How to deal with foot conditions arising out of diabetes

Diabetes, also called the silent killer is one serious disease which affects health in a serious manner. The blood glucose commonly known as blood sugar level rises to an extreme extent either because of inadequate insulin production or because body cells don’t respond to insulin. Sometimes both may happen thus worsening the condition. The end result: several complications related to heart, eyes, kidneys, nerves and skin. 

When an individual is affected with diabetes certain foot problems can take serious turn. Even ordinary problems become severe. This happens because of nerve damage when your feet loose sensation. 

Alarming foot conditions related to diabetes

• Neuropathy How does it feel when your feet can’t sense anything! No pain, heat nor cold, even if you get injured. A stone or a pin may get tucked inside your shoes and you wear it the whole day without realizing anything. Your foot may get injured but you fail to notice it till the skin breaks down and gets infected. You don’t sense any painful blisters. Yes, this sounds really creepy and dangerous! This is what diabetic neuropathy can cause to your foot – serious nerve damage. Because of neuropathy, you may notice sudden changes in the shape of feet and toes, commonly called hammer toes, Charcot feet or Bunions.
  While for some these symptoms remain mild and unnoticeable for many the neuropathy can turn out to be painful, grave and even fatal too.
  
• Skin changes
Your foot skin may turn dry, start to crack or peel. This is because nerves which control oil and moisture fail to work properly.

• Calluses
Development of callus happens more often and the growth is quite alarming. If not treated in time, these can turn into open sores or ulcers.

• Poor blood circulation
Your foot loses the ability to fight infection and heal fast. Because of diabetes blood vessels of the foot and leg become narrow and hard. Poor circulation results in inadequate supply of oxygen and nutrition to skin and other tissues.

Foot care for diabetes affected patients 

As mentioned in the very beginning, diabetes being a silent killer, often gets detected at a later stage. However by leading a healthy lifestyle and consulting a physician on regular basis, it is possible to keep this killer disease under control. For particular foot conditions arising out of diabetes, it is better to get in touch with a podiatrist. Since foot care and diabetes are closely related only an expert “foot doctor” will be able to guide you about the right course of treatment. 

Many podiatrists recommend specially designed orthotics with Plastazote foam, for diabetic foot. Plastazote, also referred as soft tissue supplementation, are available in two densities. The softest density is used for cushion on top while the firmer density offers bottom support. The best thing is that after 2 to 6 weeks of usage they mold perfectly with the curves of your feet thus providing the right comfort and protection for diabetic foot. Many diabetic patients have benefited by wearing footwear containing Plastazote foam. However, make sure that the footwear has removable insoles, high & wide toe box, rocker soles and firm heel contours. 

By following a healthy routine and keeping close watch of your foot conditions you can avert severe outcomes. To ensure protection from cuts and bruises, try to wear shoes with socks most of the time. Using heating pads to keep the foot warm can be risky since you may not feel the rising temperature. If any cut or bruise takes time to heal then get in touch with your doctor. For appropriate foot care tips, do consult an expert podiatrist.

Foot Exercises for Bunions

Bunions

This is a bony outgrowth at the joint at the base of your big toe. If you suffer from a bunion, your big toe will point towards the other toes of that foot, pushing the joint outwards. Bunions can cause, pain, swelling and tenderness. Bunions could be hereditary, or they can arise due to wearing ill fitting shoes. It occurs more often in people who have flexible joints. Certain illnesses like RA and gout could cause bunions.

Treating bunions

There are a number of ways to treat bunions. Podiatrists usually try non surgical ways to treat bunions. Only in extreme cases will foot surgery be considered. Topical pain relievers help relieve the pain and swelling. There are spongy toe separators available. These can be tucked between the big toe and the next on, stopping the big toes from projecting inwards. 

Moleskin straps help hold the big toe in position. Toe alignment splints stop the projection of the big toe inwards. Gel bunion sleeves and tube foams are helpful. You can also get lesion pads which help heal wounds created, when the protrusion of the bunion rubs against footwear causing friction and blisters. 

These orthotic devices will only reduce the pain to an extent. In most cases, they will not be able to fully stop the inward projection of the toe. It works better in children as their foot is still in a formative stage. If you seek help in the beginning stages of the formation of a bunion, orthotics may be of more help. But usually people do not realize they are suffering from bunions till they start feeling the pain. 

Exercises for preventing bunions

Doming the foot

Sit in a straight backed chair and place your feet on the floor with both your feet together, keeping your feet relaxed. Now raise the arch of your foot off the floor balancing the foot on the big toe, little toe and the heel. Do not curl your toes. Now relax your foot once more. 

Half squat heel raises

Stand with your feet parallel to one another and slightly apart. Bend your knees as you go down for a squat and then straighten up and continue on to stand balanced on your toes with your heel raised. Try balance more towards your big toe. 

Raising your heel

This can be done sitting or standing, though standing heel raises are more effective. Stand with your feet slightly apart, feet parallel to one another and raise your heel off the floor, till you are balancing your body weight on your toes. Shift the balance as much as possible onto your big toe. Then lower your feet again. 

Squat to heel spring rise

Try this out slowly first and if you feel pain anywhere, do not do this exercise. You could try it sitting down. If standing, squat halfway and then spring up till your heel is slightly off the floor. Then, go down again to squat position. If you are sitting, keep the full foot on the floor and then raise the heel off and then back down. 

Repeat each exercise ten times to start with and work up to 25 repetitions a day. If you can’t do that many repetitions in one sitting, split it up over the day. If the standing exercises cause pain, do only the sitting ones. It is better to have your podiatrist show you the right way to do these exercises, as you do not want to hurt some other part of your body while doing these exercises. With a little help you could keep the bunions at bay!

A guide to choosing athletic shoes

The wrong type of footwear

Many foot problems arise due to wearing ill fitting footwear. People think formal footwear or evening footwear when they talk about bad fitting footwear. There is a wide range of athletic footwear available in the market. What do you do when your old shoes are worn out and you need new ones? You go to your favorite footwear store, and pick up a shoe that looks good and feels good. You walk about in it, up and down the shop and if it feels comfortable, you buy it. Little do you realize that choosing the right kind of athletic footwear is as important! 

If you are a couch potato who does minimal to no exercise at all, any pair of shoes is fine. But if you do any kind of exercise, like gyming, jogging, walking etc, you need to find the right footwear that will support that kind of activity. If you are into more athletic activities like basketball or football, even if it is in the park with your colleagues or friends, it pays to buy the right kind of shoes. 

Tips to buying good athletic shoes

Every kind of exercise uses different parts of your feet. You know that different muscles are used for different sports. You can feel the tension in those muscles when performing that activity. Likewise, different spots of your feet get stressed when participating in different kinds of sports. The shoes that you wear should support the area of stress, depending on the activity that you are performing. 

Test your foot

The first step to choosing the right shoes is to understand your feet. The best way to do that is to look at your last pair of worn out shoes. Check and see which parts of the shoes are worn out. Depending on your activity and the shape of your foot and your gait, the shoe will be more worn out in certain areas. Now you know which part of your feet needs more cushioning and support.

Read up on shoes

There is a lot of material online about the different kinds of shoes available. This is not merely marketing. Most shoes these days are tested thoroughly, and used by sportspeople, before being vetted as good for that particular activity.

Talk to your podiatrist

If you have any kind of foot problem it is a good idea to talk to your podiatrist and get their inputs. They could also give you more information on splints and guards to protect your feet.

Ask the salespeople

The salesperson knows the products inside out. If you explain to them the kind of activity that you indulge in, they will be able to help you find a shoe that is designed for that activity.

Don’t multi task shoes

Many people use the same shoes for running, basketball, skipping etc. If you regularly do a number of different sports at the same time, you should have shoes that complement that sport. Otherwise by using the wrong shoe for the wrong sport, you could end up injuring yourself. For example, walking shoes are stiff, running shoes are flexible. If you alternate regularly between both these exercises, you should have different shoes for each. 

Be aware of foot change

Due to sports or age and many other reasons, the shape of your feet and your stress points could change. So you should check your old shoes for new worn out spots, and see a podiatrist and get advice before getting new shoes.

Remember, shoes can make or break your foot!

Flat feet in adults

What is flat feet?

Flat feet occur when the arch of the foot collapses. The entire foot is in contact with the floor since the arch that supports the leg has collapsed. Flat feet can be hereditary and can occur in children. When it is diagnosed in children, it can be corrected using special shoes that help raise the arch of the feet. 

Can flat feet occur in adults?

Flat feet can occur in adults because of injury or prolonged stress to the foot. This is called adult acquired flat footedness. If flat feet occur in an adult, it is due to the collapse of the arch and this acquired flat foot is permanent. The reason why flat feet occur often as people age is due to the usual and known risks like hypertension, obesity and diabetes. Flat feet can sometimes occur in pregnant women but it is usually temporary. 

Symptoms that accompany AAFD

1. There may be pain along the posterior tendon of the tibia which is on the inside of the foot or ankle. There may be swelling around the ankles.

2. Collapse of the arch may cause a shift in the heel bone and this may put pressure on the fibula causing stress related pain and swelling.

3. People who gym regularly or jog will be unable to do so if their arch collapses. Any kind of high impact activity will be quite painful and in severe cases, people can have difficulty with normal walking.

4. Old injuries or the onset of arthritis may cause an arch collapse resulting in flat footedness

5. Diabetics could get flat feet and they should be extra careful as their illness may cause numbness in the extremities and the patient may not feel pain. 

How does an arch collapse happen?

AAFD is caused when the posterior tendon of the tibia is damaged. This tendon begins at the calf and goes along the inside of the leg and attaches to the bones of the feet. This tendon is responsible for holding the arch of your foot up. If this tendon gets injured, the arch of your foot will collapse. In people with arthritis or diabetes, the steady degeneration of the tendon will lead to an eventual collapse of the arch. 

Treating AAFD

There are special shoes and other orthotics to help in the treatment of flat feet. AAFD is permanent so there is no cure for it. But your podiatrist will be able to help you treat it and lessen the pain. Some helpful products that are available for flat feet are:

• For mild cases where the pain is not so severe, gel supports that conform to the contours of your foot and have a raised arch will help support your collapsed arch. These gel supports can be fitted into any kind of shoe and worn on a regular basis.
• For a more painful AAFD, the Orthofeet BioSole-Gel Self Forming Orthotics Sport is a self-forming arch-support that uses bladder construction, filled with polyurethane foam and viscoelastic gel and shapes dynamically to the contours of the foot without bottoming out.
• In severe cases, Aircast AirLift™ PTTD Brace offers foot support and ankle stabilization. Located under the foot arch is the aircell. This is adjustable with the Hand Bulb (included with the brace). When it is inflated, the aircell can accommodate variances in arch shapes and heights and can comfortably lift the foot arch to achieve a more natural foot position.

AAFD cannot be cured but a podiatrist will be able to help you deal effectively with the symptoms that it causes!

Diabetics and foot problems

People who suffer from diabetes are at a high risk for a number of problems including foot ailments. Some of the common foot problems that people who suffer from diabetes could get are diabetic neuropathy, peripheral vascular disease, athlete’s foot, fungal infection of the nails, ingrown toenails, bunions, calluses, corns, blisters etc.

Preventing diabetic related foot problems

By taking care of your diabetes, you are taking care of your foot problems too. But even so, it is advisable for a diabetic to see a podiatrist regularly to make sure that they are not at risk from any kind of foot ailments. Wearing the right kind of shoes can go a long way in keeping foot problems at bay. 

There are some good looking shoes especially made for people with diabetes. They look good and protect the feet. Some of them are:

The Orthofeet Women's Slip-On Wedge 

This is a therapeutic shoe that looks as great as it feels. Orthofeet shoes offer the most comfortable fit and pain relief for those suffering from diabetes, plantar fasciitis, heel spurs, bunions, hammertoes, corns, Morton’s neuroma, and swollen feet and toes. Orthofeet Easy Slip-On Low-Heel shoes combine handsome, non-binding design, along with a unique closure system and therapeutic shoe detailing for the ultimate comfort and protection. 

Orthofeet Women's Slip-On Wedge Shoe with a strap

This is a lightweight shoe with a moderate wedge design that provides comfort and looks attractive. It has supple leather with extra foam padding in the tongue and collar. The hook and loop straps and a wide opening make for an easy on/off shoe. The construction across the metatarsals provides extra room, if needed, to accommodate swollen feet and forefoot deformities, especially bunions. It has seamless fabric lining, padded with foam enhances comfort and protection. It has a stretchable padded collar along the entire edge of the upper insures comfortable fit, box and eliminates pressure points. Wider and deeper toe box ensures a comfortable fit, even for those with hammertoes and corns. It has a cushioning sole for added comfort. It is made of light weight EVA midsole and rubber outsole. It has an adjustable and customized fit with a single strap that can be fastened on either side of the shoe. 

SteriShoe Ultraviolet Shoe Sanitizer

The SteriShoe Ultraviolet Shoe Sanitizer is a safe, easy and highly effective way to provide a healthier in-shoe environment for feet and is doctor tested and recommended. It kills up to 99.9% of the germs that cause foot infections and offensive shoe odor and helps keep at-risk feet safer. The combination of sweat and heat inside the shoe makes for a perfect breeding ground for the bacteria and fungi that cause toenail fungus, athlete’s foot, and foul odor. And when foot conditions already exist, then shoes can also be a common source of post-treatment re-infection. Therefore, to fully minimize the likelihood of new or re-infection, germs must be eradicated at the risk source! Hundreds of doctors dispense SteriShoe and patients across the US benefit from SteriShoe every day. 

The innovative SteriShoe® shoe sanitizer kills the germs that reside inside shoes with a special germicidal ultraviolet light (UVC). With the first treatment, SteriShoe destroys up to 99.9% of the microorganisms in shoes, including the bacteria and fungi that cause toenail fungus (onychomycosis), athlete’s foot (tinea pedis) and offensive foot odor. SteriShoe is also an excellent choice for those with diabetes or concerned about their foot hygiene.

With this kind of good looking and comfortable shoes available, people suffering from diabetes no longer need to compromise looks for protection.

Did you know that foot burning may be due to diabetic neuropathy?

Burning feet!

When you hear the term burning feet, the image that jumps to mind is ‘feet on fire’. Well, you won’t be too far wrong. People who suffer from burning feet actually feel their foot getting warm and in severe cases, the feet feel as though they are burning up.

Burning feet is usually associated with neuropathy due to diabetes. There are a number of other reasons why people could suffer from burning feet. Some of them include Lyme disease, alcohol abuse, AIDS, thyroid problems, kidney disease, vitamin deficiencies, hypertension etc. One of the most common reasons for burning feet is neuropathy caused by diabetes.

Diabetic neuropathy induced burning feet

If diabetic neuropathy has been diagnozed as the primary cause of burning feet, the diabetes which is the cause of the burning feet has to be treated. When a person suffers from diabetes, he/she should be careful with their sugar levels and keep their diabetes under control. If not controlled, diabetes could leave to nerve damage or neuropathy. The many symptoms associated with neuropathy are numbness, pins and needles, burning sensation etc.

The first object of the doctor’s treatment will be to bring the diabetes under control to stop further nerve damage. Numbness and burning feet are just the first stages of nerve damage. If left untreated, it could lead to permanent nerve damage.

Reasons why diabetics are more prone to neuropathy

Though high sugar levels can be the cause of diabetic neuropathy, other factors can hasten it. These factors include substance abuse, kidney disease, vitamin deficiency, hypothyroidism etc. Any of these could increase the chances of a diabetic getting neuropathy. So, it is important for diabetics to not only take care of the sugar levels but also take holistic care of their bodies.

Symptomatic treatment of burning feet

There are quite a few over the counter oral medication and topical creams to help deal with burning feet. But if you are a diabetic and your burning feet is due to diabetic neuropathy, it would be better to seek the advice of a doctor before taking any medication. The doctor will be able to prescribe medication for your burning feet which will not interfere with your ongoing treatment of diabetes. These medications should help relieve the pain of burning feet.

Holistic treatment of burning feet

Burning feet are the symptoms of a more dangerous cause like diabetes. So to treat burning feet, the underlying cause which is diabetes should be treated. One of the first things a person should do if they suffer from burning feet, is to get themselves checked for diabetes. If diabetes is ruled out, other tests can be done to ascertain the underlying problem. If the cause is diabetes, then see a doctor to find out how high your sugar levels are and what kind of treatment is needed.

If your sugar levels are not very high, your doctor may put you on a diet regimen to control the diabetes. If your diabetes is more advanced you may have to start taking medication for it. Whether you have burning feet or not, if you are a diabetic, you should visit a podiatrist regularly because diabetics are prone to a number of foot problems. Diabetics can get numbness of the feet which means that if your feet get injured, you may not realize it. There are many products to help people with diabetic neuropathy protect their feet. 

By taking certain protective measures, you can safeguard your feet against the side effects of diabetic neuropathy.

Solutions to prevent bunion

What are bunions?

Bunions are called hallux abducto valgus in medical terms. They are an enlargement and a deviation of the large toe which could be accompanied by swelling and lesions. Bunions occur due to a variety of reasons. They could be hereditary. They could be caused by wearing ill fitting, uncomfortable shoes for long periods of time. When ill fitting shoes are worn there is friction between the shoe and the large toe which leads to bunions. The toe is pushed inwards at the end causing the knuckle of the toes to seemingly protrude out giving a triangular shape to that part of the foot. In severe cases the inward deviation of the big toe could be so severe that it actually goes over or under the second toe.

Symptoms of bunions

The signs and symptoms of a bunion include swelling, redness or soreness around your big toe joint, persistent or intermittent pain, a large protrusion on the side or base of your large toes and appearance of corns and calluses on the big toe. Thickening of the skin at the base of the big toe and restriction of the movement of your big toe accompanied by intense pain are other symptoms. If the bunion has been forming for a while, the patient could be in so much pain that even walking could get difficult.

Bunion Prevention

Bunions form over a long period of time. Even for people who have protruding knuckles, the formation of a bunion can be prevented by wearing shoes that can accommodate the protrusion. When people who already have protruding knuckles wear close fitting shoes, the friction will be more and the formation of bunions will be swifter. Taking care of the feet during childhood and the teenage years can help control the formation of bunions for a long time.

Simple foot exercises can strengthen your feet and help you avoid bunions. Wear shoes that fit properly and that do not cramp or pinch your toes. Wearing high heels or pointed toes should be kept to an absolute minimum or not at all.

Treatment of bunions

If you already suffer from bunions, here are a couple of things that you can do to help lessen the pain.

• Wear comfortable shoes that have enough toe space
• Open toes sandals which are not constricting is a good idea, at least till the swelling and pain of the bunion comes down.
• Wear socks if you have to wear shoes, so that there is less friction between the toe and the shoe.
• Have a warm foot soak with Epsom salts and moisturize your feet regularly to keep it soft and to prevent chaffing.
• If you have to wear closed shoes to work, take them off and air your feet a couple of times a day.

Surgical Options for bunions

If you are suffering from a severe case of bunions and are in a lot of pain, the podiatrist may suggest a surgical procedure to remove the bunion. Most foot doctors use surgery only as the last measure. They will try to help you cope with the symptoms of bunions with preventive care and oral and topical treatments as much as they can. Only in rare cases do podiatrists consider surgery.

As in most cases, prevention is better than cure. If you do have a history of bunions, then you should take care to wear footwear that does not aggravate the bunion. If you see any symptoms related to bunions, see a doctor immediately. The faster it is detected, the swifter the treatment would be.