Diabetic Foot Care
Diabetes affects millions of people every year. Blood vessels located all over the body are damaged due to diabetes—even the blood vessels of the feet. Neuropathy, or nerve damage, can result from slower blood flow in the legs and feet. In diabetic patients, neuropathy is very important to monitor, as diabetics are at risk for developing ulcers.
Always washing and thoroughly drying the feet are pertinent parts of diabetic foot care. There should be a focus on cleaning between the toes. Even if no pain is felt, the entire foot should be examined for redness and sores. Neuropathy can often mask the pain of sores and ulcers and can cause these conditions to be overlooked. Use a mirror to examine the underside of your feet if needed. It is recommended that diabetics wear well-fitting socks.
Patients with diabetes should have their doctor monitor their blood levels because blood sugar levels play a huge role in diabetic care. Monitoring these levels on a regular basis is highly advised. It is very important to keep your blood sugar levels in the normal range, which can be determined by your physician. There are medications that may be prescribed to help with any neuropathy experienced by the diabetic patient. It is also advisable to visit a podiatrist if one is experiencing any conditions involving the feet, such as ingrown toenails, which in more severe cases can cause infection.
Diabetic feet must be inspected daily. Diabetic foot care at home is possible if a patient is provided with instructions from their podiatrist. Patients can relieve dry heels with creams or ointments. Suspected wounds should warrant an immediate call to the podiatrist. Gangrene is a serious problem for diabetics and can lead to sepsis and amputation in its worst cases. Early treatment and daily inspection of diabetic feet are keys to staying healthy.
Peripheral Artery Disease
Peripheral artery disease (PAD), or peripheral arterial disease, is a circulatory problem in which there is a reduction of blood flow to the limbs due to narrowed arteries. When peripheral artery disease develops, the extremities do not receive enough blood flow; this may cause symptoms to develop such as claudication, or leg pain when walking. The legs are the most common site of peripheral artery disease.
Claudication, or leg pain when walking, is one of several symptoms that can develop due to peripheral artery disease. Other symptoms caused by the disease include painful cramping in the hips, thighs, or calves after certain activities; leg numbness or weakness; coldness in the lower leg or foot; sores on the lower extremities that do not heal; hair loss on the lower extremities; and a missing or weak pulse in the lower extremities. In more severe cases, pain may even occur when the body is at rest or when lying down.
Peripheral artery disease is typically caused by atherosclerosis, a condition in which fatty deposits build up in the arterial walls and reduce blood flow. Smoking, diabetes, obesity, high blood pressure, and high cholesterol are some of the risk factors for peripheral artery disease.
If you are experiencing pain, numbness, or other symptoms in the lower extremities, see your healthcare professional immediately. Diagnosed peripheral artery disease can be treated with various medications, angioplasty and surgery, exercise programs, or alternative medicine. It is important to consult a healthcare professional to determine the best treatment for you.
Stress Fractures of the Foot and Ankle
Our bones are important aspects of our body and they are constantly changing. The heavier the workload for a bone, the more likely it is that calcium will be placed in it. When a bone isn’t used often, there won’t be much calcium within it. When stress from repetitive loads prevent the bone from being able to repair itself, cracks will start to form. Stress fractures are defined as cracks in a bone that result from repetitive force, such as overuse.
The most common cause of stress fractures is a sudden increase in intensity and duration of physical activity. For example, if you begin to run long distances without working your way into doing so, you will be more likely to develop a stress fracture.
Common symptoms of stress fractures are pain and swelling near the weight bearing area on the injured bone. When initial x-rays are performed, it is possible that the fracture will not show up. However, once the stress on the area continues, the damage will increase, and the fracture will be severe enough to show up on an x-ray. Certain parts of the foot are more likely to develop stress fractures than others. Areas that typically have these fractures are: the metatarsals, the navicular bone, the calcaneus, tibia, and fibula.
Since women are at an increased risk of developing osteoporosis, they are twice as likely as men to sustain a stress fracture. Additionally, old age causes a decrease in bone mineral density which is why elderly people are also likely to develop these fractures.
It is important for you to be professionally diagnosed by a podiatrist if you suspect you have a stress fracture, because there are other injuries that can easily be mistaken for a fracture. Sprains, strains, shin splints, plantar fasciitis, and Morton’s neuroma can all easily be mistaken for stress fractures in the foot. Your podiatrist will likely ask you a series of questions to determine what type of pain you are experiencing. These questions will help your doctor identify whether you have a stress fracture.
The best method of treatment for a stress fracture is rest. Additionally, a walking boot, cast, or crutches, will help rest the area that is injured. The typical healing time for stress fractures is 4-12 weeks, however this depends on which bone is involved.
Understanding Corns and Calluses
Corns and Calluses are both hardened layers of thickened skin that develop because of friction. Both ailments are typically found on the feet and may be unsightly. Although they have similarities, corns and calluses are different from each other.
Some causes of corns and calluses may be wearing ill-fitting shoes and not wearing socks. If you wear tight shoes, your feet will constantly be forced to rub against the shoes, causing friction. If you fail to wear socks, you are also causing your feet to endure excess friction.
There are some signs that may help you determine whether you have one of these two conditions. The first symptom is a thick, rough area of skin. Another common symptom is a hardened, raised bump on the foot. You may also experience tenderness or pain under the skin in addition to flaky, dry, or waxy skin.
There are also risk factors that may make someone more prone to developing corns and calluses. If you are already dealing with bunions or hammertoe, you may be more vulnerable to having corns and calluses as well. Other risk factors are foot deformities such as bone spurs, which can cause constant rubbing inside the shoe.
Corns tend to be smaller than calluses and they usually have a hard center surrounded by inflamed skin. They also tend to develop on the parts of the body that don’t bear as much weight such as the tops and sides of toes. Corns may also be painful for those who have them. On the other hand, calluses are rarely painful. These tend to develop on the bottom of the feet and may vary in size and shape.
Fortunately, most people only need treatment for corns and calluses if they are experiencing discomfort. At home treatments for corns and calluses should be avoided, because they will likely lead to infection. If you have either of these ailments it is advised that you consult with your podiatrist to determine the best treatment option for you.
Sports Related Foot And Ankle Injuries
Foot and ankle injuries are common among people who participate in sports. Several factors contribute to this. They include failing to stretch or warm up properly, not wearing the proper type of shoe and not taping or providing other types of support for the ankle or foot. The most common foot and ankle injuries suffered by people involved in sports are plantar fasciitis, ankle sprains and Achilles tendon damage or ruptures. If not treated properly, they can lead to permanent disability.
Treating these injuries is relatively simple if they are identified and addressed early. Many athletes dismiss the initial aches and pains associated with injury as just soreness or tired muscles. Their first response is usually to try to work through it. This can lead to serious problems. Many minor injuries are made far more serious when athletes continue to put strain and pressure on them. That attitude can change a mild strain into a serious strain and a minor tear into a rupture. Athletes should have unusual aches and pains evaluated by a skilled medical professional.
Plantar fasciitis is a painful injury. It is inflammation of the plantar fascia, the thick band of tissue running from the heel to the base of the toes. If left untreated, it can lead to a degenerative disease called plantar fasciosis. There are several effective treatments for this ailment. Doctors often prescribe rest, massages, stretching, night splints, physical therapy, anti-inflammatory medication, corticosteroids or surgery, usually in that order. The most effective treatment for plantar fasciitis is orthotics, which offers foot support. Surgery is occasionally used as a last resort, but it comes with the risk of nerve damage and infection and often does not stop the pain.
The Achilles tendon is the largest tendon in the body. It connects the calf muscles to the heel bone. Running, jumping and walking all impact this tendon. Two common injuries to the Achilles tendon are tendonitis and a rupture of the tendon. Tendonitis is inflammation in the tendon often caused by an increase in the amount of stress placed on it. Non-surgical treatments include rest, ice or anti-inflammatory medication. A rupture (tear) of the Achilles tendon can be treated by placing the lower leg in a cast for several weeks or with surgery. Many physicians feel surgery is the better option because it lowers the risk of re-ruptures. Both methods require 4 to 6 months of rehabilitation.
Ankle sprains are the most common sports related foot and ankle injury. A sprain occurs when the ligament holding the ankle bones and joint stretches beyond its normal range. It can be treated non-surgically with a combination of rest, ice wrapped around the joint for 30 minutes immediately after injury, compression by a bandage and elevating the ankle above the heart for 48 hours. This combination is referred to as RICE. Severe ankle sprains in which the ligaments are torn may require reconstructive surgery followed by rehabilitation.
Investing in Custom Orthotics Means Investing in Foot Health
Custom orthotics offer a tailored approach to foot health, providing a host of benefits that extend far beyond conventional shoe inserts. One of the primary advantages lies in their ability to address specific biomechanical issues. Unlike off-the-shelf inserts, custom orthotics are crafted based on an individual's unique foot structure, gait, and any existing foot conditions.
The personalized design of custom orthotics ensures optimal support for the arches, promoting proper alignment and distributing pressure evenly across the feet. This can be particularly beneficial for individuals dealing with issues such as overpronation or underpronation, as custom orthotics help correct imbalances that may lead to discomfort or injury.
Beyond biomechanics, custom orthotics can alleviate a range of foot problems, including plantar fasciitis, bunions, and metatarsalgia. They provide targeted relief to areas under stress, reducing pain and inflammation. Additionally, for those with specific medical conditions like diabetes, custom orthotics can play a crucial role in preventing complications associated with poor foot health.
Comfort is another key aspect of custom orthotics. By accommodating the unique contours of an individual's feet, these inserts enhance overall comfort, making daily activities more enjoyable. Whether for athletes looking to optimize performance or individuals seeking relief from chronic foot pain, custom orthotics offer a versatile solution.
Investing in custom orthotics is an investment in long-term foot health. They not only provide immediate relief but also contribute to the prevention of future issues. With the ability to seamlessly integrate into various types of footwear, custom orthotics empower individuals to prioritize foot comfort without compromising on style. In essence, custom orthotics are a personalized prescription for happy, healthy, and pain-free feet.
Foot Surgery
In most cases, foot surgery is often chosen as the last available option for conditions that have otherwise been unsuccessfully treated. Surgery may be necessary for several reasons, including the removal of foot deformities (e.g. bone spurs or bunions), arthritis problems, reconstruction due to injury, and congenital malformations (e.g. club foot or flat feet). Regardless of one’s age, foot surgery may be the only successful option for treatment for certain conditions.
The type of surgery one undergoes depends on the type of foot condition the patient has. For the removal of a bunion growth, a bunionectomy is necessary. If the bones in the feet need to be realigned or fused together, a surgical fusion of the foot is needed. For pain or nerve issues, a patient may require surgery in which the tissues surrounding the painful nerve are removed. Initially, less invasive treatments are generally attempted; surgery is often the last measure taken if other treatments are unsuccessful.
While in many cases surgery is often deemed as the final resort, choosing surgery comes with certain benefits. The associated pain experienced in relation to the particular condition is often relieved with surgery, allowing patients to quickly resume daily activities. The greatest benefit, however, is that surgery generally eliminates the problem immediately.
Podiatry history has shown that foot treatments continue to evolve over time. In the field of foot surgery, endoscopic surgery is just one of the many advanced forms of surgery. As technology vastly improves so too will the various techniques in foot surgery, which already require smaller and smaller incisions with the use of better and more efficient tools. Thanks to such innovations, surgery is no longer as invasive as it was in the past, allowing for faster and easier recoveries.
Proper Shoe Fitting
When it comes to maintaining foot health, wearing properly-fitting shoes is important. While wearing the appropriate pair of shoes may seem like a trivial concern, the reality is that improperly fitted shoes cause an astounding amount of injuries to the feet. The overall structure and the biomechanics of our bodies are directly affected by our posture, gait, and feet. Because of this, pain and discomfort felt throughout the body are often related to a problem in the feet. And, most foot problems usually stem from improper footwear.
Shoes should not be purchased with the expectation that they will easily stretch and contort to the size and shape of your feet. When shopping for footwear, look for shoes that fit correctly and comfortably as soon as you put them on. Do not purchase shoes that are too large or that slip in the heel area when you walk. Do not choose shoes that are loose with the intention of wearing thicker socks to compensate for the space. The widest portion of the shoe, the ball of the foot, must be made sure to fit comfortably in the shoe.
Keeping all of these suggestions in mind may be difficult when shopping and when trying to select from a wide array of different shoes. Nonetheless, your time and money will be wasted if you purchase a pair of shoes that are too uncomfortable for you to actually wear them. After finally selecting and purchasing a pair of shoes, try them on at home. To truly ensure whether or not your shoes fit comfortably with normal activity, walk around on a carpeted surface to determine how they feel on your feet.
The possibility of damaging your feet’s 33 joints, 26 bones, and 100+ ligaments is much higher than many people suspect. Finding an appropriate and properly-fitted pair of shoes is perhaps the single most important action you can take to maintain excellent foot health and help prevent injury. The fact that our feet continue to change with age is one that many people often forget. Even if our feet no longer change in size when we mature, our feet will still change in shape.
If you already have pre-existing foot problems, there is a greater possibility that wearing improperly-fitted shoes will worsen those problems. The good news, however, is that appropriate footwear is not difficult to find. While shopping for shoes, remember that improper footwear can detrimentally affect the feet, the entire body and its biomechanical structure as well. The shoes you wear can greatly impact your legs, back, and entire body, as your posture and gait are related to your feet. Finding and selecting the best properly-fitted shoes is necessary in achieving optimal health.
Three Grades of Ankle Sprains
An ankle sprain occurs when one or more ankle ligament gets overly stretched. Ligaments are strong bands of tissue that bind and support the bones and other structures that make up the ankle. In more severe ankle sprains, the ligament(s) tear—either partially or completely—and there may be an audible popping noise at the moment of injury.
Ankle sprains are quite common and can occur when the ankle rolls outwardly (eversion) or inwardly (inversion), causing the ligament(s) to stretch beyond normal limits, or even tear. Falls, twists, or blows to the ankle during sports or other activities can cause this injury, as well as wearing improper footwear, running on uneven surfaces, or having weak ankles.
Depending on the injury’s severity, an ankle sprain will be classified as Grade I, Grade II, or Grade III. Grade I sprains involve ligament(s) being overly stretched but not torn, with symptoms of mild pain, swelling, and ankle instability. There may also be some difficulty bearing weight. A Grade II sprain usually involves a partial tear of the ligament which brings more intensity in these symptoms, along with possible bruising. With a Grade III sprain, the ligament is completely torn, the symptoms are severe, and it may not be possible to put weight on the affected foot at all.
To diagnose and grade an ankle sprain, a podiatrist will perform a physical examination, checking for tenderness and range of motion in the ankle. For more severe sprains, X-rays or other imaging studies may be necessary.
It is vitally important to have an ankle sprain treated properly as improper healing often leads to future ankle sprains and possibly even chronic ankle stability. Treatment for an ankle sprain will vary, depending on its severity, and may include the RICE method (Rest/Ice/Compression/Elevation), physical therapy, bracing, medications, and possibly even surgery to repair a torn ligament. Rehabilitation is very important for the sprain to heal properly and to restore functionality.
Tarsal Tunnel Syndrome
Tarsal tunnel syndrome is a condition in which there is a compression of the posterior tibial nerve. The posterior tibial nerve runs along the inside of the ankle into the foot. Tarsal tunnel syndrome is named for the tarsal tunnel, which is a thin space along the inside of the ankle beside the ankle bones. This space contains various nerves, arteries, and tendons, and includes the posterior tibial nerve. The tibial nerve is the peripheral nerve in the leg responsible for sensation and movement of the foot and calf muscles. In tarsal tunnel syndrome the tibial nerve is compressed, causing tingling or burning, numbness, and pain.
Common causes of tarsal tunnel syndrome involve pressure or an injury. Injuries that produce inflammation and swelling in or around the tunnel may place pressure on the posterior tibial nerve. Direct pressure on the tibial nerve for an extended period of time, sometimes caused by other body structures close by or trauma to the tibial nerve, can result in tarsal tunnel syndrome. Diseases that damage nerves, such as diabetes or arthritis, may cause tarsal tunnel syndrome. Those with flat feet are at risk for developing the condition, as the extra pressure and strain placed on the foot may compress the posterior tibial nerve.
Feeling different sensations in the foot at different times is a common symptom of tarsal tunnel syndrome. An afflicted person may experience pain, tingling, burning or other unusual sensations in the foot of the affected leg. Symptoms are primarily felt on bottom of the foot and/or the inside of the ankle. Symptoms can appear suddenly and may occur due to overuse of the foot.
To diagnose tarsal tunnel syndrome, your podiatrist may examine the foot and tap the posterior tibial nerve to see if symptoms surface. He or she may also order an MRI to determine if a mass is present.
Treating tarsal tunnel syndrome will depend on the decision of your podiatrist. Multiple options are available, however, and can include rest, ice, immobilization, oral medications such as anti-inflammatory drugs (NSAIDS), physical therapy, injection therapy, orthotics, supportive shoes, braces, and surgery.
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Investing in Custom Orthotics Means Investing in Foot Health
Custom orthotics offer a tailored approach to foot health, providing a host of benefits that extend far beyond conventional shoe inserts. One of the primary advantages lies in their ability to address specific biomechanical issues. Unlike off-the-shelf inserts, custom orthotics are crafted based on an individual's unique foot structure, gait, and any existing foot conditions.
The personalized design of custom orthotics ensures optimal support for the arches, promoting proper alignment and distributing pressure evenly across the feet. This can be particularly beneficial for individuals dealing with issues such as overpronation or underpronation, as custom orthotics help correct imbalances that may lead to discomfort or injury.
Beyond biomechanics, custom orthotics can alleviate a range of foot problems, including plantar fasciitis, bunions, and metatarsalgia. They provide targeted relief to areas under stress, reducing pain and inflammation. Additionally, for those with specific medical conditions like diabetes, custom orthotics can play a crucial role in preventing complications associated with poor foot health.
Comfort is another key aspect of custom orthotics. By accommodating the unique contours of an individual's feet, these inserts enhance overall comfort, making daily activities more enjoyable. Whether for athletes looking to optimize performance or individuals seeking relief from chronic foot pain, custom orthotics offer a versatile solution.
Investing in custom orthotics is an investment in long-term foot health. They not only provide immediate relief but also contribute to the prevention of future issues. With the ability to seamlessly integrate into various types of footwear, custom orthotics empower individuals to prioritize foot comfort without compromising on style. In essence, custom orthotics are a personalized prescription for happy, healthy, and pain-free feet.
Athlete’s Foot
Athlete’s foot, or tinea pedis, is a skin disease caused by a fungal infection. The infection typically occurs between the toes, and the feet are most subject to this disease because shoes best create the warm, dark, and moist environment in which fungus thrives. Other areas that create a similar environment, such as swimming pools, public showers, and locker rooms; can also promote fungi growth.
Symptoms of athlete’s foot include dry skin, itching, scaling, inflammation, and blistering. Sometimes, blisters can evolve into the cracks or breaks in the skin. The exposed tissue can then create pain, swelling, and discharge. The spread of infection can cause itching and burning as well.
While athlete’s foot commonly occurs between the toes, it may also spread to the toenails or soles of the feet. Other parts of the body, such as the groin or underarms, can also become infected if they are touched after the original area of infection is scratched. Aside from physical contact, athlete’s foot can also spread through the contamination of footwear, clothing or bedsheets.
Proper foot hygiene is essential in preventing athlete’s foot. You can prevent the fungus from spreading by frequently washing your feet using soap and water, thoroughly drying the feet between the toes, changing shoes and socks every day to reduce moisture, and ensuring that bathroom and shower floors are disinfected. Other tips include using shower shoes, avoiding walking barefoot in public environments, wearing light and airy shoes, and wearing socks that keep the feet dry.
While treatment for athlete’s foot can involve topical or oral antifungal drugs, mild cases of the infection can be treated by dusting foot powder in shoes and socks. Any treatment used can be supplemented by frequently bathing the feet and drying the toes. If proper foot hygiene and self-care do not ease your case of athlete’s foot, contact your podiatrist. He will determine if the underlying cause of your condition is truly a fungus. If that is the case, a comprehensive treatment plan may be suggested with the inclusion of prescription antifungal medications.
All About Plantar Warts
Plantar warts are warts that are only found on the feet, hence the term “plantar”, which means “relating to the foot.” They are caused by the human papillomavirus, or HPV, and occur when this virus gets into open wounds on the feet. The warts themselves are hard bumps on the foot. They are easily recognizable, mostly found on the heels or ball of the foot. Plantar warts are non-malignant, but they can cause some pain, discomfort, and are often unsightly. Removing them is a common step toward treating them.
Plantar warts can cause some pain while standing, sometimes felt as tenderness on the sole of your foot. Unless the wart has grown into the foot behind a callus, you will be able to see the fleshy wart. A podiatrist should only be consulted if there is an excessive amount of pain. Plantar warts are not cancerous or dangerous, but they can affect your walking and continually reappear. Anyone who suffers from diabetes or a compromised immune system disease should seek out care immediately.
Podiatrists are easily able to diagnose plantar warts. They usually scrape off a tiny bit of the rough skin to make tiny blood clots visible and examine the inside of warts. However, a biopsy can be done if the doctor is not able to diagnose them from simply looking at them. Although plantar warts usually do not require an excessive amount of treatment, there are ways to go about removing them. A common method is to freeze them off using liquid nitrogen, removing them using an electrical tool, or burning them off via laser treatment. For a less invasive treatment option, topical creams can be used through a doctor’s prescription. This treatment method takes more time, however. Keep the wart covered for protection in between daily treatments.
The best way to avoid developing plantar warts is to avoid walking barefoot in public places. Avoid this especially if you have open sores or cuts on your feet. It is also important to avoid direct contact with warts in general, as they are highly contagious.
Geriatrics and Podiatry
Bone density loss, dry skin, poor circulation, and rough and brittle nails are some of the common problems that can occur as people age. The effect that these problems has on foot health should be of particular concern in comprehensive geriatric care.
Feet that are diseased or injured have a negative effect on overall health and safety. Painful feet limit a person’s willingness and ability to stay active. Poor foot health can also cause gait change, which can lead to falls and accidents. Even though recovery time from health problems naturally slows as we age, many foot problems can be avoided altogether with regular prophylactic care.
Feet should be thoroughly washed in warm water daily. Care must be taken to dry the feet well, making sure to dry between and under the toes. Any left-over moisture can cause problems like foot fungus. After cleaning feet carefully check for problems such as cracked skin, bruises, swelling, cuts, corns, or other irregularities.
Examine toenails for ingrown, jagged, or split nails. Long toenails should be cut straight across. Never cut toenails at an angle or down the side as this may lead to ingrown nails.
Cracked and dry feet should be treated once or twice a day with a non-greasy moisturizer. Rub the moisturizer into the skin and allow it to dry before putting on socks and shoes. Sweaty feet can be dusted with a small amount of talcum powder. Avoid putting talcum directly into shoes as this may make feet slip within the shoe and cause a serious fall.
Wear clean dry socks each day. Not only do clean socks feel better on the feet, but socks worn for longer periods may harbor disease and odor-causing bacteria. Socks should not be tight around the top as they can leave marks on the leg. Socks that are too small can bring about bruising caused by pressure against the toes.
Wear comfortable and well-fitting shoes. If possible, consult a professional footwear specialist when purchasing shoes. Do not walk around barefoot as this exposes the feet to possible injury and bacteria.
Good foot health allows a more active lifestyle, which improves blood flow. Good circulation aids in recovery from injury or illness. It is also important for maintaining overall health.
Serious health problems can manifest themselves as symptoms in the feet. The elderly should seek professional help from a podiatrist if experiencing foot problems like tingling, numbness, pain, infection, or a sore that does not heal. Taking care of these problems right away can prevent the development of severe cases.
