We need to talk about....feet

For a long time I didn't get why older women were forever groaning about their feet and saying they could no longer wear high heels.
Surely, I rationalized, feet are our one true friend in that they stay the same size all our lives?
Well, I've been boning up on feet (sorry!) and it seems my ideas were all wrong.
Firstly, your feet probably will change size.  As we get older, our feet get flatter. The connective tissues called ligaments can stretch out over time, leaving our arches aching and our feet flattening, You may find you go up a size. My mum was shocked when I suggested she buy a larger size, but she was glad she did.

Then there's the fat cushions. The fat cushions on our feet start to disappear because of decreasing collagen production. So although our feet may feel fine in the morning, they're likely to be painful in the afternoon because we're effectively standing on bone. Ouch.

Arthritis can strike. It most commonly strikes the big toe or the mid foot joints on the top of our feet. Besides pain, there might be stiffness in the morning that improves once we get moving, then worsens again at night. Shoe inserts, exercises to increase range of motion, and losing weight if you need to may help.

It gets worse. Years of squeezing feet into pointed shoes, or shoes that are too small, may result in clawed toes, "hammertoes." To prevent—and ease—hammertoes, cover corns and calluses with padding and trade in your pointy-toed pumps for shoes with wider toe boxes.

Tendons can tighten with age which also affects our feet. The water content in our tendons declines with age, stiffening the cords in our ankles, among other places. Not only can this interfere with Downward Dog, it also places us at greater risk for tears and ruptures.

The curse of bunions

Finally in this litany of woe, you might start to see signs of bunions appearing - particularly if one of your parents had them. This is a particular horror to me because my mother has "final stage" bunions where all the toes fan out in the wrong direction. As a consequence, she has to wear those velco sandals because normal shoes, even those in the wide ranges, don't fit.

A bunion is a bony deformity of the joint at the base of the big toe. The medical name is hallux valgus. The main sign of a bunion is the big toe pointing towards the other toes on the same foot, which may force the foot bone attached to it (the first metatarsal) to stick outwards.

It seems there isn't much we can do to prevent bunions. Shoes with narrow toes can trigger a bunion, but they're not the underlying cause. Bunions run in families, because foot type (shape and structure) is hereditary, and some types are more prone to bunions than others. Low arches, flat feet, and loose joints and tendons all increase the risk.

Non-surgical treatments are usually tried first, including painkillers, orthotics (insoles) and bunion pads. However, these can only help to reduce the symptoms of bunions, such as pain. They don't improve the appearance of your foot.

Surgery may be considered if your symptoms are severe and don't respond to non-surgical treatments. The type of surgery will depend on the level of deformity, the severity of your symptoms, your age, and any other associated medical conditions.

Great, huh?

What are the best shoes to wear?

Now I've never really worn very high heels because I could never walk in them. I've gravitated towards mid-height block heels or wedges, and occasionally flat shoes.  But flat shoes are not necessarily a great choice, particularly if they're ballet flats or flip flops. There's no arch support whatsoever, which keeps the feet from functioning optimally. Ballet flats can lead to knee, hip, and back problems. Poor arch support is also associated with a painful foot condition called plantar fasciitis. However, if you love ballet flats, over-the-counter inserts may help prevent mild foot pain. Heel pads can provide extra cushioning for achy heels.

Flip flops are a bad choice for feet: the risk of getting splinters or other foot injuries is higher when the feet are so exposed. People with diabetes should not wear flip-flops, because simple cuts and scrapes can lead to serious complications. In addition, many flip-flops provide no arch support. So wear them on the beach by all means, but when you're on holiday try not to wear them all the time. A better choice is shoes like Fit Flops: sporty, fitted sandals and other "toning shoes" designed for a more intense workout while walking.

I've been looking with interest at a range called Yoga Sandals, which have separators for each toe and according to converts can arrest bunions in their tracks. Unfortunately they have to be shipped from the US: I couldn't find any in the UK except sandals in size large. They come in several colours: mint green below.

What about other exercise sandals like Dr Scholl and Birkenstocks? "Exercise sandals are no bad thing," according to reflexologist and chiropodist Ruth Hawe, "I'm really pleased to see women wearing more foot-friendly and foot-shaped shoes, because fashion shoes with heels restrict the activity of the muscles, tendons and ligaments in the feet and legs, tightening and shortening them," she says.

Some retailers have ranges of shoes with technology that's intended to make them more comfortable. Marks and Spencer have shoes with Insolia® which reduces pressure on our feet to ensure we stay stylishly on our feet all day long. I don't think I've ever tried these so would be interested to hear your thoughts - do they work?

One thing I have tried is the gel insoles you can get from Dr Scholl and Boots. These help relieve pressure on your soles when wearing high heels for a special occasion. I didn't find them one iota of benefit and they had a nasty habit of working loose and exposing themselves!

Make the best of the feet you've got

So now you're thoroughly depressed at where your feet are headed. Give them some kindness. Make the best of the feet you've got. I don't wear nail polish in the winter because it gives my nails chance to recover from the impact of wearing it all summer  (sorry yoga colleagues!). I also quickly rub on some Boots Foot Cream every day, and occasionally slough off any rough skin. This way your feet will always be moisturized and you'll avoid the dreadful scaly ankles which we see on ladies with sandals in the summer. Desperate cases should try a product from Footner (at Boots) which has your skin flaking off in spectacular fashion a week after you apply it.

A pedicure is always a treat, particularly when the feet are popped into heated bootees. Keep up the good work by using an orange stick occasionally to gently push back the cuticles on your nails, and keep your nail polish fresh. There's nothing worse than disappearing nail polish applied a couple of months ago.

Finally, don't forget to exercise your feet - and I don't just mean with walking. My yoga teacher is excellent at incorporating foot exercises into our classes. It really helps. Here's a quick workout you can do when you're on the phone or watching TV:

Circle your feet. Rotate your ankles ten times in each direction.
Flex your feet by pointing your toes up and down 10 times.
Roll your feet heel-to-toe against the floor 10 times each.
Massage the arches by rolling a tennis ball underfoot while seated.
Push the fingers through the gap next to each toe, and bend the toes backwards and forwards.

My feet - circa 2007 in Cyprus!

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