The Irony of Aging

Maybe it’s on my mind because I just celebrated a birthday- fear not, I’ve demonstrated my continued virility by welcoming a new baby into the world the day before my birthday- but it does seem like there are some cruel cosmic jokes associated with the aging process.   We can forsake all the obvious Viagra and Depends jokes that would commonly be inserted at this point and instead discuss one that I stare at on a daily basis. And that would be the displacement of fat that we will derive from being alive should we survive till 105 (name that song anyone?).

As we may have discussed previously in the hallowed halls of this NYC podiatry blog- who knows, there have been so many and I’m not as young as I was when I wrote the last one- there is a fat pad that exists on the bottom of the foot. This padding is located under the heels and ball of the foot and serves as cushioning from the thousand natural shocks that flesh is heir to (playwright anyone?). Now over time, as part of the natural aging process, this padding atrophies, or thins out. So, the ball of the foot that starts to hurt somewhere around my age (guesses, anyone?) does so due to a natural physiologic process. And if it feels like the bottom of the foot has lost its cushioning it’s because it has.

The irony is that we lose fat in places where it would be helpful and gain it in places where it is unwanted, two trends that we all try desperately to avoid. I can wholeheartedly recommend diet and exercise for the second problem; unfortunately I don’t have an elegant solution for the first. The best I can tell my dear NYC podiatry patients is that some shoes may not be as comfortable as they once were and your current shoes may need a bit more padding, or even an orthotic. There are injectables for the bottom of the foot, mostly in the form of dermal fillers used by dermatologists and plastic surgeons for the face, however the results are temporary and somewhat mixed.

So if you’re becoming a bit more, ahem, seasoned, and the feet just don’t feel cushioned anymore, it’s not just in your head. It’s actually in your feet, or not in your feet as it were. But all is not lost: it’s a great ride, and we can enjoy it together.

See you in the office.

Ernest Isaacson

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