Most people only think about their feet when something hurts. By the time you are over 60, your feet have carried decades of load, and the way they look, feel and move starts to shift. A lot of that is normal ageing. Some of it is treatable. Knowing which is which is what a Podiatry assessment is for.
01 . The ageing foot
What changes in the feet after 60
A few things happen to the feet as the years stack up. The fat pad under the heel and ball of the foot thins out, which is part of why standing for longer feels harder. The skin gets drier and more prone to cracking, especially around the heel. Toenails thicken and become tougher to trim safely at home. The small joints in the midfoot and big toe lose some range of motion, and conditions like bunions or hammer toes can become more pronounced.
Feeling changes too. A lot of people lose some of the fine sensation in their feet as they get older, even without diabetes. That matters more than it sounds. Your feet rely on that feeling to sense pressure, find their position, and pick up small injuries. When the feeling dulls, a blister, a corn or a small wound can start without you noticing.
This is the backdrop for everything else in this post. The common problems that bring people to a Podiatry clinic, like bunions, corns, calluses, ingrown toenails and heel pain, are not separate from the ageing changes above. They sit on top of them.
02 . Diabetes and arthritis
Diabetes, arthritis and the feet
Two chronic conditions change foot care more than any others: diabetes and arthritis.
If you have diabetes, foot problems can start fast, and two changes are why. The first is in the nerves. They stop sending the usual warnings, so a blister or a rub goes unnoticed, especially in the toes. The second is in the circulation. Blood flow to the feet drops, so when something does go wrong, it heals slowly. Put those together and a small injury, a blister, a corn pared too hard, a shoe rub, can turn into an ulcer that does not heal. That is why international guidelines on diabetic foot care recommend a professional foot check at least once a year for anyone with diabetes, and more often if the foot is higher risk. Diabetes Australia publishes plain-language guidance on daily foot checks, sock and shoe choice, and when to call your care team.
Arthritis affects the feet differently. Osteoarthritis commonly settles in the big toe joint and the midfoot, causing stiffness and pain on push-off. Rheumatoid arthritis can affect the small joints across the forefoot, sometimes causing visible changes in foot shape. In both cases, footwear becomes a clinical tool, not just a fashion choice. Stiffer-soled shoes, deeper toe boxes and accommodative insoles can take load off painful joints without resorting to medication.
The practical upshot for older adults with either condition: routine Podiatry care moves from optional to recommended. Small problems caught early stay small.
Routine foot care for older adults with diabetes or arthritis turns small problems into solved ones, before they become large ones.
03 . Balance and falls
Feet, balance and falls prevention
Falls are one of the most common reasons older Australians end up in hospital. The risk rises sharply after 65, and the consequences are serious: hip fractures, head injuries, a loss of independence. The Australian Institute of Health and Welfare documents this clearly. Most falls are preventable, and Podiatry is one part of a broader prevention plan that also includes Physiotherapy, Exercise Physiology and medication review.
A Podiatry falls-risk assessment usually covers four things:
- Gait. How you walk. The Podiatrist watches you walk a short distance and looks for asymmetry, shortened steps, foot clearance and how confidently your weight transfers from one foot to the other.
- Footwear. What you have on your feet. Slippers, worn-out walking shoes, backless sandals and unsupportive flats all increase falls risk in older adults. The fix is often a single pair of well-fitted shoes with a fixed heel, a firm sole and a closed toe box.
- Foot pain and joint range. Pain changes how you walk. Reduced ankle or big-toe range changes how you walk. Both reduce your ability to recover from a stumble.
- Sensation and proprioception. How well the feet detect ground and position. This is where neuropathy, footwear cushioning, and balance training all interact.
The deliverable from a falls-risk assessment is usually a short list: a footwear recommendation, sometimes a referral for custom or off-the-shelf orthotics, sometimes a referral on to Physiotherapy for balance and strength work, and a plain-English explanation of what to do at home. See our companion piece on balance, falls and Physiotherapy for the strength and balance side, and exercise and bone health for the bone-loading context.
04 . Foot pain
When foot pain is not just ageing
Foot pain is common after 60. It is not inevitable. A lot of the pain older adults live with has a name and a known cause. Heel pain on the first few steps in the morning. A sharp ache under the ball of the foot. A stiff big toe joint after a long walk. Each one has treatment options that work.
The most common patterns:
- Sharp pain under the heel, worst on the first few steps in the morning. This is plantar heel pain. It tends to ease as you get moving, and it usually responds to footwear changes, stretches and load management. Our piece on anterior ankle impingement and related ankle conditions covers the related ankle stiffness work.
- Pain and stiffness in the big toe joint, worse after a long walk. This is often hallux rigidus, an arthritis pattern in the big toe joint (the first metatarsophalangeal joint). It responds to stiffer-soled shoes, sometimes a rocker sole, sometimes a custom orthotic.
- Pain under the ball of the foot, like walking on a pebble. This is forefoot pain, or metatarsalgia. It responds to metatarsal padding, footwear changes and load management.
- An arch that is flattening, with pain on the inside of the ankle. This is posterior tibial dysfunction. It is more common after 60, especially in women, and the earlier it is caught, the simpler the treatment.
The common theme: persistent foot pain has a cause, and the cause has a treatment. A Podiatrist works out what is causing it, explains it, and matches treatment to your situation. That treatment may include footwear changes, custom or off-the-shelf orthotics, stretches and strengthening, manual therapy, or onward referral to Physiotherapy or your GP. For the Podiatry service overview at Optimum Health Solutions, see our service page.
05 . When to book
When to see a Podiatrist
A Podiatry appointment is the right next step if any of the following are true:
- You have diabetes and have not had a professional foot check in the last 12 months.
- You have foot pain that has been around for more than 2-3 weeks.
- Your nails have become too thick or shaped to trim safely at home.
- You have noticed a wound, blister or sore on the foot that is taking longer than a week to heal.
- You have had a fall, or a near-fall, in the last 12 months.
- You are not sure whether your shoes are doing you any favours.
- You have noticed a change in the shape of your foot (a widening forefoot, a flattening arch, a new bump).
Most older adults benefit from a routine Podiatry check at least once a year. People with diabetes, rheumatoid arthritis, peripheral vascular disease or a history of foot ulceration usually benefit from more frequent reviews. Your Podiatrist will tell you what cadence fits your situation.
If you are not sure whether you need to come in, our team is happy to talk through it on the phone or by email. Book a Podiatry assessment via our bookings directory, or send a referral through our referrers hub.
Further reading
If you want to understand specific aspects of foot health after 60 in more detail, these guides may help:
- Balance, falls and Physiotherapy. The strength and balance side of falls prevention.
- Exercise and bone health. The bone-loading context for fracture-risk reduction.
- Anterior ankle impingement syndrome. Stiff ankles and how they are treated.
- Podiatry services explained. A general overview of what Podiatry covers.
