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Posts for: March, 2010
What is diabetes?
Diabetes is a condition in which the amount of glucose (sugar) in the blood is too high because the body is unable to use it properly. This is because the body's method of converting glucose into energy is not working as it should.
THERE ARE TWO COMMON FORMS OF DIABETES:
-Type 1, also known as insulin dependent diabetes. This usually affects children and young adults. People with this type of diabetes require daily insulin injections.
-Type 2, also known as non-insulin dependent diabetes, is by far the most common and usually affects people over the age of 40 years old.
How diabetes can affect your feet
Your feet are supplied with blood to keep them healthy. They also have a multitude of nerves that act as an emergency warning system. For example, if you have a stone in your shoe, nerves will send a message to your brain to investigate. However, if your diabetes is poorly controlled for a long period of time, this may lead to:
-nerve damage, or "peripheral neuropathy", which impairs sensation to the feet, and/or
-reduced blood supply, also known as "poor circulation"
Nerve damage may mean that you no longer notice the stone in your shoe, due to loss of sensation to your feet. This could then lead to an injury you can't feel, and possibly infection. If you have poor circulation, any injuries or infections to your feet (i.e. cuts, burns, or scratches) will take longer to heal. this is due to less blood flowing into the arteries in your feet. Blood provides energy to work muscles and aids in healing any tissue damage. If you have poor circulation, you will need to take extra care to protect your feet from injury. Most foot problems in people who have diabetes occur when injuries- and often infections- go unnoticed and untreated, or when healing is delayed due to poor circulation.
How can I detect any changes early?
A six monthly foot assessment by your podiatrist will help to detect any changes early- before they become a problem. In an assessment, your podiatrist will examine your circulation by feeling foot pulses. They will also examine sensation by testing reflexes, vibration and pressure sensitivity. Your podiatrist will also look for general foot conditions that may lead to future problems. They will also work with you to show you how to monitor your own feet, in between consultations.
TO PREVENT PROBLEMS
-Protect your feet from injury
-Inspect your feet every day (your podiatrist can show you how). After a shower, while drying your feet thoroughly, is a great time for this daily activity.
-See your podiatrist immediately if something is not healing.
GENERAL GUIDE:
-Maintain acceptable blood sugar level control
-Don't smoke
-Exercise regularly
-Avoid barefoot walking
-Keep your feet clean
-Wear well-fitting shoes
-Cut and file nails carefully
-Have corns, calluses and other foot problems treated by a podiatrist
-Seek your podiatrist's advice before using a commercial corn cure
Footwear advice
The best type of footwear fits well and protects your feet. Whenever possible, wear shoes to avoid injury. Ensure your shoe is deep enough and broad enough.
Some other pointers
-Where possible, wear lace-up shoes as they don't cause foot and leg fatigue or lead to toe-clawing.
-Check inside your shoes for rough edges or exposed tacks- shake them out to make sure there is nothing inside.
-Cotton hosiery, socks and tights, worn with leather upper shoes are good choices.
Remember:
-Altered sensations may lead to numbness in the feet. Cuts, blisters, ingrown toenails and corns may go unnoticed.
-Reduced blood supply (poor circulation) can slow down the healing process.
-Protect your feet from injury.
-Inspect your feet every day.
-Have a Regular (every 6 months) foot assessment.
Heel pain is one of the most common conditions treated by podiatrists. It is often a message from the body that something is in need of medical attention. Pain that occurs right after an injury or early in an illness may play a protective role, often warning us about the damage we have suffered.
Who gets heel pain?
The greatest incidence of heel pain is seen in middle-aged men and women. It is also seen in those who take part in regular sporting activities and those significantly overweight and on their feet a lot. Heel pain can also occur in children, usually between 8 and 13, as they become increasingly active in sporting activities.
The causes of heel pain
While heel pain has many causes, it is usually the result of faulty biomechanics (abnormalities in the way we walk and/or the structure of our feet). This can place too much stress on the heel bone and the soft tissues attached to it. The stress may also result from injury, or a bruise incurred while walking, running or jumping on hard surfaces; wearing poorly constructed footwear; or being significantly overweight. Systemic diseases such as arthritis and diabetes can also contribute to heel pain.
Common Complications
Heel Spur
A common cause of heel pain is the heel spur, a bony growth under the heel bone. There are no visible features on the heel, but a deep painful spot can be found in or around the middle of the sole of the heel. Approximately 10% of the population may have heel spurs without pain. Heel spurs result from strain on the muscles of the foot. This may result from biomechanical imbalance, a common condition occurring in many people.
Plantar Fasciitis
Both heel pain and heel spurs are frequently associated with an inflammation of the long band of tissue that connects the heel and the ball of the foot. The inflammation of this arch area is called plantar fasciitis. The inflammation may be aggravated by shoes that lack appropriate support, especially in the arch area, and by the chronic irritation that sometimes accompanies an athletic lifestyle.
Other Causes of Heel Pain
-Excessive rolling in of the feet when walking.
-An inflamed bursa (bursitis), a small, irritated sack of fluid at the back of the heel.
-A neuroma (a nerve growth).
-Other soft-tissue growths.
-Heel bumps or "pump bumps", a bone enlargement at the back of the heel bone.
-Bruises or stress fractures to the heel bone.
Overcoming the problem
If pain and other symptoms of inflammation- redness, swelling, heat- persist, you should limit normal daily activities and consult your local podiatrist. Your podiatrist may conduct a number of x-rays to look for heel spurs or fractures.
Treatment
Early treatment might involve exercise and shoe recommendations, taping or strapping, and anti-inflammatory medication (such as aspirin). Taping and strapping supports the foot, placing stressed muscles in a restful state and preventing stretching of the plantar of the plantar fascia. Other physical therapies may also be used, including ice packs and ultra-sounds. Orthotic devices (shoe inserts) are also commonly used to treat heel pain. These orthotics are custom molded to your feet and correct the biomechanical imbalances that you may have. These treatments will effectively treat the majority of heel and arch pain without the need for surgery. Only a relatively few cases of heel pain require surgery. If required, surgery is usually for the removal of a spur, but also may involve release of the plantar fascia, removal of a bursa, or a removal of a neuroma or other soft-tissue growth.
Recovery
Your recovery will depend on the cause of your heel pain and your additional health. If you are suffering with a heel spur or plantar fasciitis, it normally takes about six to eight weeks for a healthy individual to fully recover. That is when the injured area is fully rested or properly strapped.
Preventing Future Problems
Footwear
Wear shoes that fit well, on the front, back and sides, and have shock-absorbent soles, rigid uppers and supportive heel counters. Do not wear shoes with excessive wear on the heels and soles.
Stretches and Exercise
Prepare properly before exercising. Warm-up before running or walking, and do some stretching exercises afterward. Pace yourself when you participate in athletic activities. If overweight, try non-weight-bearing activities such as swimming, cycling, or using a stair-steeper or elliptical machine. Mixing these activities with high-impact work outs such as running and activities involving jumping is a good idea for any athlete or exercise participant. Exercise will also help reduce your body weight, which adds to the stress on your feet.
Additional Control
Your podiatrist may also use taping or strapping to provide extra support for your foot. Orthotic devices (shoe inserts) custom made to suit your needs and your feet may also be prescribed for daily use.