Is foot pad loss a thing?
… and is it an inevitable part of ‘getting older’?
A reader asks:
“Can you do a piece on aging feet? I’ve been told that the soles get thin with age. Finding this painfully true and don’t want to give up being barefoot.”
And, I wouldn’t want that either!
(To be clear, we are referring to the shock-absorbing fatty pads largely over the heel bone and the balls of the feet at the toe joints - areas that receive the greatest impact of our steps.)
In pondering this request, a couple of questions came to my mind:
1. Is fat pad loss on feet an ‘actual thing’, and, if so… ,
2. Is this a natural consequence of aging, or, one more thing that presents after a lifetime of modern movement habits within a modern non-movement environment?
(And, most importantly, 3. Can this loss of foot padding be reversed, or at least, slowed down?)
Let’s break this down:
Is foot pad loss even a ‘thing?
*Atrophy is defined as: partial or complete wasting away of a part of the body.
Causes of atrophy include mutations, poor nourishment, poor circulation, loss of hormonal support, loss of nerve supply to the target organ, excessive amount of apoptosis of cells, and disuse or lack of exercise or disease intrinsic to the tissue itself.”
According to most foot experts, they would agree, yes, it is a thing.
It’s often referred to as ‘age-related atrophy’*, but, as one article I researched tellingly revealed, it’s a ‘diagnosis of exclusion’.
Meaning, as ‘there are no tissue thickness parameters to define the condition', in the case of foot pain, it may be a label one gets in the absence of other, more obvious factors.
Which brings us to the next point:
Age is an obvious factor.
There are a great many so-called age-related degenerative conditions that may or may not be so much about the age of a person, as they are the age of the habit.
Or, a lifetime of a bunch of habits, within a generation that all happened to be living within a particular culture or environment or some other set of influences that are harder to measure.
This is key - for this question and a million others - that have inextricably linked all manner of disease states to the avoidable act of getting older, because in most research done on these conditions, age is the most obvious and consistent factor.
(However, this article actually does state that that it’s not been possible to determine if the atrophy is age-related or pathology.)
So, what we’re seeing is that after a certain age, a significant enough percentage of the population who are presenting with foot pain - and factors like injuries, diabetes, rheumatoid arthritis, etc. have been ruled out - we’re left with this atrophy/foot pad loss diagnosis.
(Causes of which ‘may include’ - because even those foot experts admittedly aren’t really sure - high-heeled shoe wearing, lots of intense exercise, over-use of cortisone injections for pain, high arches, and another favorite go-to: genetics.)
A third key point:
Environment is almost ALWAYS overlooked in human movement research…
… particularly as it relates to movement within a modern day environment, vs. a ‘primitive’ environment.
By environment, of course, I’m referring to man-made indoor vs. natural outdoor.
But also, the more relational environment of the foot inside a shoe, and how all of that affects the environment of the various parts and forces generated within the foot itself.
I surmised that walking around not only in shoes - but, also on hard floors and concrete - most days over a lifetime, was a key part of this, as well as other painful foot conditions.
And, that the internal movement environment of the foot was also being affected adversely - in particular, as it related to the ‘fluid’ aspects of fascia.
“The evolution of the human foot was never influenced by or ultimately designed for the harmonic unity with a surface covering, i.e., a shoe.”
This opinion (and one that I heartily applaud :) was included in a white paper from the website of the Institute for Preventative Foot Health®, entitled, “New Treatment Modalities for the Modern Foot”.
If you’re a foot and movement nerd like me, I invite you to read it (though, I do think it’s also a sort of soft-sales pitch), because it offers come fascinating foot facts (as well as the hopefully-unintentional pun about ‘great strides made in foot research).
Nonetheless, here a few highlights:
Modern (and by modern, we’re talking 1800’s) shoes were created largely in response to protection from modern floors: brick, wood, linoleum, macadam, etc.;
It would make sense that feet pounding around bare on such hard surfaces would eventually lead to degenerative issues like foot pad loss, therefore, shoes would provide some benefit via cushioning, which was part of the point;
However - as in often the case with human ingenuity - the solution to this one problem created a whole host of others.
(I have nothing against human ingenuity - except in cases where we keep insisting we can ‘improve upon nature’.)
I think even the most committed shoe-wearers among us might agree that footwear is, at best, uncomfortable - but just saying that ideally, we all should go barefooting in nature is neither practical, helpful, nor getting to the mechanics of the question at hand.
One major consequence of shoes and manmade surfaces this white paper addresses is that of shearing.
We may be aware of the movement of the foot relative to the surface it’s moving over.
We are less aware of the movement within the foot relative to that surface.
With each step, those parts: bone, muscle, etc. are sliding around within the foot bag defined by skin.
To the degree that the surface is unyielding more of that movement is happening interiorly along various planes of direction, with components of the foot rubbing against each other in ways that a natural foot never anticipated.
“Shearing is minimized in the natural state of the human foot walking on natural surfaces. These surfaces, i.e., grass, dirt, gravel and sand, have the ability to dissipate forces in both the vertical and horizontal planes.
That is, as the human foot impacts and propels off of these natural surfaces, the surface itself gives way in both the vertical and horizontal planes. A movement interface occurs within the supportive surface itself. Movement does not occur between fixed plantar pad and skin and the metatarsal bones.
The foot rests on the supportive natural surface; and the natural surface glides and gives beneath the foot, minimizing the damaging forces”
~ from “New Treatment Modalities for the Modern Foot”, Institute for Preventative Foot Health®
The point here is that the forces generated by walking, running and other ambulatory actions within the foot would be dissipated by the yielding qualities of natural surfaces, like, grass, dirt, sand and gravel.
In the case of unyielding surfaces, such as wood, stone, linoleum, macadam, and even the inside of shoes, those multi-directional forces are translated into the foot - namely between the bony and muscular parts, and the skin - creating shearing forces that eventually break down the fatty pads between.
This makes way more sense to me than simply aging feet.
Granted, I do not discount that the body goes through changes as we age - I’m accepting that harsh reality myself. :)
In Chinese Medicine, the life cycle is defined by the rise and fall of the Yin qualities of the body: fluidity, pliability, buoyancy, as illustrated in the nails, hair, bones, muscle tone, even attitude, etc.
But, the environment within which we move (or not) and how we move within that environment (or not) … and how our internal environment is moved by all that moving (or not!) … also has bearing on how quickly or slowly we regenerate or age.
There are two other key points of disruption when it comes to footwear and the man-made environments: sweating and pumping, but I will leave those for future posts.
So, can foot pad loss and other issues be reversed, or at least, slowed down?…
I have more research to do before I can answer that question confidently.
I’d like to believe that tissue and cells can be regenerated through improving the inner and outer environment so as to be more functionally nutritious for the human body.
And, with consideration for each person’s unique situation, gaining more mobility and engaging in healthier movement environments is almost always a beneficial thing.
The Restorative Exercise work I offer includes not just ‘corrective exercises’, but how those exercises are done by YOUR body, and in alignment with your life.
Work with me!
In person, or via Zoom - I can help you get your feet moving!
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