APMA News - September/October 2024 - 9

STEADI Feet and Footwear Fact Sheet:
FACT SHEET
Feet and Footwear
for Older Adults
Footcare and safe shoes can prevent falls
Falls are the leading cause of injury for older adults (ages 65 and
older) and can have serious consequences, like limited mobility and
loss of independence. Routine care for feet and proper supportive
footwear can reduce your risk of falls.
What foot problems are associated with falls?
Foot related risk factors that increase fall risk:
* Increased foot pain
* Reduced flexibility in ankle joint
* Reduced calf muscle strength (the muscle that helps you rise on
the balls of your feet)
* Reduced sensation resulting from neuropathy (nerve damage)
* Presence of a bunion (hallux valgus deformity) or toe deformities
What makes a shoe safe?
Firm collar heel
for stability
Laces or straps
to ensure shoes
'hold' onto foot
when walking
Beveled heel to
prevent slipping
* Wear sturdy shoes with low
heels, traction, and strong
arch and heel support.
Footwear Tips
Health Tips
* Your healthcare provider
or podiatrist can check
your feet and determine
if there are issues that
increase your risk of falling.
Podiatrists diagnose and
treat foot conditions.
* Ask your healthcare
provider to check your
feet once a year.
* See a podiatrist if you
have foot problems, such
as toe or foot deformities
or foot pain.
* Work with a physical
therapist to learn exercises
to increase strength and
flexibility of foot and ankle.
Safety Tips
* Always wear properly fitted
shoes inside and outside
your home.
What makes a shoe unsafe?
Soft or stretched uppers
allow the foot to slide
around in the sole
Lack of laces means
the foot can slide out
of the shoe
Footwear Tips
Safety Tips
* Avoid walking in only
socks inside and outside
your home.
* Avoid wearing shoes with
heels over one inch, with
no ankle support, or with
a smooth sole.
Slippery or worn soles are a
balance hazard, particularly
in wet weather
Avoid high heels (more
than 1 inch), especially
ones with narrow heels
Examples of appropriate shoes to reduce
risk of falls
* Avoid wearing shoes with
no back (such as a mule
or clog) or strappy back
(such as a slingback).
Footwear Tips
* Shop for shoes later
in the day to ensure a
proper fit.
* Have your feet measured
to ensure appropriate
shoe width and length.
* Accommodate foot
deformities such as
bunions or hammertoes
by choosing shoes with
a wide toe box.
Thin, firm
midsole to
'feel' ground
underneath
Textured sole
to prevent
slipping
Broad, flared
heel to maximize
contact with
the ground
Working with your
healthcare provider or
podiatrist to address
foot problems and using
appropriate footwear can
reduce your risk of falling.
www.cdc.gov/steadi
Stopping Elderly Accidents,
Deaths & Injuries
Stopping Elderly Accidents,
Deaths & Injuries
www.cdc.gov/steadi
2024
* Consider a pedorthist,
a specialist in footwear
and devices, for
footwear and orthotic
recommendations to
provide the best possible
support for walking. See
www.pedorthics.org for
a searchable directory of
credentialed pedorthists.
joints in the foot and ankle. Arthritis can affect the
balance and stability of the body. Also, the use of
narcotic pain relievers in the treatment of arthritis
pain can result in increased fall risk.
How do you incorporate balance and
gait assessments into your routine
patient evaluations?
All patients over 65 should be asked three initial
screening questions:
1. Have you fallen in the past year?
2. Do you worry or have a fear of falling?
3. Do you feel unsteady?
If the patient answers yes to even one of these
questions, a physical assessment including the
Sit to Stand test, Timed Up and Go, and Four
Stage Balance Test should be administered. In
Iowa, we are developing a no-cost CME training
for providers and community health workers to
learn or brush up on the STEADI fall screening
and assessments.
Talk about custom orthotics or footwear
adjustments and how they may
play a significant role in preventing falls.
Stabilizing braces and custom orthotics address
foot and gait abnormalities, which then can prevent
falls. The importance of proper accommodative
shoes and prescribed devices for neuropathic
patients, particularly those who have a partial foot
amputation, cannot be overstated.
To increase falls prevention awareness, the
National Council on Aging encourages sharing
with patients shoe recommendations to reduce
falls. Visit www.apma.org/seal to view APMA SealAccepted
footwear and products to recommend
to your patients.
What are the key messages you emphasize
to patients when educating
them about falls prevention?
Physical activity is the number-one way to prevent
falls. Many older adults have a significant worry or
fear of falling that can lead to avoidance of activities
APMA.ORG
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http://www.pedorthics.org http://www.cdc.gov/steadi http://www.cdc.gov/steadi http://www.apma.org/seal http://www.APMA.ORG
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