Foot Care

8/12/2009
Peter Wishnie, D.P.M.
Comments (0)

Cryotherapy in New Jersey

Summer Bumming Hard on Your Feet!

Though it is hard to admit in a heat wave, summer is coming to a halt. It won’t be long until the kids are at school, and pumpkin picking, football games, and turkey dinners will be on the agenda! Thankfully there is still a good month of sandals and barbeque left! But, are your feet still up for the summer challenge or has summer gotten the best of them already. You may need to pay special attention to your feet on the last stretch of fun in the sun!

Complaint: My feet are dry and cracked. My feet are itchy, red, and sometimes have blisters.
Cause: Believe it or not, both of these complaints will often root from the same problem! Warm, dark, humid environments create a delightful home for fungus! Dry feet are a sign of sweaty feet and sweaty feet are a precursor to fungal feet.
Prevention: The number one thing to avoid is going barefoot in public. Wear sandals around the pool, in the locker room, and in public showers. When possible wear sandals over shoes to allow your feet to breath. Wear dry shoes, change socks often and inspect your feet on a regular basis.

Complaint: I have calluses or corns making my feet ugly. I have thick skin on my foot and it hurts.
Cause: The summer shoe selection can be referred to as the podiatrist’s best resource for job security. Too often men and women put their feet in shoes or sandals that are nowhere near the shape of their foot. This causes the foot to rub against the shoe. Friction causes a buildup of skin that can become painful or unsightly.
Prevention: Wearing wide toed shoes or just properly fitting shoes can help with this problem! Over the counter creams and lotions can help soften the skin, but be careful with corn pads. They often make the problem worse over time. If the callus or corn is continuously painful see a podiatric physician to properly remove the ailment.

Complaint: I have warts. I have a hard, flat, bump on the bottom of my foot.
Cause: Warts are caused by the human papilloma virus. It only takes a small cut or opening in the skin to allow the virus into your skin. These opening are often unseen by the naked eye. Some people are more susceptible to getting warts and need to take extra precautions to avoid the virus.
Preventions: Avoid walking around barefoot, even in your own home! If your family members have warts, you can all get warts! Avoid at home or over the counter treatments. Picking at the wart or improperly removing them can make the wart spread and what started out as one wart can quickly multiply creating a mosaic of many warts.

So as summer comes to an end make sure you keep your feet healthy and safe. If you have any
questions or concerns about your foot health or other summer threats to your feet, seek medical help
from a foot and ankle specialist also referred as a podiatrist. They are trained to treat all foot ailmentsof children an

Posted by Dr. Peter A. Wishnie at 1:37 PM 0 comments

To read more blog posts by Peter Wishnie click here.

Labels: cryotherapy foot foot health NJ pain podiatrist in Hillsborough podiatrist in Piscataway

Foot Problems

Easy Insurance Benefits Guide

General

Foot and Ankle Pain

Knee Pain Is A Foot Problem

Date: 07/04/2010

Up to 75% of athletes have chronic knee pain. Is your knee pain driving you crazy? There are a million different reasons why so many people suffer from knee pain. Henry (Hank) Aaron, a home run king, is one of many professionals that suffer from arthritis in the knee. Is there anything you can do to treat or prevent these aches and pains in the knee?

All arthritides are irreversible. Once you have arthritis, you will always have arthritis. The first thing to identify is what is causing the arthritis. Weight is a very important factor. The heavier a person is the more stress and strain that is place on the knee.

Many people attribute activities to knee problems. Though high stress, pivoting, and jarring activities put a lot of stress on the knee, it does not always lead to arthritis. More importantly, a person’s biomechanics can cause chronic increased forces and instability that leads to damage and injuries. The knee is the most unstable joint in the body.

Most other joints have boney boarders that help stabilize the joint. The knee is simply two bones separated by cartilage and ligaments and surrounded by muscles, tendons, and ligaments. These are all soft tissue structures. The knee is surrounded by two more stable joints in the body, the hip and the ankle. However, small problems in these joints easily affect the unstable knee joint. Thus, if someone has chronic ankle or hip problems, it is not unlikely that they will also suffer from knee problems.

Since soft tissues are the major stabilizers of the joint, they can be strengthened with physical therapy, strength training, stretching and range of motion exercises. A biomechanical exam can be done to assess your ankle and hip range of motion, stability and muscle tightness that causes changes in joint function. Most people benefit from several different forms of physical therapy and other treatments gauged at correcting the mechanics of the joint, such as orthotics, custom shoe inserts made by a podiatarist.

Orthotics are not just for your foot pain! You may not have any foot pain and still benefit from orthotics. Many of my patients are extremely active in sports and running. From weekend warriors to obsessive marathon runners, I have heard patients say their orthotics helped their knees, hip, back and everything in between. Biomechanics is the application of mechanical principles to the human body and is studied extensively by podiatrists. Many of the basic concepts are also applied in physical therapy and sports training are biomechanical in nature. Orthotics are devices that enhance function and compensate for biomechanical problems in the leg. Changing joint positions and alignment in the foot and ankle have a direct effect on your knee and hip.
Not everyone needs orthotics, but many people benefit from them.

My clinical experience has me convinced me that orthotics are necessary treatment modalities for a number of musculoskeletal disorders in the lower extremity including arthritis.




My broken Ankle was Fixed, so Why does it Still Hurt?

Date: 04/19/2010

Some of us are very sensible and still end up in accidents. Some of us do foolish things and obviously end up in accidents. Whether it was a car accident, sport’s accident or a stupid accident, should we have to suffer for the rest of our lives? Ankle fractures are very painful and the surgery includes multiple screws and plates. The recovery period is long and hard. But one would think five, ten, twenty years down the road your ankle would be free from pain. For some, this is true. For others, and ankle fracture leads to lifelong arthritis and pain.

There are four bones that make up your ankle. The tibia, fibula, and the talus articulate with one another to make the ankle joint. Many ligaments surround the joint to stabilize the bones into proper alignment to provide optimal function. Typical ankle fractures involve the breaking of the tibia and fibula bones and damage to a number of ligaments.

To reestablish a competent joint, surgery is almost always necessary. The surgeon will realign the fragments and fixate them back into place using screws. Plates are also used to stabilize the injured area of bone. Essentially, the surgeon will reposition the bones as close as possible back to normal.

Unfortunately, many suffer long term effects from an ankle injury. When the bones break and the ligaments lose their integrity, the bones can slam into and damage the articluar cartilage. The talus, the other bone that makes up the ankle joint, has a thick layer of cartilage that is poorly vascularized. The poor blood flow to the cartilage and the extent of the damage can make it difficult for the body to self repair the injury. These injuries to the cartilage are difficult to assess during surgery. If a surgeon chooses to address these small and difficult injuries, it involves more studied, more procedures and more cost to the patient. Thus, many surgeons chose not to address the injury.

The majority of the time, the body does a sufficient job at repairing the cartilage damage. If the lesion is small, the body’s repair process works sufficiently. Occasionally the lesions are larger and lead to osteoarthritis or degenerative joint disease. It is believed that this may be the reason why some people have residual pain after an ankle fracture. Treating larger cartilage lesions is done by using grafts, preferably from the patients. They will take small pieces of cartilage from your knee or other joints. Some synthetic transplants can also be used. An ankle fracture surgery is already very complex and doctors are not certain treating the cartilage problem at the time of the ankle surgery is what is best for the patient. The longer a surgery takes, the higher the risk of complications.

Some are willing to accept that arthritis is an unfortunate side effect of ankle fractures, but many doctors are studying and researching ways to reduce the number of people living with pain after a fracture. Doctor’s want to make their patients feel better, but sometimes there are too many barriers to completely eradicate the pain. Please be assured that we are dedicated in helping you with your foot and ankle issues even if the battle seems impossible.

Running Podiatrist's First Aid Kit

Common Running Pains & Injuries

Date: 06/30/2010

Aches and Pains of Running

Even with the best preparation, aches and pains are an inevitable result of a new jogging regimen. If the pain subsides with slow easy exercise, you may continue, but if it gets worse, stop the activity and rest. If it persists, see your podiatrist.

The most common pain associated with jogging is known as runner’s knee, a catch-all for jogging-related knee pain. One of the most common causes of runner’s knee is excessive pronation, or rolling in and down, of the foot. This syndrome is now often called the patello-femoral pain syndrome.

Orthoses (arch supports — shoe inserts) prescribed by your podiatrist are the best way to alleviate the problem. Occasionally, rubber pads in the arch of the shoe will help.

Shin splints, which painfully appear at the front and inside of the leg, are caused by running on hard surfaces, overstriding, muscle imbalance, or overuse. Treatment includes changing running technique or insertion of an orthotic device in the shoe.

Common Running Injuries

Plantar fasciitis (arch pain) — Arch pain is often caused by frequent stress on the plantar aspect, or bottom of the foot. When the plantar fascia, a supportive, fibrous band of tissue running from the heel to the ball of the foot, becomes injured, pain on the bottom of the foot results. Forefoot and rearfoot instability, with excessive pronation, may result in plantar fasciitis. Overtraining may contribute. Shoes with good midfoot stability may help prevent plantar fasciitis. If pain persists visit your sports podiatrist.

Heel spurs — Heel spur syndrome, related to plantar fasciitis, occurs after calcium deposits build up on the underside of the heel bone. Heel spurs form gradually over many months. Both plantar fasciitis and heel spurs can be avoided by a proper warm-up that includes stretching the band of tissue on the bottom of the foot. The soft tissue injury is usually the cause of the pain and not the spur itself.

Sesamoiditis — Sometimes referred to as the ball bearings of the foot, the sesamoids are a set of accessory bones found beneath the large first metatarsal bone. Incredible forces are exerted on the sesamoid bones during aerobics, and inflammation and fractures can occur. Proper shoe selection and custom orthotic devices can be useful in treating sesamoiditis.

Shin splints — Aside from ankle sprains, shin splints are perhaps the most common injury to the lower body, as the muscles attached to the shin bone bring the foot up and down. The pain is usually an inflammation of the shin muscle and tendon due to stress factors. Treat shin pain with cold compresses immediately after the workout to reduce inflammation. Proper stretching before the workout should prevent the onset of shin splints. Strengthening of muscles also helps reduce shin splints.

Achilles tendon and calf pain — The frequent rising on the toes of an aerobics routine often creates pain and tightness in the large muscles in the back of the legs, which can create pain and tightness in the calf and inflammation of the achilles tendon. Again, stretching the calf muscles gently and gradually before and after the workout will ordinarily help alleviate the pain and stiffness.

Stress fractures — Stress fractures often occur from overtraining. Make sure you gradually increase your running distance and intensity and have an adequate dietary intake of calcium.


Before beginning an exercise regimen, proper stretching is essential. If muscles are properly warmed up, the strain on muscles, tendons, and joints is reduced.

The foot is an engineering marvel consisting of 26 bones, 33 joints, 112 ligaments, and a network of tendons, nerves, and blood vessels all working together to establish the graceful synergy involved in running. Running requires balance, support and propulsion which all depend on the foot. Therefore, it is important to make sure your feet and shoes are in good working order before undertaking a serious running regimen.

A good start for someone just starting a training regimen is to examine your feet for anything that may seem irregular to you, such as lumps and bumps, skin irritations or discoloration. A podiatrist can perform a thorough evaluation and recommend any treatment if necessary along with shoe buying recommendations. Of course if you have any underlying medical conditions or have not been seen by a doctor in less than a year, a thorough check up is recommended before starting any training program.





TightRope Procedure

Date: 06/17/2010

Stop bunion pain today! New advancements in bunion surgery...
Dr. Vargas Performs New Tightrope Procedure for Bunions!!
Revolutionary procedure for bunions using a device called a tightrope. There is no doubt that this procedure represents a huge advancement in bunion surgery.

Traditionally, the bunion procedures I perform involve a bone cut to reposition the bone which is held together with a pin or a screw. Following the surgery, patients walk around in a cast boot for 4-6 weeks to allow for bone healing. With the new tightrope procedure patients experience a faster recovery, less pain and fewer complications. Patients are out of the cast boot and into regular shoes as soon as 3 weeks postoperatively.

While the tightrope procedure is not indicated in every type of bunion deformity, it can be performed in the vast majority. It represents a revolutionary change in bunion surgery and will allow more people to undergo bunion correction due to a faster recovery, less pain and fewer complications. This means fewer days missed at work or less down time with the kids – 2 of the main reasons many people avoid bunion correction.

Pain Free Bunion Surgery

A Different Kind of Bunion

Date: 10/21/2009

Ever wonder why the big toe joint is so achy? Does it feel stiff, sore, or swollen? Your big toe joint can go through a lot of abuse over years. It gets stubbed, jammed, and squeezed into shoes. All of this microtrauma can lead to long term damage. Who would have thought your big toe could be such a pain.
Hallux is another name for you big toe. Like any joint, your hallux joint consists of two bones with a layer of cartilage on both ends. The cartilage provides for a sleeker surface and absorbs shock to protect the bones from damage. When one suffers from arthritis it is due to a breakdown or damage to the cartilage that causes the bone to run up against bone. This rough friction causes swelling and pain.

Over the years your big toe joint can suffer damage from simple accidents like stubbing your toe in the middle of the right, dropping an object on your toe, and so many other things. Eventually, the cartilage gets damaged and is slowly destroyed. The first symptom of this destruction is limited joint motion. When we walk, our big toe joint should have about 65 degrees of motion. With joint damage, the amount of motion gets smaller and smaller and BAM! The pain hits you out of nowhere! All of a sudden you notice your big toe is stiff or rigid and oh so painful.

Hallux Limitus refers to a decrease in big toe joint motion and Hallux Rigidus is when there is complete loss of big toe joint movement. The early symptoms of hallux limitus consist of pain and stiffness in the joint when walking, standing, and especially squatting. There may be an increase in pain in colder temperatures and damp weather. There is often swelling at the joint. Over time the jamming of bone up against one another can cause new bone formation that forms a bump on the top of your joint. This bump is called a bone spur. This will cause the joint to be more painful and it will eventually lose complete motion or become rigid.

Patients often confuse this disease with a bunion because they both form a bump by the big toe. Though a bunion is also very painful, it is a completely different problem. Bunions are formed when your bones get displaced off to the side. Thus, the bump is on the inside of your foot. With hallux Limitus and Rigidus, the bump is on top.

The treatment for Hallux Limitus/Rigidus depends on how far along the disease has progressed. At early stages, it is important to promote motion at the joint. The more the joint is exercised, the better the outcome will be. This can be customized with orthotics and physical therapy. In cases of a more severe hallux limitus, surgery might be needed to remove the bump or sometimes the joint is replaced with a metallic joint implant. If the disease progresses to Hallux Rigidus, the therapy is surrounded around minimizing joint movement to decrease the pain. This can often be done with orthotics, but in most cases surgery is necessary.

Sometimes, the lack of motion at the big toe joint is asymptomatic. However, the person’s gait is altered and is suffering from knee or lower back pain or even pain on the outside of the foot. When you can’t push off with the big toe joint, you will need to apply more pressure on the outside of that foot. This can lead to pain in other areas of the body.

So, if you are suffering from pain along the big toe joint, do not hesitate to see a podiatrist. In the early stages of these deformities, surgery can possibly be prevented. If you are having back or knee pain, make sure your doctor checks your feet. Remember, if the ground floor is broken, then the other floors will crumble as well.




Bunions at the Dinner Table

Date: 09/27/2009

Victoria Beckham, also known as Posh Spice, has made the news several times this year. Not because of her husband’s amazing talents or her singing career, but rather because of her feet. This Spice Girl has a very serious dilemma. Should she correct her bunions or should she continue to wear sexy shoes and deal with the pain?

A bunion deformity is when your big toe tilts toward your small toes. Over time, the big toe creeps further and further along and causes a bump to protrude out on the side of your foot. This bump is actually the bones that make up the joint at your big toe. There is not one thing that causes bunions. Simply wearing high heels will not lead to bunions though they may make the bunion worse. The most common factor linked to bunions is hypermobility of a joint in the mid-section of your foot.

Hypermobility does not mean flexibility but rather movement when there is not suppose to be movement. Think of a table with four legs but one leg is a little off. The table is designed to be stable, but a tiny flaw causes it to tilt when you apply pressure to the surface. If you place some support such as a pack of napkins under the disabled leg, the table is no longer hypermobile. Detecting hypermobility in the foot is not as easy to notice as an uneven dinner table, but with careful examination, podiatric physicians are able to detect this problem that is often associated with bunions.

When treating bunions, the initial approach is conservative therapy of orthotics, padding, and strapping. These treatments are similar to the concept of putting the napkins under the unsteady table to make it less hypermobile. But, at some point the bunion gets to the point where surgical correction is necessary. Just as there is probably a dozen ways to take the unstable table to the shop and make it functional, there a dozen ways to correct a bunion. The skill of the surgeon is to determine what procedure is best to prevent the problem from reoccurring. To do this, the surgeon must identify the root of the problem. As we mentioned before, hypermobility is the most likely cause for most bunions.

Lets go back to the table example. If we wanted to correct our unsteady table, is it best to saw the other three legs down, or figure out why the one leg is shorter and try to correct the site where the problem exists. The reason that so many patients and doctors have trouble treating a bunion at its root is because of the crucial recovery time. A Lapidus procedure is the most reliable technique to correct bunions due to hypermobility. This procedure fuses, or unites, the two bones at the location of the hypermobility, which is along the midfoot region. The doctor could do the procedure and have a perfect operative result, but the most important part of the treatment is the patient’s ability to stay off their foot! After surgery, a patient has to be put in a cumbersome cast and is unable to bear weight on their foot for six weeks. With all bunion surgeries, the patient must exercise the big toe joint to ensure proper motion. Some recovery time may be spent with a physical therapist to assist in strength training your foot back into action.
It is essential that bunion treatments are done correctly the first time.

When the focus is on the cause of the problem and not how to immediately improve appearance, the patient will be much more pleased with the surgical results in the long run. If you are serious about getting your bunions corrected, then you must also take the doctor’s post-operative instructions serious. I wonder if this is what is holding Victoria Beckham back from getting her bunion fixed. This “A” list celebrity would rather run around in excruciating pain in an unsightly bunion to please all the Spice Girl fans. Back here in the real world, you can run around with your children or girlfriend’ pain free and bunion free if you take the time to treat it right!

Diabetic Foot Tips

Antioxidants May Hold The Key To Diabetic Complications

Date: 06/29/2010

Over the years, oxidative stress has been implicated with causing many of the complications of diabetes.  Although diabetes and increased blood sugars are the true cause, oxygen free radicals are usually the mechanism for causing the damage to blood vessels, nerves and cells.  Some studies even implicate oxidative stress for heart disease.

Oxidative Stress:  As the cells go through the normal oxygen cycle, active oxygen species are produced that are usually reduced by the enzymes of the body.  If the reactive oxygen species are produced in higher amounts than the body can reduce, we get free radicals.  These free radicals react with tissues and produce the stress that causes tissue to malfunction.  This malfunctioning is called oxidative stress.

Antioxidants have long been utilized to reduce the free radicals and improve oxidative stress.  A new study states that Vitamin C may improve complications of diabetes, consistent with the antioxidant benefits.  Although this study was run using vitamin C at a dosage injected into the blood stream, it shows that antioxidants may be a valuable option to reduce complications of diabetes.  More is to come......




Aerobics Trumps Walking for Health Benefits

Date: 06/01/2010

I found this article very interesting. We always prompt our diabetic patients to start a walking program, but perhaps we should be encouraging them to go to the gym and start an aerobic exercise program! Things that make you say "Hmmmm!."

Aerobics Trumps Walking for Health Benefits

You Do Not Have To Live With Heel Pain

Does Your Pump Bump Have One or Two Humps?

Date: 10/28/2009

It sounds like a catchy lyric from the Black Eye Peas or Beyonce, but “Pump Bump” is a common term used among podiatric physicians. Do you have pain behind your heel? Do shoes irritate areas behind your heel and cause pain? Do you feel an abnormal bump behind your heel? It may be a bump that is irritated by your pump and thus a pump bump!

Pump Bump may also be referred to as a Haglund’s deformity as well as a retrocalcaneal bursitis. Typically, women most commonly complain of the irritation due to their selected shoes designed for fashion rather than comfort. The pain is sharp and along the side of the Achilles tendon insertion into the heel. Many of my patients find significant relief when they wear athletic shoes or backless shoes, but additional treatment is often needed to be completely pain free.

Typically a pump bump is caused by some abnormality in the heel bone. It may be that the heel bone tilts slightly out or pronates. Or, the heel bone may be tilted upward in a high arch. The Achilles tendon is only attached to the middle one-third of the heel bone. The upper one-third of the heel normally allows a nice gliding motion of the tendon like a pulley. When the heel bone is mal-positioned, the gliding motion is less smooth. Eventually, the unusual rubbing of the Achilles tendon causes irritation and the body develops a bursa. The bursa then becomes inflamed and causes pain in the heel.

On examination, the back of the heel will appear red, slightly swollen and painful to the touch. X-rays or ultrasound will often reveal some degree of boney deformity or mechanical disruption.

When changing shoes does not resolve the painful symptoms, it is necessary to see a podiatric physician to begin a treatment regimen that will hopefully keep you out of surgery. A heel lift can be put in the shoe. This will elevate the heel and reduce the area of friction on the shoe. NSAIDs are also used to decrease the inflammation, but it should be noted that if the shoe is still rubbing hard up against the bump the drugs will not be of great effect. Some of my patients have seen great relief by stretching their Achilles tendon 2-3 times a day. In addition, cryosurgery, which is a minimally invasive procedure helps relieve the inflammation along the heel. In most cases, the pain at the back of the heel is due to the constant pulling of the Achilles tendon along a sack of tissue in this area. This is called bursitis. Cryosurgery requires a very small incision along the area and then a probe that sends liquid nitrous oxide at a temperature of (-) 72 degrees is placed into the inflamed area. This reduces the inflammation, thus relieving the pain permanently. One can walk right away after the procedure with their regular sneakers.

Depending on the cause of your bump, orthoses may be necessary to correct the mechanical problem of your heel. Sometimes, the bump is unable to be resolved by the treatments and surgical excision of the bone bump is necessary.




Children Get Heel Pain Too and They are Not Faking IT!

Date: 10/28/2009

Many of us think that foot problems are one of the aches and pains of aging. But heel pain is not normal nor is it isolated to only adults. I have seen my share fair of children and teens that are having difficulty playing sports or participating in gym classes because of heel pain!

Sever’s disease is the most common cause of childhood heel pain and usually affects children 8-14 years of age. Traditionally, the disease was thought to affect males much more predominately, but now that we are seeing more young women athletes, the incidence is nearing the same between genders. Sever’s disease is medically described as osteochondritis of the calcaneal apophysis. This is an injury to the growth plate in the back of your heal. During development, all bones in the body start as cartilage and fill in with calcium and other minerals to create a strong skeleton. This process is referred to as ossification. The calcaneus, or heel bone, has two separate areas of ossification that are connected by the cartilaginous growth plate.

Because of overuse or tight muscles, these two ossification centers are pulled away from each other causing strain on the growth plate. Overtime simple activities such as running, jumping or even standing can cause severe heel pain. I will often see children limping into my office when they have this condition.

Luckily, this is a self limiting condition meaning it will eventually go away. Unfortunately, children will have to tone down their activity schedule to reduce the pain. It is important to make the children as comfortable as possible and keep them active in their favorite’s sports, but we also have to be reasonable in the treatment options. Physical therapy will help the child stretch the muscles to decrease the pull on the developing calcaneus and Thera-band exercises can be used to strengthen the area. Ice massages will also help decrease the inflammation which is the culprit of pain. Heel lifts placed in the shoes, to decrease the pressure of the Achilles tendon on the calcaneus , and orthoses can also bring relief. Occasionally, there is need for a cast to immobilize the area to ensure proper healing. Though NSAIDS can bring relief to pain, large does are not always recommended for children. Thus, I prefer to have children to try topical pain relievers first.

Since Sever’s Disease can last up to 18 months, it is important to treat it aggressively soon as possible. Thus the child is not stuck on the bench, disappointed in their inability to perform. It may be necessary to take a short break from vigorous sports or exercise to allow proper healing time, but that is much better than sitting on the bench for an entire year!

The Truth About Orthotics

Are Orthotics An Arch Support?

Date: 01/27/2010

Often orthotics are recommended, but are they just an arch support?

As opposed to an arch support that can be purchased at many stores, an orthotic has some distinct advantages:

1. Orthotics are designed to last for years, instead of months from an arch support.

2. An arch support (and most shoes) are designed for the average foot, but an orthotic is custom made for your foot.

3. Although an arch support will provide support to the arch, the orthotic supports the entire foot and cradles the heel.

4. An arch support may flatten with running or increased pressure, where an orthotic will be firm and maintain the position of the foot.

5. An orthotic actually improves or optimizes walking or running patterns by rotating the foot into "neutral position". In this position, the foot functions at the highest level.

Dr Brandt R Gibson, DPM
Mountain West Foot & Ankle Institute
36 North 1100 East, Suite B
American Fork, UT 84003
(801)756-0765
http://www.utahfootdoc.com/

Foot Product Reviews

Treat Peripheral Neuropathy With Neuremedy

Date: 04/06/2009


Order Neuremedy Here!!!

For years, people suffering with peripheral neuropathy have been told that there's nothing that can be done for them, other than taking medication to manage the discomfort. Peripheral neuropathy is a syndrome in which nerves are damaged and results in a numbness or pain in the lower extremity.

There are definite causes of neuropathy that can be found. For instance, it is a common occurrence with diabetes. The process that causes neuropathy in diabetics is the diminished capacity of the small vessels in the extremity. You can read more about diabetic neuropathy, its causes and treatment here.

Recent studies have shown that many people suffering from peripheral neuropathy have low plasma levels of the essential nutrient thiamine (vitamin B1). Thiamine is necessary for proper nerve function. Food alone is not sufficient to elevate the levels of the nutrient. In my practice, I've been using Neuremedy, which has a bioactive form of thiamine called benfotiamine. Benfotiamine has been used since the early 1960's to successfully treat tens of thousands of people suffering from peripheral neuropathy in Asia and Europe. Neuremedy does not have any adverse effects and does not interact with any medication.

Many of my patients, who have been previously told that there's nothing that can be done for them, have found improvement with taking Neuremedy. While it does not work for everyone, I have been impressed with the results so far.

If you'd like to purchase Neuremedy, visit your podiatrist or click here to order online.
For more information about Neuremedy, visit our website.

Dr. Andrew Schneider
www.tanglewoodfootspecialists.com

Children's Feet

This Little Tootsie Went to the Market

Date: 03/15/2010

Baby Foot Advice

Your bundle of joy enters the world and dad quickly checks to make sure he/she is strong. Ten toes!!! Great, now what do we do? When you have a healthy baby, all you want is to keep them healthy. Here are a few tips to keep your baby’s feet happy.

Many new parents are alarmed when they see discolored, wrinkled, and peeling skin on their new born. This is a normal finding and is not a reason to rush to the emergency room. One must not forget that a baby spends months trapped in a fluid filled sack in mom’s stomach. Imaging what your feet would look like after lying in the bath tub for only a couple of hours! It takes time for the skin to get use to the new world.

Toenails are the obvious foot chore on babies. The nails should be kept short to prevent scratches and sores. Use a baby nail clipper and be sure not to cut the nails too short. If cut too close to the skin, an ingrown nail can develop. It is a good habit to check your baby’s feet regularly after a bath. Look at the nails and the general appearance of the foot. Also, make sure to dry the feet off completely. Bacteria and Fungus can easily accumulate on a moist foot.

Shoes for babies and toddlers have become very popular and stylish. Though we think we are helping our children by putting them in shoes, it is actually better for development for a child to walk around barefoot. It is recommended to always have your children wear shoes outdoors since rough surfaces and outdoor debris can easily puncture the skin. Yes, of course the shoes are adorable and we love to buy them and try them on and put them with their cute outfits, but honestly you’re better off letting them run around in just socks. Pediped’s are a great alternative. They are hand stitched shoes that allow plenty of room for healthy growth.

Your pediatrician will check the feet for any major deformities or problems. It is normal for your child’s feet to look flat up to the age of two. You may think they look funny, too flat, or without an arch. The bones in the foot do not fully mature until 18-23 years of age. Some bones have not even started to grow yet when the baby is born! When you look closely the foot does not really look like a mini adult foot. Pediatricians are trained to look for common abnormalities and to refer you and your child to a podiatrist if a problem is suspected. If you are worried or have questions about your child’s feet, a podiatric physician can evaluate and treat children.




Will My Child Outgrow Flat Feet?

Date: 12/13/2009

Flat feet can also be referred to as pes plannus, pes planovalgus, valgo plannus, or pronation syndrome. It is commonly described as a foot without and arch. Flexible and Rigid flatfoot are the two basic forms. A flat foot is rigid when the arch appears flat when the child is sitting and when the child is standing. The flexible flatfoot is when the foot appears normal when the child is sitting, but the arch collapses when the child bears any weight on the foot. The flexible form is less severe and much more common.

Flatfoot is normal in children under three years old. Young children are very flexible and will appear to have flat feet. It is normal for the child’s foot to appear as it is rolled in and pointing outward until they past their toddler years. You may need to see a podiatrist if you child still appears flat as they near the age to attend school.

The podiatrist will evaluate the entire lower extremity to determine if the child is experiencing any weakness or pain. The child may complain of pain in the foot, ankle or the knee. The child may also have a history of clumsiness, or a voluntary decrease in activity. The doctor will take x-rays to evaluate the joints and alignment of the bones.

A tight calf is a common finding in all flatfoot patients. This may be a significant component to the patient’s present and future pain. Thus, it is common for children to undergo physical therapy to learn stretches and exercises that target the calf muscles.

The gold standard in treating flatfoot is orthotic therapy. Orthoses are custom made shoe inserts that assist in foot function. Since the orthoses are custom made, they are design to address the child’s specific foot structure and associated problems. These devices will help prevent the flatfoot from progressing and decrease the current pain that the child is experiencing.

Surgery is a treatment of last resort. In rare cases, a child will continue to have pain or disabling fatigue after all conservative treatments are attempted. Surgery is invasive and often unnecessary to control flatfoot pain, so it is not attempted until the doctor and parent have exhausted all other treatment options.

In these severe cases, where the child’s flat foot is flexible, an implant can be placed in the rear part of the foot. One type of implants is the Hyprocure. The procedure takes only seven minutes and is made with a tiny incision. The implant causes an immediate arch and rarely needs to be removed. This procedure is done in children with severe pain in the arch or where the arch is so collapsed it will lead to an arthritic condition when they get older.

Many parents worry about their children’s flat feet, but in most cases the children grow out of them by the time they reach kindergarten. At this age, we begin to worry that the child may actually have a flatfoot. Generally these feet are easily managed and the child can have a normal and active life with no limitations. Be aware of children’s feet and their pain. It is common for children to fall and cry, but it is not common for a child to have foot pain or fatigue. It is always better to treat the flat foot immediately on a conservative basis because once they reach the age of three it might be very difficult to correct.

Foot Pain in Kids

Orthotics for Children?

Date: 04/28/2010

Recently a lot of my adult patients have been asking me when is the appropriate age to have their child's feet evaluated. Most parents wont even think about taking their child to a Podiatrist unless the child complains about their feet. Commonly it will take a parent watching their child walk to realize that something might not be correct and even then they are sometimes told by their pediatrician that it is something the child will grow out of.

Most specialists will agree that as soon as your child begins to have unassisted stance (able to walk without you holding them up) there feet should be evaluated. At 8-13 months a child will begin to weight bear. During this time the immature and misaligned osseous (bones) infant framework begins to be susceptible to the deforming forces of gravity. I believe that early intervention in the developmentally challenged foot leads to bony remodeling which can lead to a more normal alignment of the foot structure.

So how do you know if your Child's feet need Evaluation?

If you notice that your child is unbalanced, seems to be walking with a limp or a rotation in their feet. Toe walking and wearing out shoes on one side only, are also signs that require evaluation.

What to Expect with the Evaluation?

First a bio mechanical exam will be performed. A gait analysis will follow with recommendations for appropriate shoe gear as well as orthotics if crucial for ambulation. Most children are able to use an over the counter support until they are 5 or 6. Once a child is able to walk down stairs one step at a time without holding on to the handrail they have developed a propulsive phase and need more custom devices.

Most children that are placed into custom devices will require lifelong treatment. It is the parents responsibility to allow for adequate control while the child is growing. So remember if you think that your child may walk differently then the other kids have their feet checked. You could be preventing future deformities.

Keep Your Feet Feeling Young

Oprah and Dr. Oz Discuss Diabetes

Date: 07/19/2010

Today Oprah Winfrey is dedicating the entire episode to what she is calling the “silent killer”…diabetes. The episode will feature Dr. Mehmet Oz, Dr. Ian Smith, trainer Bob Greene, and chef Art Smith. Diabetes is a topic that can never have too much discussion. 23 million people in the United States have diabetes, almost 8% [...]

Healthy Steps for Your Feet for your life

The Journey to a Texas Ironman

Date: 07/24/2010

Swim training is one of my favorite disciplines especially right now given the weather in Texas. It’s a great time to let your body work and your mind float right along. Here are some tips that have come to mind while cruising through open water swims:

When you come across a snake think of yourself driving on the road. Let the serpent have the right of way then increase your speed after it passes you.

Look ahead of you at least every 10 strokes. This will help in preventing head on collisions with water debris, fellow swimmers or better yet the boater who thinks you might be that one big catch.

Don’t carry your cell phone with you in the water. Besides, do you really know anyone who can swim and text at the same time?

Make sure there are others with you in the water. That way, you can compare your fabulous after lake scent plus being with others is safer and a lot more fun.

Feeling kinda dull or lacking in personality? Slap on a hot pink swim cap and accessorize. A bit of bling while you do your thing always causes a stir.

Avoid swallowing the water. This will prevent your future offspring from looking like an alien.

Remember where you started. It’s really a pain to locate your shoes and towel if you forget where you started. Then again, it’s also kinda funny moving a friend’s stuff up a few yards. The look of confusion of your fellow swimmer is very entertaining...not that I have ever done that before.

Consider modesty. We really don’t want to see your body parts as you change after the swim. Keep 'em guessing is my thought.

Finally, respect the lake. Mother nature does not want your empty goo packs or plastic bottles left laying on the ground. She did not and has no future plans to use them. So keep your lake clean and pick up after yourself.

Happy swimming and training….and as always, talk to ya next week!

Janet
Healthy Steps was created for you with the proper fitting shoe and orthotic in mind. Whether you wear orthotics and need properly fitting shoes or are looking for shoes that are comfortable with style, let the staff at Healthy Steps be of service to you. Healthy Steps is a division of Foot and Ankle Associates of North Texas (FAANT). For more information or foot health tips visit our website at www.faant.com

The Houston Running Chronicles

A Podiatrist's Barefoot Running Blog (Part 3)

Date: 07/28/2010

Posting a quick update from Dr. Randy Beckman and his experience running in the Vibram Five Fingers:

I’m so excited. I ran Sunday and today in my five fingers a Whole Mile!! I had to take off a week or so due to family travels but was still running in regular shoes. I ran the miles in good time with no pain. I am finding that concrete is more comfortable than grass. This morning I did feel my calves get tighter. Not like Popeye or anything, but a little tighter. Until next time,

Beckman out!

You can learn more about Dr. Beckman at www.TxFootDoctor.com. I thank him for continuing to share his experiences and look forward to more.

My Child's Foot

Too Much "Screen Time" Can Cause Foot Pain

Date: 03/22/2010

If your children are like mine, they like to watch television, play video or computer games, searching the internet and often even spend time listening to iPods or watching videos.  This time has been nicknamed "screen time", because it limits the activity level of the child as they look at a "screen".  Many people wonder if this excessive time can lead to problems.  Studies have shown that as "screen time" increases, so does the childs weight.  Childhood obesity has become more of a problem and can lead to many health problems including heart disease, blood pressure problems, diabetes and many others.  In fact, childhood obesity has even been related to foot or leg pain.

According to a study in Pediatrics, published in the April 2010 issue, obese children have more leg, foot, and ankle injuries than similarly aged children of a healthy weight. The study, after measuring 23,000 children ages 3 to 14 years old, found that the one in six of whom were considered obese had significantly higher risk of injury to the foot or ankle.  This was even taking into account the increased activity level (even in high risk sports) of the healthy weight children.

With this understanding, and the significant risk of systemic health problems, I have continued to encourage my children to remain active.  We involve them in more sports, encourage them to spend time outside and even limit the time television or computers can be on during the day.  As we facilitate this increased activity, and continue to be careful about the childhood eating habits, the risks of childhood obesity is decreased as is the associated risk for foot pain and foot or ankle injury. 

I guess "screen time" really can cause foot pain!  For more information, visit our Children's Foot page.

Dr Brandt R Gibson
Moutain West Foot & Ankle Institute
36 North 1100 East, Suite B
American Fork, UT 84003
www.UtahFootDoc.com

The Diabetic Foot

Vitamin C May Reduce Damage From Diabetes

Date: 06/29/2010

In a new study on Vitamin C, it was found that oxidative stress can be alleviated by antioxidant activity of vitamin C.  In fact, it helped significantly.  Although the amounts were administered through the blood stream (not by oral over-the-counter treatment), it is promising for the options at treating the complications and injuries commonly encountered in diabetes.

My findings have been similar.  As antioxidants are added to the diet, including vitamins and minerals by supplement or by diet high in fruits and vegetables, diabetic complications can improve.  These are promising findings and more is coming.

Dr Brandt R Gibson
Mountain West Foot & Ankle Institute
36 North 1100 East, Suite B
American Fork, UT 84003
801-756-0765
http://www.UtahFootDoc.com

If the Shoe Fits...

NEED AN EXTRA 12 INCHES? WOMEN TRY THESE SHOES…OR NOT!

Date: 05/31/2010

A Romanian man, known as the “shoe architect” has created a line of stilettos that will increase a women’s height by twelve inches! Mihai Albu claims his shoes are distinctly appealing to most women since many do not have long legs. The shoes are miraculous sculptress of beauty. With feathers and jewels, skull heads and curves, he has created masterpieces for fashion. Not only are these shoe eye catching, they are also wallet drying! A pair of Mihai Albu’s shoes cost over $1,500. That is a lot of money, for something I would never put on my feet!

Yes, these shoes are beautiful and truly a piece of art, but probably the most ridiculous thing you could put on your feet. We would all like to be a little taller, but at what expense? Not only will these shoes hurt the pocketbook, they will also hurt the foot and ankle and all other body parts that hit floor after an easy accident in these towering skyscraper shoes.



Have you ever sprained your ankle? The first reason to not wear these shoes is an ankle sprain. After an ankle sprain or other similar injuries, your ligaments get damaged and weakened. Your ankle is inevitably less stable and you are prone to more injuries in the future. Not really a good idea to jump into intensely tall shoes that gives you zero protection to the ankle and makes you quite unstable. I would give you two hours in these shoes before you injured yourself, and I am being generous!

Do the balls of your feet ever hurt? Your foot is not designed to walk only on the balls of your feet and your toes. This week, I removed a fractured bone from women in her 20s. She injured her sesamoid bone, a small bone near your big toe. The injury occurred while dancing in high heels all night at a wedding. She unfortunately could not heal the bone and it had to be removed. Stress fractures are also common. To heal these types of fractures, surgery is usually not necessary. The area will need to be immobile in a surgical boot or cast. A severely unattractive and cumbersome device that has to be worn in replace of your cute high heels.

High heels are attractive and fashionable. I understand why women love to buy them and wear them. Many of them are truly pieces of art, but some should just be art. Not all shoe skyscrapers should be worn. Many should be admired from the store window or from the box. As soon as they hit the feet, they are disastrous. Be sensible.




I Am a Hippocrit!

Date: 02/03/2010

Podiatrist Demands you Wear Flip Flops?

We are nearing the time of the year that families, couples, and friends pack up their bathing suits and head south for a much needed vacation. You may be anxiously awaiting the sand, sun, and cocktails. Burring your feet in the sand beats the day to day routine of boots, snow, and cold toes. With the growing check lists for your upcoming departure, foot health may not be on your list of thing to prepare for, but maybe it should! The number most vital thing to pack to save your feet are sandals or Flip Flops!

It is not often that you hear a podiatric physician promoting flip-flops, but they can be very important in protecting you on your vacation. We often forget that viruses, bacteria, and fungus enjoy the warm weather as much as we do. Though walking around barefoot can be relaxing, it is dangerous. You can pick up warts, athletes foot, and bacterial infection just about anywhere. Always wear sandals by the pool and even in your hotel room on the carpet. Do you know who stayed in your room last and how well did they clean the carpet?

Walking barefoot in the sand is very relaxing until you step on a piece of glass, a sharp twig, a shell or whatever the last metal detector-vacationer dropped from his pocket. Flip flops do not offer you any support, but they do provide a barrier between you and something harmful. Wearing flip flops can prevent you from getting an open wound. You may be thinking so what; a little cut on my foot won’t ruin my vacation. Not only are you at risk of getting an infection, but you will also be in a lot of pain. Even a small cut is easily aggravated by the salt water in the ocean or the chlorine in the pool. Planning on going golfing? How will your cut feel after a full day of walking on the greens?

On a nice tropical evening, it is so enjoyable to take a walk on the boardwalk or watch the sunset off the deck. Where there is wood, there are splinters! I see a number of patients every year with splinters in their foot. Sometimes, they remember the exact moment the stubborn piece of wood found a home in their foot, other times they had no idea their pain was being caused by a splinter. Two things can happen with a splinter in your foot. First, the wood harvests bacteria and can cause a local infection. The area will be red, hot, swollen, and some drainage from the wound site may be noted. If possible, your body will identify the splinter and immediately wall it off to prevent an infection. This walling off mechanism may cause a painful cyst that would need to be surgically excised.

It is very rare for a podiatric physician to tell you to wear your flip-flops. Vacationing is a great time to pull out the flip flops and use them for your safety. It should be noted that flip flops only provide protection and do not provide any support. Thus, if you are doing a lot of walking or standing, you should be wearing a more supportive shoe gear.

Peripheral Neuropathy

Neuropathy Can Be Improved With Alternative Medications

Date: 03/08/2010

As I continue to see increasing numbers of patients with nerve changes to their feet, I am continuing to review traditional and alternative medications for the treatment of these disorders.  Instead of telling my patients that nothing can be done for peripheral neuropathy, I continue to find information that can improve the symptoms.

In a small clinical study run for six months comparing Evening Primrose oil and a placebo, Evening Primrose oil was shown to produce significant improvement of neuropathy over this time.  It was taken at a dosage of 2000mg (2grams) twice a day to get this improvement.  Although the study was small and many individuals don't get the same results, it has been shown to work and should be considered.

Why does it work?  Evening Primrose oil contains an essential amino acid gamma-linolenic acid (GLA) that works with the body to protect nerves and rebuild nervous tissue.  At the above dosage, a patient is getting 360mg a day.  Many people are also trying ALA (alpha-linolenic acid) to get the same results. 

For additional treatment options for peripheral neuropathy, visit our website.

Dr Brandt R Gibson
Mountain West Foot & Ankle Institute
36 North 1100 East, Suite B
American Fork, UT 84003
801-756-0765
www.UtahFootDoc.com

Foot & Ankle Health

A Picture Of Health

Date: 11/21/2009

If you had a microscope into your body, an x-ray of the structures, and a mirror into the innermost parts of your body, would you take a look? Maybe you would be even more interested if this picture could help limit future pain or prevent future disease.

As I continue to see patients day to day, many would love to find ways to prevent the foot and ankle problems that are now interfering with their lives. Some even look for options to ensure they can stay active. I feel this information is important and should be available to everyone that desires it.

For this reason, we have created a new free report that will let you not only stay active, but help you understand how careful foot and ankle care can prevent pain, keep you active and even give you a picture into your overall body health.

Request this report and Optimize What You Were Born With...

Dr Brandt R. Gibson
Mountain West Foot & Ankle Institute
American Fork, Utah
http://www.utahfootdoc.com/

Utah Running Doctor

Barefoot Running, What's The Truth?

Date: 03/13/2010

Barefoot running is not new, in fact it has been around since the beginning of mankind. Often man had to run to find food, or keep from being food. This reasoning is often the justification for barefoot running. They will often even quote "studies" that prove running shoes are bad, or barefoot running is good. 

But what is the truth about barefoot running? Here is a good discussion that was brought to my attention: http://www.prolaborthotics.com/Blog/tabid/90/EntryID/132/Default.aspx

Dr Brandt R Gibson
Mountain West Foot & Ankle Institute
36 North 1100 East, Suite B
American Fork, UT 84003
801-756-0765
www.UtahFootDoc.com




Should I Change My Running To Increase Speed?

Date: 11/10/2009

Here on the internet, I have seen articles on barefoot running, including a recommendation to run 100 miles barefoot, and I have seen recommendations to run on the forefoot or midfoot.  I recently have adjusted my running to increase speed and wanted to discuss some of these claims.  Before it all, I recommend that you continue what is normal for you!

Forefoot or midfoot running has been said to increase speed of long-distance runners.  This is based on a single study that found that 23.7% of runners used a midfoot pattern and that in this study these runners were faster.  It is based on the fact that sprinters run on their toes (forefoot running).  More recent studies, however, including one by Dr Hamill, a professor of kinesiology at the University of Massachusetts at Amherst, have shown some benefits to each type of running.  Rearfoot running, for example, has been shown to be more energy efficient.  No significant speed differences were shown, when all other factors were as efficient as possible.  My recommendation, therefore, is that you not try to adjust your running pattern to forefoot or midfoot from rearfoot or even to rearfoot from forefoot/midfoot.

Barefoot running is a subject that should be considered carefully.  If you walk and run barefoot already, then again I would not recommend you change. If you are thinking about it because of some book or website, please consider the following recommendations from the APMA:

Barefoot running has become an increasing trend, and a possible alternative or training adjunct to running with shoes. While anecdotal evidence and testimonials proliferate on the Internet and in the media about the possible health benefits of barefoot running, research has not yet adequately shed light on the immediate and long term effects of this practice.


Barefoot running has been touted as improving strength and balance, while promoting a more natural running style. However, risks of barefoot running include a lack of protection, which may lead to injuries such as puncture wounds, and increased stress on the lower extremities. Currently, inconclusive scientific research has been conducted regarding the benefits and/or risks of barefoot running.

The American Podiatric Medical Association, along with the American Academy of Podiatric Sports Medicine, encourages the public to consult a podiatrist with a strong background in sports medicine to make an informed decision on all aspects of their running and training programs.

Again, my recommendations (and the pattern I am following) is to continue to run in the way that is natural for you.  Run smart and keep running for a longtime to come.  I will be speeding up my running, but through natural processes of speed work and careful training regimen.
Dr Brandt R Gibson
Mountain West Foot & Ankle Institute
36 North 1100 East, Suite B
American Fork, UT 84003
801-756-0765
www.UtahFootDoc.com

Diabetic Foot Problems

Sock It To You!

Date: 03/19/2009

The Perfect Sock

We use them almost every day. They come in all different forms and sizes and some even come with bells and bows. What am I talking about? Your socks! Do you ever wonder if your socks are feet friendly? Believe it or not but socks made out of the wrong fabric or that are poorly made may worsen some common foot conditions.

The American Podiatric Medical Association (APMA) recommends the following when shopping for socks:

Purchase a sock made of a polysynthetic blend. This material will best wick away moisture from the foot, which can prevent blister formation and irritation.

Avoid socks with large seams at the toe or in other areas. Those with diabetes or decreased circulation, who have an increased chance of developing irritation and blistering of the foot skin, should seek out seamless socks whenever possible.

Choose thickness of sock material based on personal preference and comfort.

Evaluate each sock’s fit, making sure that there is no loose fabric around toes or heels.

Conversely, socks that are too tight can decrease circulation and comfort.

If you suffer from sweaty feet also known as hyperhydrosis, it is especially important to buy the correct socks. You may think 100% cotton is the best way to go but a blend of cotton with other natural materials will do a better job of wicking away moisture. Choosing the right sock will keep your feet dryer and less stinky. Maybe you will think again when buying your husband’s socks!
Noticing the importance of choosing the right socks, the APMA recently recognized and gave the seal of acceptance to two new sock products. Injinji Footwear Performance Series Tetratsok has a patented anatomical, five toe-design that separates toes with an anti-friction seamless membrane. The sock is made out of a combination of coolmax wicking fiber, and a durable shell cover of nylon and lycra. This helps protect the foot from slipping and sliding in your shoe.
The Takeda Legwear Big Toe R x L socks are designed specifically for the right and left feet. This allows for a snug and comfortable fit. BigToe R x L socks is also made from Coolmax fabric to keep moisture away from your skin.

They next time you buy socks, take a closer look at the materials. Slip them on and see how they fit. Are they snug? Can you feel the seams? Are there any knobs of fabric that are rubbing against your feet? Just as importantly are your shoes. If your shoes are too tight, it will exacerbate the effects of poor quality socks. Make sure your shoes are the right size and gives you room to wiggle your toes.




Diabetes and Foot Ulcers

Date: 02/11/2009

There are over 23 million American with diabetes, and another 57 million with pre-diabetes. Many argue that diabetes is becoming an epidemic. As technology continues to advance the efficiency of our world, it also takes away the need for physical exertion. In order to get the exercise necessary to stay healthy, we have to “go work out.” Most of us are dropping the ball on this; and thus, America is gaining weight. This combined with fast food and fat filled diets are causing diabetes to be on a continual rise. Unfortunately, many underestimate the severity of the disease. Diabetes is a very serious condition that has many complications which includes blindness, cardiovascular disease, kidney failure, and foot ulcerations. These complications are acquired over time and greatly increase mortality rates. A person diagnosed with diabetes before the age of 40 will lose 15-20 years of their life!
Out of all of the complications linked to diabetes, the complication that causes the most hospitalizations is foot ulceration. Many of these ulcers may lead to amputations and this greatly increases the mortality rate. A person has a better chance of survival with colon or breast cancer than they do having a diabetic amputation. There are several reasons why diabetes has such strong effects on the feet; all of these complications combine into a formula for disaster if one does take proper measures to protect their feet and their health.
Causes foot ulcers 1o1
1) Macrovascular/Microvascular complications. Diabetes is the inability of the body to control blood glucose levels. The rise in blood glucose, or hyperglycemia, is when there is excess sugar in your blood stream. This can facilitate clot formation and increase your chance of heart attack and stroke, but more commonly leads to micro vascular complication that decreases your blood flow in small vessels and in your extremities. A decrease in blood supply in an area, such as the foot, makes it difficult for your body to keep those tissues healthy.
2) Foot deformities. The excess sugar in circulation can deposit in tissues and joints and lead to foot deformation. Diabetics may see changes in their foot structure or feel pain with motion. In very serious cases, the foot develops Charcot’s foot. In this instance, the bones in the foot are actually being destroyed. The deformity is often described as the foot becoming a” bag of bones.” These deformations change how forces are applied across the foot. Normally, when walking, weight is nearly evenly distributed across your foot, deformations cause increases in pressure at certain areas. This facilitates tissue break down
3) Peripheral Neuropathy. Neuropathy is the loss of nerve function. The nerves most commonly affected are sensory nerves. Over time, diabetics experience nerve damage due to the increased levels of sugar. Initially, this damage presents as tingling and burning but eventually leads to loss of feeling. Thus, diabetics lose the ability to feel pain, the body’s natural warning sign. It is very dangerous for diabetics to be unable to perceive a problem in the foot. For an example: If one steps on a piece of glass, they would be unaware and walk around on the glass all day.
Preventing Ulcers 101?
1) Controlling your blood sugar levels with diet and exercise is the best way to prevent all diabetic complications. When diet and exercise is not enough, there are medications that can assist your body in maintaining appropriate amounts of sugar in your blood.
2) Inspect your feet regularly. Look in-between your toes under and all around. Watch your feet for any changes in appearance, temperature, and feeling. Before or when changes are noted, contact a podiatric physician. A podiatric physician can help prevent and accommodate changes in your feet due to diabetes.
3) Avoid walking around barefoot, in sandals, or any other open shoes. This leaves your feet vulnerable to getting cuts, bruises, bumps, and infections.
Diabetes is a multisystem disease that can cause many complications. Foot ulcers are highly prevalent, but also highly preventable. It is important to consult your physician to help you control your blood sugar levels. Podiatric Physicians are foot specialist that have extensive training in diabetic feet and wound care. They will provide you with the best care to prevent foot ulcers and amputations, the leading cause of diabetic hospitalizations.