Your Feet at 60, 70, and Beyond: What Changes and What You Can Do About It

There's a quiet assumption that runs through medicine - and through society in general - that sore, tired, aching feet are simply what happens when you get older. You've walked a million steps. Things wear out. That's life.

Here's what a podiatrist will tell you: that assumption is wrong, and it costs people years of comfortable, active living.

Foot pain is extraordinarily common in older adults - studies suggest more than 75% of people over 65 report at least one significant foot problem. But common is not the same as inevitable. Most of what makes older feet hurt is specific, identifiable, and - with the right care - treatable. This guide is about understanding what's actually happening in your feet as you age, and what you can realistically do about it.

What Aging Actually Does to Your Feet

The changes are gradual and tend to arrive in stages, which is part of why people miss them. There's no single morning where everything shifts. Instead, a slow accumulation of small biological changes eventually adds up to something that feels very different from the feet you had at 40.

The Fat Pads Thin Out

One of the most underappreciated changes in the aging foot is the atrophy of the fat pads beneath the heel and the ball of the foot. When you're young, these pads are thick, well-hydrated, and serve as natural shock absorbers - the engineering equivalent of high-quality running shoe cushioning built right into your anatomy. By the time most people reach their 60s and 70s, those pads have thinned considerably.

The result: every step on a hard floor transmits more force directly to bone and joint than it used to. People describe it as feeling like they're walking on rocks, or like the padding has been removed from the bottom of their shoes. Which is, in a very literal anatomical sense, exactly what has happened.

Custom orthotics and accommodative insoles can restore much of that lost cushioning - but only if someone has told you that fat pad atrophy is the source of your pain. Many older adults have been walking on this condition for years without a name for it.

The Skin Becomes Vulnerable

Skin throughout the body thins with age as collagen production slows and the epidermis loses elasticity. On the feet - which face constant mechanical stress, friction, and moisture - this creates a particularly challenging environment. Thin skin tears more easily, heals more slowly, and loses much of its ability to redistribute pressure. Small wounds that would have healed in days for a younger person can linger for weeks in older skin.

At the same time, the skin becomes drier. Sebaceous (oil) glands and sweat glands in the feet reduce their output, leaving the skin without its natural protective moisture barrier. The result is cracking - especially around the heels. Those cracks, called heel fissures, are more than uncomfortable. In people with diabetes or poor circulation, a deep heel fissure can become a portal for infection.

Simple interventions help enormously: daily moisturizing with a urea-based cream (not between the toes, where trapped moisture causes problems), wearing moisture-wicking socks, and scheduling regular podiatric skin care.

Circulation Slows

The feet are the farthest point from the heart, and age brings changes to blood vessels that make the journey harder. Arterial walls stiffen and narrow, reducing the volume of oxygen-rich blood reaching the foot. Peripheral arterial disease (PAD) - the buildup of plaque in the arteries of the legs and feet - becomes substantially more common after age 60, particularly in people who have ever smoked, have diabetes, or have high blood pressure or cholesterol.

Poor circulation has consequences that extend well beyond cold feet. Tissues that don't receive adequate blood supply are slow to heal. Infections that would be minor in a well-vascularized foot can escalate quickly when circulation is compromised. And because the nerves also depend on healthy blood supply, circulatory problems and neuropathy often develop in tandem.

Signs of circulation concerns to watch for: legs or feet that are consistently cold, a pale or dusky color to the skin, slow-healing cuts or blisters, hair loss on the lower leg, or a cramping pain in the calf when walking that resolves with rest (called claudication).

Nerves Become Less Reliable

Peripheral neuropathy - damage to or deterioration of the peripheral nerves - affects approximately one in four adults over 65. Diabetes is the most common cause, but neuropathy also stems from vitamin B12 deficiency, hypothyroidism, alcohol use, certain medications (including some chemotherapy agents), and the simple process of aging itself.

The danger of neuropathy in the foot is not the numbness itself - it's what the numbness allows. A small pebble in a shoe, a blister from a new pair of shoes, an ingrown toenail rubbing against the neighboring toe: any of these would send an immediate pain signal to a person with intact sensation, prompting quick action. In a foot with neuropathy, the signal is absent or severely muted. The wound worsens silently, sometimes for days, before it's noticed visually.

For people with diabetes especially, this combination - neuropathy, poor circulation, slow healing - is the pathway that leads to diabetic foot ulcers and, in serious cases, amputation. Early detection of neuropathy through simple in-office sensation testing, and regular professional foot monitoring, is how that pathway gets interrupted.

Joints Accumulate Decades of Wear

The foot contains 26 bones, 33 joints, and over 100 tendons, ligaments, and muscles. All of them have been in continuous mechanical service for six or seven decades by the time a person reaches their late 60s. The cartilage that cushions the joints thins. The ligaments that stabilize them stretch and loosen. The tendons that power movement become stiffer, less elastic, and more prone to inflammation.

Osteoarthritis of the foot and ankle is common and often underdiagnosed. People attribute stiffness and aching to "old age" rather than to a specific joint condition that can be treated. The big toe joint is particularly vulnerable - a condition called hallux rigidus (limited big toe motion due to arthritis) is among the most frequent sources of gait-altering foot pain in older adults.

The Nail Problem Nobody Talks About

Toenail care becomes genuinely medically complex in older age, and yet it rarely gets the attention it deserves in primary care settings.

As circulation diminishes, nail growth slows and nail plate quality changes. Nails become thicker, more brittle, more opaque, and often yellowish. Fungal infections (onychomycosis) are extremely common in older adults - prevalence rates in people over 70 approach 50% in some studies - and they compound the problem, making nails even thicker, more distorted, and harder to trim safely.

For a healthy 30-year-old, thick toenails are mainly a cosmetic nuisance. For an older adult - particularly one with diabetes, neuropathy, or peripheral arterial disease - a severely thickened toenail can generate enough chronic pressure on the nail bed to cause a wound. Improperly trimmed nails can ingrow and create an entry point for infection. These are not hypothetical risks. They are the precursors of serious complications that podiatrists see and treat regularly.

Safe, professional nail care every 8 to 12 weeks is one of the highest-value preventive health measures available to older adults. It is not a luxury. It is the maintenance that keeps feet safe.

Footwear: The Most Powerful Tool You Have

If you could change one thing about the way an older person interacts with their feet, and that change would simultaneously reduce fall risk, prevent ulcers, reduce joint pain, and extend independent mobility - that thing would be footwear.

What makes a shoe appropriate for an aging foot?

• Adequate width: Feet spread and widen with age. Shoes that fit at 40 are often too narrow at 70. A shoe that compresses the forefoot increases pressure on bunions, hammertoes, and the ball of the foot.
• A firm, supportive sole: Thin, flexible soles offer no shock absorption. Older feet need a sole with meaningful cushion and some rigidity to support weakened foot muscles.
• A closed, protective toe box: Sandals and open-toed shoes - popular for comfort in older adults - leave the foot exposed to bumps, drops, and abrasions that can become serious wounds in high-risk patients.
• Low heel with good traction: High heels shift weight to the already-strained ball of the foot and dramatically increase fall risk. A low, wide heel with a non-slip sole is ideal.
• A secure fastening system: Laces, velcro, or straps that allow the shoe to be snugged to the foot - not a slip-on that allows the foot to slide with each step.

Slippers deserve special mention. Many older adults develop the habit of wearing soft, backless slippers around the house because they feel comfortable. Slippers with no back, no structure, and a smooth sole are among the most dangerous footwear choices an older person can make. Falls in the home - many of which involve slipping out of improper footwear - are a leading cause of serious injury and hospitalization in older adults. A supportive house shoe with a closed back and a rubber sole is a meaningful safety upgrade.

When to See a Podiatrist (Sooner Than You Think)

The threshold for seeking podiatric evaluation should be lower in older adults than in younger ones - not because older people are fragile, but because the consequences of waiting are higher and the value of early intervention is greater.

See a podiatrist if you notice any of the following:

• Foot or ankle pain that limits your walking, activity, or sleep
• A wound, blister, or sore on your foot that hasn't healed within two weeks - especially if you have diabetes
• Numbness, tingling, or burning sensations in the feet
• Skin that appears very pale, purple, or dusky, or feet that are consistently much colder than your hands
• Toenails that are thickened, discolored, or so difficult to trim that you're avoiding doing it
• A change in how you walk - any tendency to shuffle, favor one side, or avoid putting weight on a particular area
• Swelling in one or both feet that is new or unexplained
• A painful bump at the base of the big toe (bunion) or curled toes (hammertoes) that are getting worse

For patients with diabetes, peripheral arterial disease, or neuropathy, a preventive visit every 8 to 12 weeks is appropriate even in the absence of a specific complaint. Regular professional monitoring catches problems at the stage when they're manageable.

What a Geriatric Foot Evaluation Looks Like at Vertex Podiatry

A geriatric foot visit with Dr. Golan is unhurried by design. It begins with a thorough review of your medical history and all current medications - because many drugs affect circulation, wound healing, and fall risk in ways that are directly relevant to foot care. The physical examination covers circulation (pulses, capillary refill, skin temperature), neurological status (protective sensation testing with a monofilament, vibration testing), joint range of motion, muscle strength, gait, and a complete inspection of the skin and nails.

If nail trimming or callus reduction is needed, it's done precisely and gently during the visit. Orthotics, accommodative insoles, or footwear recommendations are provided based on your specific foot structure and walking pattern, not a generic template. If vascular or neurological concerns are identified, Dr. Golan coordinates with your primary care physician or refers you to the appropriate specialist.

The goal of every visit is simple: to keep you walking comfortably, safely, and independently for as long as possible. If your feet have been slowing you down - or if you've been quietly accepting foot pain as your new normal - schedule an evaluation at Vertex Podiatry in Grandview Heights. Call us at (614) 328-5561 or book online. Your feet have carried you a long way. It's time to take care of them.