Aging Feet Can Grow 1 Shoe Size and Hurt Barefoot, Podiatrist Says

Q: Could walking barefoot on hard floors be silently destroying the natural cushioning in your feet as you age?

No. Walking barefoot on hard floors is unlikely to be silently “destroying” the cushioning in your feet by itself. The stronger explanation, backed by podiatry experts and the reporting cited, is that aging commonly thins the fat pads under the heel and ball of the foot and weakens the ligaments, tendons and muscles that support the arch. That means hard floors often expose an existing problem rather than cause it. As the natural padding thins, people can develop a bruise-like or burning pain when barefoot on tile, wood or concrete. If arches also flatten over time, the foot can spread and absorb shock less effectively, adding strain to the plantar fascia, posterior tibial tendon and nearby joints. Still, repeated impact on unforgiving surfaces can worsen symptoms in a foot that has already lost some cushioning or support. People who are older, carry extra weight, stand for long periods, or have diabetes, arthritis or prior foot problems may be more vulnerable. What helps is not ignoring the pain. Supportive shoes, cushioning and arch-support insoles, proper width and length fitting, and periodic re-measuring of feet can reduce stress. Soft foam alone may not be enough if the issue is structural; semi-rigid support is often more useful. Persistent pain, swelling, numbness, redness, warmth, or a sudden change in arch shape should be checked by a podiatrist, because some cases reflect adult-acquired flatfoot or fat pad atrophy rather than ordinary discomfort.

Q: Why might the shoe size you have worn for decades suddenly become the hidden cause of your back pain?

Yes. A shoe size that fit for decades can become a hidden cause of back pain because feet often get longer, wider, and flatter with age, while many people keep wearing the same old size. Podiatrists say the ligaments, tendons and muscles that support the arch weaken over time. As the arch drops, the foot spreads and sometimes lengthens, changing both shoe size and foot mechanics. Weight gain and pregnancy can speed that process. If you keep wearing shoes that are now too short, too narrow, or wrong for your arch length, the foot cannot absorb shock properly. That can alter the way you walk. Flattened arches and poor-fitting shoes can increase overpronation, strain the plantar fascia and posterior tibial tendon, and shift stress up the kinetic chain into the ankles, shins, knees, hips and lower back. In other words, the back pain may start at the foot. Age also thins the fat pads under the heel and ball of the foot, so hard floors feel more painful and each step delivers more impact. Shoes that no longer fit or lack support can worsen that impact. The practical fix is to stop assuming your lifelong size is still correct. Have both feet remeasured for length, width and arch length, ideally later in the day. Look for supportive shoes with adequate width, cushioning and a roomy toe box; some people also benefit from semi-rigid arch-support insoles or custom orthotics. Persistent pain, swelling, numbness, or a sudden arch change should be evaluated by a podiatrist.

1 articles · Updated · The New York Times · Aug 21

Feet can lengthen and widen with age, sometimes by about 1 shoe size, while walking barefoot on hard floors can become painful, podiatrist Sabrina Minhas said.
Minhas said weakening ligaments, tendons and muscles let the arch gradually drop over time, making feet longer and wider and forcing some people into larger shoes.
Pain on flat surfaces stems from thinning fat pads under the heel and ball of the foot, which leaves bones with less natural cushioning.
Weight gain later in life and pregnancy can also lower arches, adding to shoe-fit changes that become more common with aging.