sometimes surgery depending on the type and location of fracture.  Physical therapy is always needed after, again to restore appropriate gait, balance, strength, and prevent future falls.
• Tendinitis and plantar fasciitis are also treated with a variety of methods – arch support is key.  Anti-inflammatory medicines are common which sometimes comes in the form of injections. Physical therapy can help with flexibility and strength issues, and often work on soft tissue healing.

Do you consider stretching and exercise to be important for seniors?

Nicole Weinhold, PT, CSC: I am a huge advocate of stretching and exercise in general, and it is so important for seniors! As we age, connective tissue naturally loses it collagen and other elastic principles, so flexibility naturally starts to become an issue.  Also, flexibility is greatly tied to activity and how aggressively we move our bodies. These types of activities for the most part decrease as we age. Therefore, we become less flexible and are more prone to several of the injuries discussed in this article.

The big question becomes HOW to stretch. There is no way to just do normal stretches for every muscle group and hope to really hit them all.  It’s an unrealistic goal that would take seemingly forever to incorporate into a daily living schedule. This is where yoga, tai chi, or even group exercise such as water aerobics, jazzercise, and etc. are great for older populations because it tends to move the body through greater ranges of motions which will help to maintain flexibility, while also working the cardiovascular system (to get that blood pumping!) and strengthening your body at the same time.

What are some preventative measures for seniors to avoid falls from a physical therapy perspective?

Nicole Weinhold, PT, CSC: Although seniors and falling is such a huge topic, some mechanical advice, such as how to move your body would include:

• Plan ahead and go slowly
• Make sure you have your feet under you and a support surface near
• Don’t change directions too quickly
• Don’t try to carry a bunch of things with both hands if you typically need support for balance
• Make sure that you square your body up before moving, especially when moving from a bed or from the car
• Get rid of loose objects such as rugs in your common living spaces and frequent walkways
• Have a hand rail available on all stairs
• Be sure to safely keep doing the stairs (with assistance if necessary) and other physical things that may seem to be getting more difficult because with age, you use it or you lose it
• From a physical therapy standpoint, make sure to keep your body moving by safely approaching challenging situations as much as you can, so you are able to handle daily living situations more easily

What are some benefits of going to physical therapy for foot injuries?

Nicole Weinhold, PT, CSC: Almost any foot or ankle problem is going to be somehow tied back to mechanical deficits. Medical treatment can treat the symptoms, and surgery can sometimes fix the alignment issues, but nothing can replace rehab for fixing the true root cause  (the weakness, the instability, the inflexibility) that caused the problem.

Another example would be finding the cause of your weight bearing compensation (so the abnormal walking that has developed because your toe was painful, you began to change the way you walk to avoid the pain ), or the weakness that developed while you were resting your fracture from injury and surgery. There are few injuries (other than an ingrown toenail) that would not benefit from some rehabilitation.

If nothing else, you would learn more about your body and how you might not be functioning at your best. Physical therapy can give you tips and tricks to better take care of your body and help increase your chances of preventing further injuries.