Footwear choice can lead to falls

Today I would like to start at the bottom.

Let's begin by asking you to look down at your feet. What are you wearing today? If you're reading this, and it's early morning, you may be barefoot or have on socks or slippers. If it's evening, it may be shoes you see at the ends of your legs. Is it possible those shoes have elevated heels?

Here's the thing. Research shows, indisputably, that what you have on your feet influences balance and gait. And your risk of falling increases dramatically if you wear certain types of footwear. Walking barefoot or in socks while indoors and wearing high-heel shoes either indoors or outdoors increases the risk of falls for older adults. Things like "heel collar height, sole hardness, tread and heel geometry" also are relevant.

The information I'm sharing comes from a compelling article on "optimizing footwear for older adults" in the Journal of Rehabilitation Research and Development. When I began to read, I was wearing soft-bottom socks. I was less than halfway through the article when I found myself trying to recall where I'd put a pair of slip-resistant shoes. I actually stopped reading to find them.

I know how hard it is to give up comfy footwear. We all have preferences — easy-to-put-on flip-floppy slippers without any backs, perhaps? Those old, scrunched-down-in-the-heel, worn-them-forever, glossy-leather slipper-shoes?

A 2008 survey focused on a group of community-dwelling people over age 65. It identified that the majority of them wore slippers or socks at home. (Unlaced shoes were a close runner-up.) In a comparative trial, their likelihood of falling was "10 times greater." And the thing about falling when you're older is that it does not typically end with hurt pride and a few bruises.

In 2006, the last year in which there was comprehensive data, Oregon's Department of Human Services found that more than 5,500 Oregon seniors were hospitalized as the result of a fall, at a cost that exceeded $120 million. And here's an even more sobering piece of information: "In Oregon, aging individuals experience fatal falls at a rate that is 70 percent higher than the national rate."

I write about this because it's personal. I fell and broke my arm last year. I'm not sure it was related to footwear — but maybe, at least partially. In the big scheme of what happens to people who are 60-plus and fracture a bone, my situation was manageable — just not very pleasant. But then, oops, it happened so fast, as recently as last week. I was walking too quickly down our carpeted stairs in my sock-slippers in the early morning and I slipped and crashed. No broken bones, but there easily could have been. It got my attention.

Your attention, please. As we age, there are many things we cannot control. Footwear is something we can. Maybe you could think of those firm-soled, slip-resistant, low-heeled shoes you plan to wear henceforth as a pair of insurance policies you keep at the end of your legs.

Sharon Johnson is an associate professor in health and human sciences at Oregon State University and on the faculty of the OSU Extension. Email her at or call 541-776-7371, ext. 210.

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