Aging of Feet, Ankles and Lower Limbs

During our life span we are heavily dependent on our feet, ankle and lower limb to carry and support us, but we rarely bother to look after them. It is crucial to maintain the alignment and health to prevent any complication, or if they do happen, they should be treated immediately. As one grows older, regular use and misuse of foot, ankle and lower limb result in many changes that affect:

- Shape & size of the feet including toes - Location of the fat pads on the underside of feet - Condition of the skin and toenails - Health of bones, ligaments, cartilages, soft tissues and muscles - Blood circulation and sensation in the feet. - Alignment, Gait and Posture

Common foot, ankle and lower limb disorder in the older adult are:

- Bunion - Hammer, Claw and overlapping of Toes - Calluses and Corn - Metatarsalgia - Fallen Arches (Medial & Transverse) - Plantar Fasciitis/Heel Spur - Achilles Tendonitis - Swelling and pain around ankle joints - Arthritic changes in lower limb joints resulting in poor weight bearing

It is very important to exercise your feet ankle and lower limb regularly to avoid chronic problems and age related deformities. Here are few exercise tips:

Sitting Position (In a up right chair):
With feet flat on floor:

1. Raise your toes off the floor several times. Keep the ball of the foot on floor. This helps maintain flexibility of the toe joints.

2. Slide foot back under the chair. Raise the heel, keeping the ball of the foot and the toes on the floor. This stretches tight muscles under the foot and maintains normal flexibility of the toe joints.

3. Press the toes into the floor. Keep them straight as much as possible, not allowing them to curl.

4. Curl the toes and draw the towel under the feet. As strength improves, add a weight to the other end of the towel.

5. Place a marble on the floor, and pick it up with your toes.

With feet dangling:

1. Spread the toes apart as far as possible, then squeeze together as tight as possible. After practice, some people can put a wide rubber band around their toes and spread them against resistance.

2. Rotate your ankle joints in clockwise, anti clock wise, up and down several times at least two to three times a day for strengthening the ankle joint and reduce swelling if any.

3. Straighten one knee and flex the ankle. Point the toes toward the knee and feel the calf muscle stretch. Repeat 5 times on each leg, alternating legs.  This exercise will help avoid cramping in the lower leg.

Standing:
Stand holding onto a counter top or chair for light balance. Rise up on your tip toes, and then rock back to your heels, lifting your toes off the floor. This improves balance and leg strength when done standing; it increases flexibility of foot and ankle and strengthens muscle on the front of your lower leg just to the outside of the shin bone.

Important Stretches:

1. Quadriceps: Stand with legs slightly apart. Take a wall support and hold one side of the ankle and bend knee. Feel the stretch in front region of thigh.

2. Hamstring: While sitting on the floor. Try to take the buttocks close to wall, extend both legs out straight. Slowly bend forward at the waist keeping upper back straight and reach for your toes with your hand. Hold and slowly release and repeat both.

3. Calf: Stand about an arm's-length from the wall. Place both hands on the wall. Take one foot behind you with heel on the ground and one foot closer to the wall. Bend the front knee and lean towards the wall until you feel a stretch in the calf of the leg behind. Do not lift the heel of the behind leg. Hold the position and slowly return to starting position.



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