One of the concerns we commonly hear from families and carers is:

“They seem a little unsteady when they walk now.”

In over 20 years working with older Australians as a podiatrist, changes in balance and walking confidence are something we frequently see as people age. What many families do not initially realise is that problems affecting the feet can sometimes play an important role in stability and mobility.

Because our feet form the body’s foundation during standing and walking, changes in foot health may affect how safely and confidently someone moves. Even relatively small problems involving pain, reduced sensation, pressure areas, or poorly fitting footwear can influence balance over time.

Falls are one of the leading causes of injury and reduced independence in older adults. According to the Australian Institute of Health and Welfare, falls are a major cause of hospitalisation among older Australians and can significantly affect long-term mobility and quality of life.

While falls risk is usually influenced by multiple factors, healthy feet and safe movement play an important part in maintaining independence and confidence as people age.

Why Balance Changes Become More Common With Age

As people get older, several natural changes occur throughout the body that may affect balance and walking stability.

Muscle strength may gradually reduce, reaction times can slow, joints often become stiffer, and vision changes may affect spatial awareness. At the same time, conditions such as arthritis, diabetes, reduced circulation, or neurological conditions may further influence mobility.

The feet themselves also change with age. Skin may become thinner, protective fat padding can reduce, joints may stiffen, and nerve sensation may decline.

Together, these changes can make older adults more vulnerable to instability, reduced walking confidence, and falls.

Many people do not notice these changes happening immediately because they often develop slowly over time.

Why the Feet Play Such an Important Role in Balance

The feet constantly provide the brain with information about pressure, movement, body position, and the surface being walked on. This information helps the body make ongoing adjustments while standing or moving.

Healthy nerves in the feet allow the brain to detect:

• changes in pressure
• uneven surfaces
• movement and body position
• balance shifts
• contact with the ground

This process happens automatically every time we stand, walk, turn, or change direction.

When foot pain, nerve damage, or instability develops, the body may receive less accurate information from the feet. This can affect balance and confidence walking, particularly on uneven ground or when moving quickly.

Some patients describe the sensation by saying:

“It feels like I can’t quite feel the ground properly.”

Others may explain it as feeling unstable or disconnected from the floor beneath them.

Reduced Nerve Sensation and Neuropathy

One of the most common foot-related factors affecting balance in older adults is reduced nerve sensation, also known as peripheral neuropathy.

Peripheral neuropathy occurs when nerves become damaged or less sensitive. According to the Mayo Clinic peripheral neuropathy guide, this can reduce the ability to feel pressure, movement, pain, or temperature changes in the feet.

People with neuropathy may experience:

• numbness in the feet
• tingling or burning sensations
• reduced awareness of foot position
• difficulty sensing uneven surfaces
• altered walking patterns

Some people describe the feeling as:

“It feels like I’m walking on cotton wool.”

When sensation becomes reduced, the body receives less feedback about the surface being walked on. This may affect coordination and stability, particularly when walking outdoors, on stairs, or in low lighting conditions.

Diabetes is one of the most common causes of peripheral neuropathy, although other medical conditions may also contribute.

How Foot Pain Can Change Walking Patterns

Foot pain can significantly affect the way someone walks, often without them fully realising it.

When a painful area develops, the body naturally attempts to reduce pressure on that part of the foot. Over time, this compensation may alter posture, balance, and movement patterns.

Common painful foot conditions affecting mobility include:

• heel pain
• Achilles tendon pain
• arthritis in the foot joints
• bunions
• nerve irritation
• corns and callus
• forefoot pain
• painful thickened nails

People may begin:

• walking more slowly
• limping
• shuffling
• holding onto furniture
• avoiding stairs
• limiting physical activity

These changes may increase instability and reduce confidence walking safely.

According to the Cleveland Clinic falls prevention guide, foot pain and walking difficulties are recognised contributors to falls risk in older adults.

Arthritis and Joint Stiffness in the Feet

Arthritis commonly affects the feet and ankles as people age. Joint stiffness, swelling, and pain may reduce the ability of the foot to move naturally during walking.

This can affect:

• walking efficiency
• balance reactions
• shock absorption
• ability to adapt to uneven surfaces

People with arthritis often unconsciously alter the way they walk to avoid painful joints. Over time, these altered walking patterns may affect other areas including the knees, hips, and lower back.

Foot arthritis may also contribute to reduced confidence moving around outdoors or walking longer distances.

The Impact of Thickened Nails and Pressure Areas

Many people do not realise that even relatively small foot problems such as thickened nails or pressure areas can affect walking comfort and stability.

Thickened toenails may become painful inside shoes and alter the way pressure is distributed across the foot. Similarly, corns and callus may create discomfort when standing or walking.

Some people gradually begin changing the way they walk to avoid these painful areas. Although this may seem minor initially, long-term compensation can affect posture and balance.

Carers are often the first people to notice these changes because they may observe someone walking more cautiously or avoiding activity.

Why Footwear Matters for Balance and Stability

Footwear is another important factor influencing balance and mobility in older adults.

Shoes that are too loose, heavily worn, poorly fitting, or lacking support may reduce stability and increase falls risk.

We often hear carers say:

“They prefer wearing slippers all the time.”

While slippers may feel comfortable, they may not always provide the support or grip needed for safe movement, particularly on smooth flooring surfaces.

According to the Better Health Channel footwear advice, supportive footwear can help improve stability and reduce pressure on the feet.

Supportive footwear should generally:

• fit securely without excessive looseness
• provide good grip and traction
• support natural walking patterns
• minimise pressure areas
• provide cushioning and stability
• have secure fastening where possible

Worn-out footwear may also lose cushioning and grip over time, increasing instability.

Walking Barefoot Can Increase Risk

Some older adults prefer walking barefoot around the home because it feels comfortable or familiar. However, barefoot walking may increase risk for people with reduced sensation, poor balance, or fragile skin.

Without protective footwear, the feet are more vulnerable to:

• cuts and skin injuries
• pressure areas
• slipping
• instability on smooth surfaces

For people with diabetes or peripheral neuropathy, small injuries may go unnoticed due to reduced sensation.

Encouraging supportive footwear indoors may help improve stability and reduce injury risk.

How Carers Can Help Reduce Falls Risk

Carers and family members often play a very important role in identifying early changes affecting mobility.

Simple observations made consistently may help detect issues before they become more serious.

Helpful things carers can do include:

• observing changes in walking patterns
• monitoring balance confidence
• encouraging supportive footwear
• checking for signs of foot pain
• monitoring for swelling or redness
• arranging podiatry assessments when needed

Sometimes carers notice subtle changes such as someone holding onto furniture more often or becoming reluctant to walk outdoors.

These early signs may indicate discomfort, instability, or reduced confidence walking safely.

The Link Between Fear of Falling and Reduced Activity

One important issue we often see is that fear of falling itself may lead people to reduce activity levels.

Someone who feels unstable may begin:

• avoiding exercise
• limiting social outings
• walking shorter distances
• spending more time seated

Unfortunately, reduced movement may gradually contribute to declining muscle strength and balance, further increasing falls risk over time.

Maintaining comfortable, confident movement is therefore extremely important for overall health and independence.

Why Early Intervention Matters

Many foot-related balance problems develop gradually and are easier to manage when addressed early.

For example:

• supportive footwear may improve stability
• managing painful nails may improve walking comfort
• reducing callus may decrease pressure
• orthotic devices may improve foot function
• identifying neuropathy early may improve safety strategies

Waiting until someone has already experienced multiple falls often makes rehabilitation more difficult.

Preventative foot care aims to identify concerns before mobility significantly declines.

How Podiatrists Assess Balance and Foot Function

Podiatrists assess far more than just skin and nails during appointments. A comprehensive podiatry assessment considers how the feet are functioning overall during standing and walking.

A podiatry assessment may include:

• circulation assessment
• nerve sensation testing
• skin and nail assessment
• pressure analysis
• footwear assessment
• gait and walking analysis
• balance assessment
• mobility review

This helps identify whether foot pain, reduced sensation, footwear issues, or biomechanical factors may be contributing to instability.

Podiatrists may also work alongside GPs, physiotherapists, occupational therapists, and aged care teams as part of broader falls prevention strategies.

Supporting Mobility and Independence

Maintaining safe movement is an important part of healthy ageing and reablement-focused care.

Being able to move confidently around the home and community contributes significantly to independence, wellbeing, and quality of life.

Foot health is only one factor in falls prevention, but ensuring the feet are comfortable and functioning well can play an important role in supporting mobility.

For people receiving services through the Support at Home framework, maintaining mobility and confidence walking is often a major goal of care.

Preventative podiatry care may help support:

• confidence walking
• safer movement
• balance and stability
• ongoing activity levels
• independence at home
• participation in community activities

When Should You See a Podiatrist for Balance or Foot Problems on the Sunshine Coast?

Older adults should consider seeing a podiatrist if they develop foot pain, reduced sensation, instability when walking, thickened nails, pressure areas, or changes in mobility.

A podiatry assessment involves reviewing circulation, nerve sensation, footwear, skin health, and walking patterns to identify factors that may be affecting stability or comfort.

This is particularly important for people living with diabetes, peripheral neuropathy, arthritis, or circulation issues.

Across the Sunshine Coast, podiatry services may be available both in clinic and through mobile podiatry visits for people who find attending appointments difficult.

Mobile podiatry can be especially helpful for older adults receiving aged care or Support at Home services who may have reduced mobility or balance confidence.

Working Together to Support Safe Movement

Falls prevention often involves a team approach.

Carers, family members, podiatrists, physiotherapists, GPs, and other healthcare professionals all contribute to supporting safe movement and independence.

Carers are frequently the first people to notice changes in mobility or confidence walking. Sharing these observations during healthcare appointments can help identify concerns early and guide appropriate treatment.

By working together, it is often possible to support safer movement, maintain independence, and improve quality of life.

Frequently Asked Questions

Can foot problems really affect balance?

Yes. The feet provide important feedback to the brain about pressure, movement, and body position. Foot pain, reduced sensation, or instability can affect walking confidence and balance.

Even relatively small foot problems may contribute to altered walking patterns over time.

What is peripheral neuropathy?

Peripheral neuropathy is a condition involving reduced nerve sensation, commonly affecting the feet.

People with neuropathy may experience numbness, tingling, burning sensations, or difficulty feeling the ground properly when walking.

Why are older adults more at risk of falls?

Falls risk is influenced by multiple factors including reduced muscle strength, balance changes, arthritis, vision changes, medications, and foot problems.

Painful feet or reduced sensation may further increase instability.

Can footwear improve stability?

Supportive footwear may help improve balance, reduce pressure on the feet, and provide better grip when walking.

Shoes that are loose, worn-out, or lacking support may increase falls risk.

Why should people with diabetes monitor their feet carefully?

Diabetes may affect circulation and nerve sensation in the feet, increasing the risk of unnoticed injuries and reduced stability.

Regular foot assessments can help identify changes early.

How can carers help reduce falls risk?

Carers can help by observing walking patterns, encouraging supportive footwear, monitoring for signs of foot pain, and arranging podiatry care when changes are noticed.

Early intervention often helps prevent mobility problems becoming more severe.

Are mobile podiatry services available for older adults?

Many podiatry clinics offer mobile podiatry services for people who have difficulty attending appointments independently.

These services may be particularly useful for older adults receiving home care or aged care support.