Shuffling (not clearing of the feet when someone walks) can be caused by several issues. All potential causes need to be investigated as this is a major contributor to falls. If you or your loved one is catching their feet, this is what we’re talking about. The main thing you’ll notice is an audible scrape when the foot is being dragged across the floor. I overheard another therapist tell a patient (who was wearing tennis shoes on a wood floor) “I don’t want to hear a basketball game while you’re walking.”, as there was an audible “chirp” every time their foot made contact with the floor.
Causes
Some of the main causes of shuffling are decreased ankle range of motion, decreased leg strength, improper footwear or an altering of one’s center of balance. Some seniors, as they age, tend to start leaning or pitching forward. This can be due to several reasons, (such as tight muscles, spinal changes, etc…) and when this occurs it becomes more difficult to swing the leg all the way through while walking. Some older adults will “catch” their toe at that point. Again, this significantly increases a senior’s risk of a fall.
Another causative factor is a loss of flexibility. When we sit, the muscles at the back of our knees (hamstrings) and the muscles at the front of the hip (psoas major) are shortened. If you or your loved one sits for long periods of time, these muscles can actually become shortened or contracted. To visualize this, imagine you’re standing but partially in a sitting position with bent knees and leaning forward. This throws your center of balance forward. When you try to take a step you are much more likely to shuffle your feet or catch them on something. If your loved one is exhibiting this, bring it to their attention. If they cannot self correct this, consult their physician as physical therapy, medications or sometimes even simple exercises can help correct this.
Another potential cause of shuffling is Parkinson’s disease or Parkinsonian type conditions. This is often accompanied by a shorter step length and what some in the medical community dub the “Parkinson’s Shuffle.” While this is an unflattering term, it is used because this is one of the main signs people exhibit with Parkinson’s Disease. We’re not saying because you shuffle, you have Parkinson’s, but all potential causes of shuffling need to be examined to determine the cause.
Proper Footwear
Foot wear was noted earlier and improper footwear can be a causative factor in both shuffling and falls. I have several clients that go barefoot at home, and unless they’re a Type II diabetic with neuropathy, I don’t usually have a problem with this. What I do see that can be an issue are people wearing only socks (I know they make “non-skid socks, still not a fan…) esp on wood or tiled flooring. Many like to wear “slides” or a slip in shoe with no backing. It’s very easy for your foot to come out of or to partially kick one off while walking, causing a stumble or worse a fall. If shoes are worn in the home it is recommended that the shoe has a back to help keep it on. We have no affiliation with ”Skechers” brand shoes, but I’ve had several clients with their new “Slip-Ins” (trademark by Skechers), and they really like them. They’re easy to put on and they stay on. That might be a good choice for shoes to be worn in the home. I’m not advocating for any particular type of shoe or recommending you or your loved one go barefoot. Simply stating that socks alone and open heeled shoes do increase fall risk.
In closing, people that shuffle are at a much higher risk of falling. If you or your loved one is shuffling, please get with your physician or physical therapist to help determine the cause. Often, some simple exercises and improved flexibility will take care of the issue. Regardless, all causes of shuffling need to be investigated to help reduce fall risk. And since falls are responsible for 75% of all senior citizen injuries, addressing this issue can go a long way.