Solutions to Four Common Foot Problems

One surprise of aging: Your tootsies can feel the worse for wear. Here's how to deal with bunions, heel inflammation, hardening skin and nail fungus

by Emily Listfield
feet image
Photograph: Illustrated by Thomas Fuchs

At a recent wedding reception north of New York City, Laura R. began sharing war stories about her recent bunion surgery to remove the unsightly (and painful) bone that was bulging from the side of her foot. Whipping out her iPhone, she proudly showed off an “after” photo. As every woman at the table peppered her with questions, her husband of 21 years just laughed. “This is what it’s come to. You used to show pictures of your kids; now it’s your feet,” he said.

Almost every woman I know feels bad about her feet. Correction: Every woman I know has feet that feel bad. Really bad. I’m no exception: I have things wrong with my feet that I’d never heard of before. I haunt the foot section of the drugstore like a junkie looking for relief. I scout plus-size shoe stores even though the rest of me is not plus size. In all of this, I am rather typical. In a 2010 study by the American Podiatric Medical Association, 77 percent of adults said they had experienced a foot ailment.

The number may be even higher for women, especially as they get older. “Before 40, many women’s foot problems stem from overuse injuries or high-heel accidents,” says New York City podiatrist Johanna Youner. But after you hit 40, your feet start to pay the price for years of holding up your body. “As you age, the tendons and ligaments in your feet lose some of their elasticity, which makes your arches flatten and your feet and ankles stiffen. At the same time, your toenails tend to thicken and curl,” Youner notes. In some women, the fat pads that cushion the bottom of the feet start to thin, so walking becomes painful. (To relieve those symptoms, Youner sometimes injects the foot pads with Juvéderm, often used for filling out facial lines.)
Pregnancy can also change women’s feet. “There is some evidence that the hormones that allow the muscles to expand in the belly also relax the muscles in the feet, causing them to expand,” says Bob Baravarian, DPM, chief of podiatric foot and ankle surgery at Santa Monica/UCLA Medical Center and Orthopedic Hospital. Put everything together, and your feet can gain a half size every 10 years.

For a variety of reasons, women are more prone to foot issues than men are. There’s the pregnancy factor, as well as the greater innate laxity of women’s tendons and ligaments. But men are also much more likely to opt for, well, sensible shoes. “The more rigid the sole, the less strain on the foot, and men tend to wear flat shoes that have a lot of support built into them,” explains Baravarian. “Women who wear higher heels with pointier toes and thinner soles set themselves up for trouble.” Men also have genes on their side: Some foot issues are passed down disproportionately to women.

So are we destined to hobble into the golden years? Not necessarily. You can forestall trouble by choosing shoes that are easy on your feet for everyday use and saving the stilettos for special events. Another tack is to switch your workouts from activities that involve heavy pounding (such as running or jumping rope) to those that have little impact on your feet (such as swimming). But even if it’s too late for prevention, you still have options, because there have been significant advances in the treatment of problem feet. Here, four of the conditions that women suffer from most and the new fixes that can help.

Condition 1: Bunion
What it is: A protuberance caused by shifting of the first metatarsal (the big toe bone) toward the second toe.

Symptoms: A large bump on the big-toe side of your foot, reddened skin, swelling, pain while walking.

Causes: Bunions often result from a genetic predisposition, but you boost your chances of developing that big bump if you usually wear shoes that have a narrow toe box, says Baravarian. This kind of shoe creates pressure that can cause the first metatarsal to shift place.

First published in the September 2012 issue

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