Unsafe Footwear Impairs Balance and Increases the Risk of Fall

Elderly who fell and injured themselves often were found wearing inappropriate shoes.

In “The Guideline for the Prevention of Falls in Older Persons”, both American Geriatric Society and British Geriatric Society have pointed out inappropriate footwear as a major cause of concern.

Whether indoor or outdoor, unsafe footwear can cause loss of balance and bad gait. The risk of falls is especially high for elderly whose muscular strength and balance are already impaired.

What unsafe footwear will increase the risk of falls?

Evidences collected by researchers show that falls were often associated with the following kinds of shoes:

  • Loose, worn or backless slippers. These are one of the most common causes of older people falling.

    Backless slippers and slip-on shoes are unsafe footwear for the elderly
    Backless slippers and slip-on shoes are not safe for the elderly
  • Poorly fitting shoes. To accommodate painful feet, some elderly like to wear soft and/or overly long and wide shoes.
  • Slip-on shoes, such as sling backs or flip flops and shoes without fasteners.
  • Shoes with poor grip or worn soles can cause you to slip especially on wet surfaces.
  • Shoes with minimal contact with the ground, such as high heels, can make your foot unstable and can cause your ankle to turn.

Wear Proper Shoes to Prevent Falls

People of all ages should understand the importance of wearing well-fitting shoes, and wear suitable shoes for a particular activity. One of the main causes of foot problems such as bunions and corns is badly-fitting shoes.

Apparently, three out of four people over the age of 65 wear shoes that are too small. Perhaps it is because we did not realise our feet actually get bigger as we age. Besides, the feet and ankles may become swollen because of chronic medical conditions.

It is often a combination of foot problems and inappropriate footwear that increases the risk of falling.

What are the characteristics of safe shoes?

  • It should fit well and neither too loose or too tight on the feet. Some people may need footwear specially made to accommodate and protect swollen feet and ankles.
  • It has a high back or collar to support the ankle.
  • The sole is firm and not too thick for better sensation of foot position.
  • The sole is slip resistant with tread for good grip.
  • A low square heel which is not more than an inch to improve stability.
  • Adjustable fastener – laces or buckles or Velcro – on the front so that it won’t slip off easily.

Indoor footwear

As mentioned earlier, elderly should avoid loose, backless slippers. It is recommended that older people wear close-backed, well-fitted, slip-resistant slippers or house shoes indoors. A house-shoe offers the comfort of a slipper, but with the stable support of a shoe.

A wide opening makes it easier to get your foot in and out of the slipper which is important if you have swollen feet. But make sure it can be strapped down securely so that it won’t slip off easily.

Do not walk bare-footed or in socks or stockings.

For some cultures and in hot climate, folks may prefer to walk bare-footed at home. However, it has been shown that a proper pair of shoes provide more grip than bare feet and enhance walking stability. Shoes also protect the feet from mechanical injuries.

Get help

Podiatrists, also called chiropodists in UK and Ireland, are foot care specialists. Ask your doctor to refer you to one if you have pain or any other foot problems.

Your podiatrist can help you choose suitable shoes and orthotic inserts if you need them.

Diabetes sufferers will benefit from seam-free footwear made to avoid rubbing, which can lead to ulcers that are difficult to heal. In UK, specially fitted footwear can be purchased free of VAT if the wearer has a chronic medical condition such as diabetes. You should be able to get further information about this from a podiatrist as well.



Further Reading:

Menant J, Steele J, Menz H, Munro B, Lord S (2008). Optimizing Footwear for Older People at Risk of Falls. Journal of Rehabilitation Research & Development, 45(8), pp. 1167–1182.


Leave a comment

[convertkit form=5193450]