“Age is an issue of mind over matter. If you don’t mind, it doesn’t matter.” Mark Twain
At what age are you considered old? For policy makers in government and business, the shift to old age starts at 65 when you become eligible for Medicare, Social Security, and retirement. The research world uses the mid-60’s as a benchmark, sometimes lumping people into two groups, one that defines those at 65 as “old”, and the other, starting around 75, labeled as “very old”. But most of us believe these arbitrary demarcations of age are a poor measure of what it means to be old. If you take a survey of people in their mid-60’s you’re likely to find some who are in serious physical decline as well as those who are running marathons. There are retirees starting new careers at 65 as well as seasoned CEO’s, politicians, and Supreme Court justices entering their 8th decade. The 65 and over population is a group that defies categorization; collectively, they have the most diverse life experiences of any other age group studied.
A chronological definition of old age is not meaningful and, importantly, has no biological basis. Due to improvements in health care, sanitation, and quality of life, the health and vitality of people between 65 and 75 is more likely to mirror that of a middle-aged person than someone who is sick and frail. Even so, we seem to hold on to our myths about aging, none of which are backed by any evidence. The inevitability of cognitive decline, aches and pains, poor sleep, weight gain, and a loss of balance and falling are part of the cultural biases we hold about growing old. And yet years of research conducted by the World Health Organization and the National Institutes on Aging consistently show that these “problems” associated with aging have less to do with one’s birthday than they do lifelong habits, especially those related to physical activity and exercise.
Research related to aging is showing that the conditions we typically associate with the process of getting old are really an amalgamation of bad habits coming home to roost. Common sense dictates that if one lives long enough, a lifetime of smoking, drinking, poor eating habits, and hours on the couch eventually catches up to us. And it is not just the obviously unhealthy habits that cause problems; all our habitual tendencies can accumulate and impact our health as we enter the later decades of life. Running marathons, cycling, and bootcamp classes in your 40’s and 50’s may keep you in great shape, but the back pain from chronically tight hamstrings and high impact exercise can make you miserable in your 60’s. Many of the actions we take at one point in life that seem inconsequential have the potential to create disability down the road.
What we so frequently label as the “aches and pains” of growing old are frequently the long-term consequences of deeply ingrained movement patterns that were established at an earlier time in life. Initially these patterns may have given us a warning sign—tightness, a bit of a tweak, some discomfort—but we considered them inconsequential or a slight inconvenience. When it comes to the body, ignorance is usually not bliss, so what starts as a tweak in one decade of life blossoms into disability later in life. Age doesn’t cause pain and discomfort, but chronically ignoring or discounting subtle pain signals in the body certainly will.
Our feet are the most ignored and underappreciated part of the body that can create the most disability later in life. There is perhaps no other area of the body that is more important to our overall long-term health than our feet, yet they are quite literally the furthest thing from our minds. Whereas we have one large bone in the upper leg and two bones in the lower, we have 26 bones in the foot. This reflects the important role the feet play in stabilizing us when standing still and providing fluidity when moving. These bones provide an enormous range of motion, enabling the sole of the foot to conform to the ground as we move through the world. The arrangements of these bones, as well as the foot’s arches, muscles, and ligaments, support our entire skeletal structure and, as such, all our bodily systems. It is no surprise that our feet determine how well we hold ourselves in relation to gravity, as well as our capacity to find stability and security in relation to the ground beneath us.
The foot has more than 30 joints, all of which make micro adjustments while we are walking and standing. Yet throughout our lifetime most of us develop limited patterns of movement that underutilize the foot’s full range of motion. On top of this is our tendency to “over-shoe” the feet, using padding or the latest engineering—foot bars, heel cushioning, and so on--that cause the foot to lose contact with the ground. The intricacy of the foot’s design was built for intimate contact with our surroundings; the numerous joints and bones enable the foot to provide feedback about where we are in space, helping us maintain balance as we stand and ambulate. What we gain in comfort or fashion with our shoes we frequently lose in sensory feedback. And a lifetime of shoes that pinch and twist the toes and put strain on the arches are sure to degrade the health of the very foundation of our body.
Shoes can be particularly hard on the toes, as many designs do not provide enough space for them to spread and expand. Toes act much like an insect’s antennae. As they spread and elongate, the toes transmit information about our position in space, helping us sense and navigate the ground beneath us. Importantly, they work to engage the arches of the foot and help to activate the muscles of the lower leg. Yet we tend to take a passive stance toward the health of our toes; without conscious attention they are likely to become stiff and rigid as we age. When toes become tight, twisted, and clenched they lose their capacity to provide the sensorimotor input that informs the body about where we are in space. Inflexible toes, combined with a loss of vision or hearing, is an important reason why people become more prone to falling in their later years.
The foot is designed with a series of muscular bridges that provide support for the entire body—the medial, lateral, and transverse arches. The medial arch is of critical importance as it is connected to several key muscle groups that support the spine and impact posture. Activation of the medial arch initiates the engagement of a series of muscles related to core stability, including the inner thigh, hip muscles, and the pelvic floor. It is also involved in maintaining the curves of the spine, supporting the movement of the rib cage muscles during breathing, and helping to align the head on top of the neck. The lateral arch stabilizes the outer leg, including the outer knee and hip, and creates stability through the center of the foot. The transverse arch spans across the bones of the feet and creates the dome like contour in the midfoot. Together these three arches function like a trampoline for the body, providing spring and suspension as we move and navigate the world around us.
The maxim associated with the arches is as below, so above, reflecting the role they play, along with the toes, in core stability and overall support of the spine. If we consider the arches as bridges, the bases of the big toe and the pinky toe act as the cornerstones and are the primary pressure points for weight bearing. This bridge gains greater stability and lift when the toes are spread and elongated. In a healthy foot, there is span, height, and spring in the arches and toes. But years of misaligned movement patterns and improper footwear results in the collapse of these structures which, much like a bridge that buckles, creates a downward collapse of the spine. Collapsed or stiff arches lose their resiliency and spring, causing trouble not only in the foot itself, but in the knees, ankles, hips, and lower back. Due to this inflexibility, our balance becomes unsteady and shaky. With time, a compromised foot structure creates a sense of disorganization within the body, leading to significant health issues—arthritis, low back pain, kyphosis, scoliosis, to name a few.
We can think of the feet as mirrors for the body as a whole, with the condition of the arches and toes reflected in how fluidly we move through the world. What we might describe as a person’s overall energy level can, in some ways, reflect the health of one’s feet. But problems in the feet develop over a lifetime, so the vitality we get from the spring in our arches starts to wane as these structures stiffen and deflate. The fatigue, tottering, shuffling, and frailty many of us fear as we grow older are not inevitable signs of aging, but the outcome of a lifetime of habitual tendencies.
Decades of neglect or misaligned movement patterns can’t easily be undone once we enter the later years of our life. But hanging on to unsupported beliefs about the misery of old age can be just as dangerous. Research suggests that merely expecting physical deterioration increases the likelihood that one will suffer physical disability and decline in later years. This does not mean we should ignore some of the changes that are associated with age, such as vision, hearing, and recovery times. Nor should we strive to be a “super ager”, climbing mountains, running marathons, and entering body building competitions. The key to healthy aging is to meet yourself where you are, understanding that where your body is now reflects what you faced in life and the way in which you navigated those challenges. It is an acceptance of your body as it is, while exploring what can change, and of charting your way forward. Doing so goes a long way to help us enter our later years with grace, compassion, and a sense of ease, no matter how old we may be.
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