With winter weather in mind, an unfortunate fact is that as we get older the risk of falls increases.
Falls and fall related injuries are a common problem as we age. People aged 65 and older have the highest risk of falling, with 30% of people older than 65 and 50% of people older than 80 falling at least once a year. Falls cost the NHS approximately £2.3 billion per year.
It has become more evident through recent research that multifaceted podiatry interventions can be effective in reducing falls. A recent study reported a 36% reduction in falls in those that received regular podiatry interventions such as routine footcare, strengthening exercises, insoles, and footwear advice.
Reasons for falling
People may fall for many different reasons. Falling should never be ignored nor should it be regarded as a normal part of ageing. Some possible reasons for falls are listed below:
LOW BLOOD PRESSURE
MEDICATIONS – MUTIPLE
Many of the above reasons can be addressed by your GP.
It is estimated that up to 80% of the elderly have a foot or leg problem affecting mobility and balance thus increasing the risk of falls. Podiatry has an important role to play in falls prevention by diagnosing podiatry related risk factors which could contribute to falls.
Podiatry related risk factors
There are many different types of foot problems that can contribute as podiatry related risk factors. There are 4 main categories:
GENERAL PODIATRY bunions, toe nail deformities, corns/callous over metatarsal heads and toes.
MUSCOSKELETAL PROBLEMS changes in foot shape and toe position, decreased muscle strength, limited joint flexibility in hip, knee and ankle, poor foot clearance when walking.
NEURO MUSCULAR PROBLEMS peripheral neuropathy in diabetes reduces distal proprioception, osteoarthritis changes and limits joint function and proprioception.
FOOTWEAR RISK FACTORS poorly fitting footwear affects posture, balance and stability, restrictions in joint flexibility.
What can a podiatrist do to help reduce falls?
Diagnose and treat foot problems such as lesions that cause pain and affect gait and balance.
Undertake a vascular/neurological assessment of muscle function and structural function of the leg, foot and ankle. Diagnosing risk factors.
Treat functional problems that cause falls.
Provide insoles to reduce pain and aid stability by supporting the foot. Advice on exercise programmes.
Provide foot health education for patient and carers.
Advise on appropriate footwear styles that prevent falls.
Refer to other professional for specialist intervention.
Practical advice when purchasing footwear
Wearing the correct footwear is one of the easiest ways to reduce your risk of falling. An ideal shoe should have the following;
Wide, deep toe box allowing room for toe movement and comfort.
Closed in padding heel counter providing support when walking.
Adequate length, width and depth.
Soft, flexible, breathable upper and lining.
Smooth internal seams and sock absorbing sole to cushion the foot.
Laces, buckles or Velcro fastenings to hold the foot firmly.
Lightweight, flexible and slip resistant sole.
Low, broad heel with round edges which provides more contact with the ground and prevents slips.
Your podiatrist can provide advice and details of local recommended stockists.
In summary, falls prevention is possible through proper care of your feet and regular consultation with a podiatrist who will assess your risk of a fall and treat any conditions in your feet to reduce your overall risk of falls.