STAGES OF LIFE

As we grow from infant to adolescent to senior citizen, our bodies change and develop. We all know that. But while we are busy growing, one part of the body, often gets neglected: the feet. Yet our feet are so vitally important to our overall health and well-being. Here are some ways you can keep your feet healthy, throughout each stage of life.

Pediatric  I  Adolescent   I   Pregnancy  I   Older Adult

Infants are born flatfooted, primarily because their feet are composed of fat and cartilage. Adipose, or baby fat, is abundant within the pediatric foot, making it broader and more square-shaped than the adult foot.

Foot shape changes as infants grow. Baby fat dissipates and the foot becomes more contoured. Arches form, cartilage turns to bone, and the foot takes on a more mature appearance.

Most foot growth and change takes place during the first six years of development, with maturity being achieved after puberty. The rate of growth is sporadic and determined by genetic and developmental factors, such as bone structure, support, and strength. Activity is also a factor: a healthy amount of exercise at all stages of childhood helps ensure proper strength of the foot and ankle.

The average age at which a child begins to walk is twelve months. At first, children walk on their toes (forefoot) but by 18-24 months most have developed the natural heel strike, mid-stance, and toe-off-motion, or gait. The medial (inside) arch develops during the first decade of life.

Why is Footwear Important at the Pediatric Stage?

Until a child begins to walk, all footwear really provides is warmth and protection. After your child begins to take his/her first steps, footwear becomes very important. Shoes should have enough toe room, along with a flexible outsole to allow the toes to continue to grip and the foot to flex naturally. As the toddler's foot begins to develop arches, a supportive and flexible footbed encourages the foot to move and develop, while protecting the foot from the hard surfaces we all walk on.

Caring for Little Feet.

Birkenstock footwear has an oblique toe, which helps support the wider, more square pediatric foot. It also gives the forefoot enough room to accommodate the chubbier pediatric foot. The deep heel cup cradles the heel, encouraging the correct alignment of the ankle joint, which is imperative for the development of foot strength.

The contoured arches provide proper support for the foot, helping to ensure development of strong feet and arches, which create good balance.
Your child's feet grow quickly so it's very important to regularly check to see if they are outgrowing their shoes. From birth to about three years old, expect to buy a new pair at least every two to three months. From three years on, you may be buying new shoes every four to six months. Toddlers will likely not be able to tell you that their shoes are too tight, so check often. If your toddler is always taking off his shoes, or if she is tripping, it may mean that it's time to check the shoe size.

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Adolescent Foot Development

It takes nearly 20 years for the foot to develop fully. During this time, cartilage turns into bone, arches take form, and muscles and tendons begin to strengthen. All of these changes enable the foot to become the dynamic foundation of the body.

What are Growth Plates?

Growth plates are the area of growing tissue near the end of bones in children and adolescents. This is where cartilage is maturing into bone. Each long bone (leg or arm bones) has at least two growth plates: one at each end.

The growth plate determines the future length and shape of the mature bone. When growth is complete—sometime during adolescence—the growth plates close and are replaced by solid bone. These regions of the body often have tendons and ligaments closely connected to them. If a growth plate is injured or damaged, growth can be disturbed.

An injury that would cause a sprain in an adult can be associated with a growth plate injury in a child. Growth plate injury can be caused by falls, direct trauma, or overuse.
Ensuring proper foot health in children helps these growth plates to mature as intended.

Overuse Injuries:

Sever's Disease

Sever's Disease is an inflammatory condition of the growth plate of the heel and is seen during periods of active bone growth, such as the early adolescent (10-14) years. Complaints of heel pain in adolescents are often actually Sever's Disease. The cause is usually lack of support and too much movement of the growth plate in the heel. Boys tend to get Sever's Disease twice as often as girls, particularly boys that are overweight.
The most common symptom is pain felt at the back and side of the heel bone. Sometimes there may be pain at the bottom of the heel. Squeezing the sides of the heel bone is often painful. One or both heels can be affected. Your child may even be limping.

With Sever's Disease, the heel becomes painful during activity; the pain is usually relieved when your child is not active. Running and jumping make the symptoms worse.

Proper treatment of Sever's Disease is very important. A cushioning heel lift, icing, and calf stretches are often prescribed. Athletic activities should be reduced until symptoms subside.

Raising the heel relieves the tension that the calf muscle puts on the heel bone. Using an ice pack after activity for twenty minutes is often helpful (repeat two to three times a day). Stretching the calf muscles five to six times a day for 60 seconds each is also beneficial. To stretch these muscles: stand about a foot away from a wall, bend one knee, and lean the body toward the wall with the back straight.

Achilles Tendonitis
Achilles tendonitis is seen more often in children over the age of 14 years old. It is characterized by pain with activity, particularly jumping sports. Rest, activity modification, a stretching program, icing, and the use of an anti inflammatory medication will usually promote healing and the ability to return to sports.

Stress Fractures
Stress fractures involving the metatarsals (the bones in the mid part of the foot) are caused by repeated trauma. Sudden changes in training intensity "too much, too soon, too fast" is a classic cause. Stopping the activity that is causing the problem is the first step. Apply an ice pack and elevate the foot above the level of the heart. Try not to put weight on the foot until after your child has been seen by a doctor. If the activity continues prior to healing, a stress fracture could become a real fracture.

Why is Proper Footwear Critical for Your Adolescent?
More and more evidence points to proper footwear as being an important factor in helping to prevent damage to bones and cartilage by ensuring the normal lines of stress across bone surfaces. This is key because imbalances in muscle groups can cause deviations in bone structure. Growth plates need to be protected, supported, and strengthened as cartilage matures into bone. Birkenstock footwear can help prevent problems because the cork footbed provides excellent support and protection for growing adolescent feet.

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There are many changes that occur throughout your body during pregnancy, and your feet are not excluded. Your entire body must create these changes to accommodate the growing baby (or babies) so that there can be healthy development.
The pregnant body releases a specific hormone that actually increases the amount of laxity within the ligaments of the body. The mother's musculoskeletal system (bones, muscles, tendons, and ligaments) makes significant adjustments for the increased weight and laxity that occurs. As a result of these changes, the pregnant body moves much differently than the non-pregnant body. Some parts of your body, such as the feet, may change permanently.
During pregnancy, the increasing weight of the baby places more stress on the mother's musculoskeletal system. The term pronation refers to the arch collapsing and the lower leg rotating inward. This is a normal part of walking. Oftentimes in pregnancy, as a result of weight gain, the arch of the foot will lessen and can begin to collapse, causing increased pronation while walking. This can create extreme stress or inflammation on the plantar fascia (the fibrous band of tissue that runs from the heel to the forefoot). It can also make walking very uncomfortable.

Many women may also experience edema (swelling), leg cramping, and varicose veins due to weight gain. The enlarging uterus puts pressure on the blood vessels in the pelvis and legs, causing circulation to slow down and blood to pool in the lower extremities, resulting in edema.

Tips for a Healthy Pregnancy.

The following tips can often help with edema, leg cramping, and varicose veins:

• Drink plenty of water to keep your body hydrated. This helps you retain less fluid.
• Eat a well-balanced diet and avoid foods high in salt, which can cause water retention.
• Elevate your feet as often as possible. If you have to sit for long periods of time, place your feet on a small stool.
• Maintain a moderate exercise program: walking, swimming, and riding a stationary bicycle are all good places to start.
• If you are driving or flying for a long period of time, take regular breaks to stretch your legs to promote circulation. Be sure to take breaks at least every hour and a half to stretch and walk around.
• Wearing maternity support panty hose, which compress the veins to keep your blood flowing, can help relieve the swelling and aching in your legs.
• Wear seamless socks that do not constrict circulation.
• Have your feet measured several times throughout your pregnancy. They will probably change sizes.

Wear proper fitting footwear. Since your feet will probably swell, wear comfortable shoes with expandable elastic panels or adjustable straps. Footwear that is too narrow or short will constrict circulation.

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By 2030, there will be almost 70 million Americans older than 65. And people over 85 years old are expected to be the fastest growing segment. As we are all getting older, how can we maintain the best health possible in our senior years?

There is substantial evidence that many health problems faced by older Americans are directly related to a decline in physical activity. In fact, recent research has shown that the elderly can improve both strength and physical capabilities through activity.

Sedentary older adults undergo more significant changes in body composition and a decline in functional capacity compared to their peers who remain active. However, many of the changes that occur with aging can be limited, prevented, or even reversed through sustained physical activity and exercise training.

What are the Musculoskeletal changes that occur?
• Decrease in muscle mass (20-40 percent over time).
• Decrease in bone mass and tensile strength of tendons and ligaments.
• Increased stiffness of muscles, tendons, and ligaments.
• Weakness of cartilage.

How do Older Feet Change?
Older feet naturally develop more problems because the skin tends to thin and lose its elasticity. Healing can take longer, and wear and tear to the joints over the years may have caused some degree of arthritis. (can we hyperlink to arthritis article here?)
But painful and uncomfortable feet aren't a natural part of growing old or something that you have to put up with. A lot can be done to improve comfort, relieve pain, and maintain your mobility.

How to Keep Older Feet Healthy.

Develop a daily foot care routine:

• Wash your feet daily in warm, not hot water.
• Dry carefully and apply lotion to your feet, except between the toes.
• Inspect your feet daily for redness, swelling, hot or cold areas, and sores that aren't healing. If you notice any of these conditions, see your health care provider.
• Keep your feet warm:
  • Exercise is the best way. Warm stockings or socks can also help. Avoid anything too tight that can restrict your circulation or cramp your toes.
  • If your feet are cold at night, wear socks.

Start an exercise program:
 

• Endurance
  • Build up your endurance gradually, with the goal of 30 minutes of endurance exercise at least four times a week.
  • You should be able to carry on a conversation while you exercise.
• Strength
  • Lift or push weights gradually, increasing the amount of weight and repetitions.
  • Do strengthening exercises at least twice a week. Don't work the same muscle group two days in a row.
• Balance
  • Strength exercises will also help with balance.
• Flexibility
  • Stretch after your regular strength and endurance exercises.
  • Do each stretch 3-5 times and hold for 10-30 seconds.

Choose the right footwear:

• The older you get, the more you need a shoe that holds your foot firmly in place to give adequate support. Throw out any shoe that fits loosely, as they won't give you enough stability when you walk.
• Look for shoes with uppers made of soft leather. Avoid uppers that don't allow the foot to breathe and won't stretch to accommodate your own foot shape.
• Select footwear that is wide enough not to cramp your toes. Feet tend to lengthen and widen as we age. You probably should be wearing a different shoe size today than what you wore at 40 years old.
• Select shoes that have shock absorbing soles to give you extra comfort while walking. When buying shoes, make sure that you can put them on and off easily. Check that the heel is held snugly in place. Laced or velcro fastening footwear will give more support and comfort than a slip-on.

For more information on exercise programs for older adults, check out Exercise: A Guide from the National Institute on Aging. This exercise guide can be downloaded for free at the following address.

http://www.niapublications.org/

Additional information on the aging process is available from the National Institute for Aging at the following address:

www.nih.gov/nia/healthinformation

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