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Diabetes and Feet | Harold Cook, DPM

Diabetes

Types 1 and 2 are both diseases of impaired glucose (sugar) metabolism. Uncontrolled, diabetes can cause long-term damage to every organ in your body, including eyes, and foot. Diabetes may cause nerve damage, also called diabetic neuropathy. Neuropathy is experienced as burning or tingling sensations or numbness in the feet.  Diabetes can also cause damage to the circulatory system (peripheral arterial disease, PAD).

If diabetes is uncontrolled it can impair the body’s immune system and make the diabetic patient more susceptible to bacterial and fungal infections. Diabetes can also damage the body structure of the foot leading to difficult to treat foot deformities. When these damaging processes combine it can lead to the formation of diabetic foot ulcerations also known as diabetic foot wounds.

It is estimated that approximately 25% of diabetic patients will develop a diabetic foot ulceration. Chronic wounds and infection combined with impaired circulation in the diabetic foot all too often can result in lower extremity amputations. However the American Podiatric Medical Association has estimated the 80% of lower extremity amputations are preventable.  Prevention of these amputations greatly improves the quality of life of the patients in question and can save costs to our overburdened healthcare system.

Prevention of diabetic foot ulcerations and amputations is best accomplished through a team effort. The treatment team for prevention of these issues includes the diabetic patient, a medical doctor, and a podiatrist. Sometimes it is necessary to add a vascular surgeon to the treatment team. The medical doctor is necessary to ensure that diabetic patients are on the correct medications to control their diabetes as well as manage any other medical issues.

 

The Podiatrist’s role in the prevention of diabetic ulcerations and amputations is to perform diabetic foot screenings, checks for neuropathy and peripheral arterial disease, as well watch for the warning signs of diabetic foot ulcerations. The podiatrist should also takes steps to educate their patient about the warning signs for diabetic foot ulcerations as well as educate their patient on how to take care of their feet between visits. When the podiatrist notices any of these warning signs it is the job of the podiatrist to initiate both surgical and non-surgical treatments to prevent ulceration or to heal ulceration that have already formed.

Common non-surgical podiatry treatments for diabetic foot health include:

  • The trimming of ingrowing nails
  • The treatment of fungal foot infections of the skin and nails
  • The prescribing of diabetic shoes and custom arch supports
  • The trimming of pre-ulcerative lesions such as calluses and corns

Antibiotic medications can also be prescribed for the treatment of bacterial infections. Physical therapy and assistive devices such as braces are additional examples of non-surgical treatments. Medications are often prescribed for the treatment or prevention of neuropathy and its symptoms.

Occasionally a surgical procedure may be required to prevent or treat diabetic foot ulcerations. These surgical treatments may include:

  • The removal of damaged tissue of wounds
  • Correction of hammertoe or bunion deformities when they are causing or are at risk of causing diabetic foot ulcerations
  • Occasionally complex reconstructive surgery can be required to correct problems caused by diabetes in the foot
  • Sometimes a vascular surgeon is needed to help improve or restore bloodflow to the foot in order for a diabetic foot ulceration to heal

The diabetic patient themselves cannot be overlooked as an important member of diabetic foot care team.

Small changes in the daily routine of the diabetic patient can have a big impact on their overall foot health.

  • The diabetic patient should check their feet daily, make sure that they are using the shoes that they are directed to wear by their doctor.
  • The diabetic patient can significantly reduce their risk of ulcerations and amputations by refraining from smoking and other tobacco products.

This team approach and strategy has a major impact on the outcome and survivability of diabetes in the United states today.

It is estimated that $245 billion is spent on the treatment of diabetes and complications caused by diabetes in the United States. Research by The APMA has shown that the inclusion of podiatrist in the care of the diabetics can save the US healthcare system $3.5 Billion per year.  So by making the team effort to treat and prevent diabetic foot complications, many amputations are prevented, the quality of life of diabetic patients is improved and the costs on our overburdened healthcare system can be greatly reduced.

Trust Physicians Footcare Team of Podiatrists to treat your foot problem and help get you back to what you love to do.

https://physiciansfootcare.com/foot-and-ankle-conditions/foot-conditions/

https://physiciansfootcare.com/contact-us/


What Are High Heels Biomechanically Doing to My Body? | Heather Driessen, DPM

My face met the ground the first time I wore heels. Okay, maybe that was bit of an exaggeration. I didn’t exactly fall but I came pretty close. I wonder what went wrong. Could it possibly have been the height? No, they were only 3 inches. Despite how “low” I thought the heel was, research has shown, as the heel’s height increases, so does the increased amount of pressure on the forefoot (ball of foot). For example:

1-inch = 22%

2-inches = 57%

3-inches = 76%

 

Can you imagine if I wore 6 inch heels?

In a survey of 100 women, 26 said they never wore heels; 74 wore them at some point in their lives. Although it has been shown over a 30 year span, less women are wearing heels today (40%) than in the 1980’s (60%);

more younger women (ages 18-25) wear high heels (50%) compared to those in their 50’s and up (35%). I found this survey very interesting. The point is most women wear heels and this practice, although declining in comparison to earlier years, is still ever present.

Recall the old adage: “Form follows function”. This was a principle associated with architecture. It states that the shape of an object should be based on its intended function or purpose. Think of it this way, high heels cause muscles in the leg to become fatigued or function abnormally for long periods of time. One may develop “form” issues in the sense of poor posture, stress on the back of the knees, shortened calf muscles, or even spine problems over time.

 

Let’s Review Some Anatomy (And How High Heels Affect Them):

Feet: The feet can be considered the base or foundation of the body’s skeleton. For those home builders out there, you may know, if you don’t have a good foundation, that house is subject to unevenness and instability. In the foot, joints become unsteady, arthritic, and painful which can lead to bunions and hammer-toes.

Calf muscle: The calf muscle or Gastrocnemius-Achilles tendon unit is one of the strongest muscle-tendons in the body. It helps one during push off and the propulsive phase of gait (walking). It works best when it is elongated and freely glides. Wearing high heels can shorten this muscle-tendon unit over time, which can lead to problems when walking barefoot or in other shoes. You might be enjoying those compliments of how nice your legs look from behind, but they may be costly in the long run.

Knees: Wearing high heels shift the knees forward, thus straining the back of the knees and hamstrings. The knee joint itself may develop arthritis over time.

Hips: As the center of gravity continues to shift forward, the hips become affected and can throw off one’s posture. Many thigh muscles originate from the hips and control how one stands, walks, or runs.

Back: As the knees and hips move forward, the back compensates by hyperextending backwards. Sure this will back your derriere look nice (hence, the cat calls again); however, this may lead to back soreness, spasms, and eventually spinal issues.

Am I saying, “Don’t EVER wear heels”? No. But, I think the best patient is a well-informed patient. Would I wear them again? Sure. Knowing what I know now, I think I will stick with a lower heel.

Our expert team of Foot Doctors know feet. Contact Physicians Footcare and schedule your immediate appointment.

https://physiciansfootcare.com/contact-us/

 


4 Typical Foot Injuries Found in Athletes | Harry Cotler, DPM

With constant running and jumping, an athlete’s body undergoes a lot of wear and tear. Although you need strong legs to participate in sports, your feet do much of the work. When athletes are suffering from ankle or foot pain, they visit Physicians Footcare

Here are 4 common foot injuries found in athletes 

  • Turf Toe: If you feel any pain or tenderness in your big toe joint, this could be due to turf toe. Repetitive hyperextension of the big toe, normally from performing box jumps, Olympic lifts, and triple extensions, causes this common foot pain. To make sure the toe isn’t fractured, get an X-ray from a foot doctor. Once fractures are ruled out, tape the toe to provide support and restrict movement. You can also wear stiff-soled shoes for added support.

 

  • Bunions: Using ligaments and bones to support the foot when you walk instead of the muscles that support the arch cause bones to shift and bunions to form. If you feel foot pain on the inside of your big toe, you may have a bunion.

 

  • Stress Fractures: If you feel tenderness in your long foot bone or the top of your foot is swollen, you might have a stress fracture. A stress fracture is an uneven balance between bone cells used for bone turnover. Over-training causes this common foot injury in athletes. To alleviate pain, apply ice to the area. A foot doctor can take repeated X-rays over a three to four-week period to see if calluses have started to form along the stress fracture. If calluses aren’t visible, the foot specialist can perform an MRI to find the damage.

 

  • Plantar Fasciitis: Wearing shoes that provide little support when running and jumping causes inflammation and tearing of the plantar fascia. Symptoms include foot pain when you get up in the morning as well heel pain and arch tenderness

 

 

Call Physicians Footcare and schedule your appointment with one of our expert podiatrist to discuss treatment

 

https://physiciansfootcare.com/foot-and-ankle-conditions/foot-conditions/


When to See a Podiatrist | Harry Cotler, DPM

Like issues with other parts of your body, not every foot problem requires a trip to the podiatrist. Some may resolve with a little rest, ice, and over-the-counter pain medicine. But, if you have a persistent problem that won’t go away, then a trip to Physicians Footcare is necessary.

Here’s a list of the type of foot problems that warrant a trip to a podiatrist:

• If you have one foot that has a flattened arch, it can be a sign of a tendon injury. Tendons that don’t function properly can lead to joint problems and misaligned bones. Prolonged tendon injuries can cause permanent damage to the foot, so the sooner you see your podiatrist the better.

• If you have a sore on your foot that won’t heal, you must see a podiatrist. Those with diabetes are especially at risk for foot sores. And if left untreated, sores may lead to amputations. The best advice is to go to your podiatrist as soon as possible. The longer you have an open sore, the more prone you are to infection which can eventually travel into your entire body, requiring hospitalization or surgery.

• If you’re experiencing foot or ankle pain that gets worse when you walk, you should see a podiatrist immediately. Many people try to live with the pain, which is not a good idea. Persistent pain may be a sign of a stress fracture. Your podiatrist can x-ray your foot to determine if a stress fracture exists.

• If you have severe pain in your foot or ankle that lasts more than 24 hours, then you need to see your podiatrist. There are a variety of conditions that could cause severe foot and ankle pain including compartment syndrome, deep vein thrombosis, or a broken bone.

• If you experience pain in your feet while they’re elevated, then you also need to see a podiatrist. For example: If you experience pain while resting your feet on an ottoman, and the pain goes away when you put your feet flat on the floor, then you may have peripheral artery disease or decreased blood flow. A Physicians Footcare podiatrist can quickly assess if you have these conditions and then refer you to the appropriate specialists for treatment.

• If you experience discoloration on areas of the foot or ankle, then you absolutely need to see a podiatrist. Your feet should look the same. Redness may be a sign of injury or infection. Blue and purple coloration could indicate vein problems. Your Physicians Footcare podiatrist is the authority on everything foot related and can quickly assess what the discoloration of your feet means and offer a treatment plan.

These are just some of the signs that you need to see a podiatrist. If you’re experiencing symptoms that persist for more than 24 hours, a visit to Physicians Footcare is warranted. As podiatrists, we’re the authority on feet and ankles. We can quickly assess your feet, treat your condition, and help get you back on your feet and back to what you love to do. 

 


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Understanding Hammertoes | Dolly Stelzer, DPM

Understanding Hammertoes

 

Hammertoe

A hammertoe is a foot deformity that occurs due to an imbalance in the muscles, tendons, or ligaments that normally hold the toe straight. The toe oftentimes resembles a claw-like shape and can produce significant discomfort and pain. It can be caused by the type of shoes you wear, your foot structure, trauma, and certain disease processes. The most common complaint is rubbing and irritation at the top of the middle knuckle joint of the toe, especially when wearing enclosed shoes.

Symptoms

  • Pain in the affected toes
  • Development of corns on the top of the joint
  • Joint Swelling and/or Redness
  • Pain in the ball of the foot under the bent toe

Causes

Certain Diseases – Arthritis and diabetes may make you more likely to develop a hammertoe

Trauma – Direct trauma to the toes could potentially lead to hammertoe

Genetics – People who are genetically predisposed to hammertoe are often more susceptible

Ill-fitting shoes – Narrow or tight fitting shoes may caused the toes to bend to fit into the shoe

Foot structure – Having high arches or bunions may make you more prone to developing a hammertoe

Treatment

Most conservative treatments are geared towards relief of pain. If you have a hammertoe, there are certain things that you can do before heading to your podiatrist. It is recommended that you wear a comfortable shoe that provides enough room for your toes. Protective toe pads and anti-inflammatories or NSAIDS are also other viable options that can provide comfort.

If your toe pain persists, you may want to have your hammertoe looked at by one of our podiatrists at Physicians Footcare.

Your options with us range from custom orthotics or inserts to relieve the pressure placed on the toes to a corticosteroid injection to even possibly surgery. It is important to seek assistance from a podiatrist in order to determine which treatment option will work best for you.

If you have any questions please contact Physicians Footcare.

Dolly Stelzer, DPM

Physicians Footcare, South Carolina

 

 


Do You Have Nail Fungus? That's A Shame! | Renee Hutto-Altman, DPM

DO YOU HAVE NAIL FUNGUS?  THAT’S A SHAME!

If you have nail fungus, you are ready to hide your toes!  Physicians Footcare wants you to show them to the world after we have helped to treat this problem.

What are some signs of nail fungus?  Lifting of the nail from the nail bed, changes in color, brittle nails, extra skin under the nails.

Can it become serious?  Fungus can spread from nail to nail and is contagious to others in yourhousehold.  Other complications include loss of the nail, bacterial infection, and recurrence after treatment.

Is it preventable?  YES!  Make sure you don’t go barefoot in public places (gyms, hotels, pools).  Don’t share shoes or purchase used shoes.  Be very cautious of nail salons and look at the feet of your family members to make sure they don’t have a problem.

Is it treatable?  Yes, it is!  At Physicians Footcare, we will confirm the diagnosis, and recommend treatment based on your medical history.  Treatments include creams, nail lacquers, laser, and oral treatment.  Your physician will also instruct you regarding the best shoe and sock hygiene.

Don’t delay.  Get ready for summer and call a Physicians Footcare office near you to schedule your consultation.  We are ready to help! www.physiciansfootcare.com

 

 

 

 

Renee Hutto-Altman, DPM
Physicians Footcare, LLC