The Overlooked Role of Foot Health in Fall Risk
Falls represent a significant source of morbidity, particularly among older adults, and are typically multifactorial in origin. Foot health is a frequently underrecognized component within this risk profile.
Several factors contribute to postural instability, including diminished proprioception, peripheral neuropathy, structural deformities, muscle weakness, and inappropriate footwear. Peripheral neuropathy—commonly associated with diabetes—impairs protective sensation and reduces the ability to perceive ground surfaces, significantly affecting balance and coordination.
Structural deformities such as hallux valgus (bunions), hammertoes, and variations in arch height can alter plantar pressure distribution and disrupt normal gait mechanics. These changes may lead to compensatory patterns that further compromise stability.
Footwear also plays a critical role. Shoes that are ill-fitting, lack adequate support, or have worn or slippery soles can increase the risk of slips, trips, and falls.
Additionally, routine foot care should not be overlooked. Hyperkeratotic lesions (calluses), elongated or dystrophic nails, and untreated dermatologic conditions can create discomfort and alter gait patterns, often subconsciously, thereby increasing fall risk.
Comprehensive assessment—including evaluation of gait, balance, and neurologic function—provides valuable insight into an individual’s fall risk. Targeted interventions such as appropriate footwear recommendations, routine foot care, and biomechanical support can improve stability and reduce the likelihood of falls.
Foot health remains a critical, yet often underestimated, factor in maintaining mobility, independence, and overall safety. Please give our office a call, for a foot assessment. We are here to help!
William E. Donahue, DPM, FACFAS
