Fallen Arches

Fallen Arches

The belly isn't the only part of your body subject to middle-age spread. As we get older, the years of walking and standing can cause feet to spread and flatten out as ligaments that support the arch lose their holding power. The result: the condition known as fallen arches, or flat feet.

"Keep in mind that we're talking about 26 bones in the foot that are supported by a series of ligaments, muscle tendons and other connective tissue," says Glenn Gastwirth, D.P.M., deputy executive director of the American Podiatric Medicine Association in Bethesda, Maryland. "Over a period of time, the ligaments stretch out or 'give' under the pressure of your weight-especially if you're overweight. So what usually happens is you go shopping for new shoes one day and suddenly realize that you now need a size 8 when you've always worn a size 6. You may think your foot has grown, but what really happens is that the foot has spread out, both in width and length."

Here's how to delay or even prevent fallen arches or reduce arch pain if it's already happened.

Tie 'em on. One reason fallen arches are most prevalent in women is that pumps and other shoes with "flimsy uppers don't give the same support as the lace-up shoes more typically worn by men, says Philip Sanfilippo, D.P.M., a podiatrist in San Francisco. "You're less likely to get fallen arches if you wear lace-ups or other styles that provide more support in the upper (the top of the shoe)." He points out that loafers, pumps and slip-ons don't give sufficient support to feet that are prone to developing fallen arches.

Get shoes made for walking or running. One way to support your arch is to wear good-quality running or walking shoes, says Dr. Gastwirth. "These shoes generally provide good support to the foot."

Add support. The top-of-the-line arch support is an orthotic insole, which may cost $900 or more and must be custom-made. "But many people with sore arches will get relief with over-the-counter arch supports for about $10," suggests Judith Smith, M.D., assistant professor of orthopedic surgery at Emory University School of Medicine in Atlanta. "The thing to remember about arch supports is that your shoe must have enough depth to accommodate them. Otherwise, you'll get a lot of rubbing on the top of your foot, or your heel will come out of the shoe." Most mens shoes are deep enough to accommodate the insoles; women should take their shoes with them to the drugstore when buying the insoles to ensure a good fit.

If your heels are high, keep them wide. High heels may be your Achilles' heel--especially if you wear them constantly. "Flatter shoes are no doubt better," says Dr. Sanfilippo. Flat heels help prevent fallen arches and are kinder to your feet if fallen arches have already occurred. "If you must wear high heels, choose styles with a wide heel. Stay away from stiletto heels."

Roll away pain. "If you're feeling pain in the arch area, you can get some relief by massaging the bottom of your foot," says Dr. Gastwirth. "A regular massage while you're watching TV can do wonders."

Stretch out. Doing the same type of stretching exercises that runners do in their warm-up can help reduce arch pain caused by a tight heel cord. One of the best exercises is to stand about three feet from a wall and place your hands on the wall. Leaning toward the wall, bring one foot forward and bend the knee so that the calf muscles of the other leg stretch. Then switch legs. "Stretching is particularly important for women who spend all week in heels and then wear exercise shoes or sneakers on weekends," says Dr. Gastwirth.

Get measured each time you buy new shoes. "Don't assume that since you always wore a particular size, you always will," says Dr. Sanfilippo. "Too many people try to squeeze into their 'regular' shoe size and wind up with serious foot problems or sores on their feet. When your arch is falling, your feet may get longer or wider and you may or may not feel pain, so getting your foot measured each time you buy shoes is a good indicator of your arch's degeneration."

Examine your shoes. "If the heel is worn down, replace it. But if the back portion of the shoe is distorted or bent to one side, get yourself into a new pair of supportive shoes like those made specifically for walking," according to Dr. Gastwirth. That's because flat feet can affect your walking stride, and failing to replace "worn" shoes may lead to knee or hip pain.