The Role Of Orthopedic Shoes In Fall Prevention Strategies

Fall Prevention
If the risk of falling is a consideration for you or a loved one then the role of orthopedic shoes in an effective fall-prevention strategy is an important one.

Each year 350,000 Americans fall and break a hip. Unfortunately roughly 20% of those that break a hip do not recover sufficiently to walk again.

The three primary risk factors for falling are;
a) poor balance
b) taking four or more prescription medicines
c) and muscle weakness.

Elderly people without these risk factors have a 12% chance of falling in a year, but those with all three have almost a 100% chance.

Often it’s difficult to discern if you or a loved one is at risk for a fall. The potential faller may walk without a walker or a cane and be very active. However an examination of their feet may well shed some insight to some prevailing risk factors. These could include swollen feet, unclipped toe nails, calluses, sores in between toes, hammertoes, bunions, heel pain, corns, arthritis – all of which can lead to a compromised gait which in turn affects balance.

As we all know, a common side effect of many medications is dizziness. Blood pressure meds may include diuretics where dehydration can also include dizziness.

So what design features should you look for in geriatric footwear?

i) Comfort
Shoes protect the feet from trauma which can often lead to a prolonged rehab where the ability to walk is affected. Once ambulation is affected muscle strength deteriorates and the risk of fall increases. So probably the most important key consideration is comfort. If the person’s shoes are not comfortable they won’t wear them, increasing the likelihood of foot injury.

ii) Lightweight and Easy to put on and take off A big clunky heavy shoe not only affects gait it also tires the legs out. Velcro closures with an adjustable strap are often preferred as it makes it easier for wearers with limited ability to reach their shoes and they can use an extended arm grip if necessary. Shoes that open up to make it easy to place the foot on the foot-bed are preferred especially where edema or even lymphedema is present.

iii) Delayed heel-strike and toe-spring Geriatric footwear should have soling designed to minimize the risk of stumbling and tripping. Often when gait in seniors begins to be compromised it’s important that neither the heel strikes prematurely nor the toe box grips on surfaces like carpet. Look for a rocker heel and toe spring front and back of the shoe.

iv) AccommodationToe deformities are common, especially in females, and necessitate the need for plenty of depth in the toe box to accommodate overlapping toes and  hammer toes. Material components in the forefoot of the shoe that can stretch and mold can provide relief from bunions, overlapping toes, hammertoes, rheumatoid arthritis and hallux valugus.

v) Affordability Budget is a major factor to consider. The majority of seniors are on a fixed budget. Under certain qualifying conditions Medicare covers shoes and inserts for diabetics, but unfortunately there is no coverage for people with lymphedema for example.

vi) Aesthetics Beauty is in the eye of the beholder. By design, accommodative footwear may not be the most attractive looking footwear but function should always be paramount rather than fashion when considering appropriate orthopedic footwear for seniors.