Friday, February 26, 2010

Tips for Diabetic Feet

Diabetes is the primary cause of a great number of secondary foot problems seen in the podiatric office. Foot problems secondary to diabetes include ulcerations, cuts, scrapes, and can include foot deformities such as bunions and hammer toes. These problems are due largely to a three-headed combination of the loss of peripheral sensation caused by diabetic neuropathy, decreased peripheral circulation, and the high frequency and impact placed on the foot on a daily basis. Small cuts, scrapes, etc. can become ulcerations and even lead to amputation if they are not taken care of. Because of the loss of protective sensation in the extremities caused by diabetic neuropathy, unless the minor skin traumas are viewed or the incident is significant enough to remember, these minor traumas can often go unnoticed. Often, the first sign of a problem is bloody or pus drainage seen on the socks.

Proper diabetic foot care is important to prevent a small injury from turning into something more serious. The first step is to follow the instructions your primary care doctor gives to keep your blood glucose levels under control. This can help to prevent the onset and less the severity of neuropathy in the extremities. The second and most important measure in foot care is daily inspection of every surface of your feet. Use a mirror or ask for help if you are not able to see the bottoms of your feet. Pick a time every day to inspect your feet and stick to that plan. Wear well-fitting, wide-toed shoes that do not pinch or squeeze on your feet. Never walk around barefoot, wearing shoes and socks as often as possible. Be careful in extremes of temperature, especially in water, to avoid burns. NEVER use heating pads or hot water bottles. Keep your feet moisturized to avoid cracking and blistering. Keep your nails neat and trimmed. If you cannot cut your nails yourself, many Medicare patients qualify for coverage to have this performed in a podiatrist’s office. It is important to remain active and avoid long periods of sitting or lying without moving your feet and ankles. Activity improves circulation to the extremities and can improve sensation as well as healing of minor cuts and scrapes.

These steps can go a long way towards avoiding major lower extremity complications due to diabetes. If you notice wounds on your feet that do not seem to go away be sure to make an appointment with your podiatrist to avoid serious complications.

For any other questions on diabetic foot care and foot problems in general, be sure to visit us at .

Friday, February 12, 2010

Deep muscle bruise may keep gold medal hopeful Vonn off the slopes

American Olympic skier Lindsey Vonn may have had her gold medal hopes dashed by a deep muscle bruise to her right shin. Vonn is considered by most to be the top downhill skier in the world, and is expected to medal in all five of her downhill events in the upcoming Winter Olympics. She has been limited of late by a deep muscle bruise to her right shin, a very painful condition which is made worse by the ski boots she must wear pressing up against the muscle.

A bruise, or hematoma, forms after trauma to tissue. In this case the muscles of the anterior compartment of the leg are involved, causing damage to the small blood vessels in the area and allowing blood to seep into the space. Bruises are generally harmless, but if the traumatic force is great enough they can lead to significant tissue damage. Bruises will begin as a localized dark blue/black and as the pooled blood cells begin to break down they will spread under forces of gravity and change colors to more green, yellow, and brown. This change in coloration is due to the breakdown of the blood cells. Bruises are painful not because of the pooling of blood but because of the underlying tissue damage that is causing the pooling.

Normal treatment of a bruise should follow the R.I.C.E method. Rest, Ice, Compression, and Elevation. Do not use heat on a bruise as it will increase the discoloration and the area that it covers, and actually promote more swelling. If the bruise does not begin to dissipate, or at least become less painful, after 48 hours consult your physician. This may be a sign of a serious underlying condition such as a fracture, severe sprain or blood clot. The use of blood thinning medication such as Coumadin can cause an increase in the frequency of bruising.

Vonn will be racing against time even before she gets on the slope, hoping that her injury will have time to heal before she reports to the starting gate. She has begun to test the shin, walking around in her boot and going on a few runs. As disappointing as it would be to the fans of USA Olympic skiing to not have her go, we should all hope Vonn is at 100 percent before competing as the incredible speeds and control needed in her sport require it. Best of luck to Lindsey and all the Olympians preparing to represent their countries and live their dreams! After watching your favorite event be sure to check us out at

Saturday, February 6, 2010

Heel pain may slow the Bulls run to the playoffs.

After a poor start to the season, the Chicago Bulls seem to be headed in the right direction. But the team’s goal of reaching the playoffs again may be derailed by an injury to the left foot of center Joakim Noah. Noah has been arguably the most effective player on the Bulls this season, being third in the league in rebounds and providing constant energy on both the offensive and defensive ends. Lately, however, Noah has been hampered by plantar fasciitis to his left foot.

Plantar fasciitis is an inflammation of the plantar fascia, a thick band of connective tissue that stretches across the bottom of the foot from the heel to the base of the toes. Plantar fasciitis is an overuse syndrome which can occur with repetitive pronation, or collapse of the arch of the foot. This stresses the attachment of the fascia to the heel. Small microtears develop which cause pain and inflammation.

Joakim Noah has attempted to work through the plantar fasciitis pain, which is a difficult task for anyone to attempt, let alone a seven-foot tall runner/jumper/cutter/pivoter. The quick stopping, starting and pivoting maneuvers cause unusual ballistic strain on the inelastic plantar fascia. After two weeks of trying to work through the pain, the Bulls coaches and their training staff have decided to provide Noah with a much needed break.

Plantar fasciitis is one of the most common causes of heel pain we treat in the office every day.

The general course of treatment for plantar fasciitis involves calf stretching, icing and support of the arch to prevent “bottoming out” of the fascia. This can be an extremely difficult condition to treat because even walking can place strain on the plantar fascia. In addition to stretching and icing, plantar fasciitis prevention includes avoiding barefoot walking, wearing well-fitting shoes, warming up before strenuous exercise, and easing yourself into a new exercise program. Understand the pain information your body is sending you. In shoe orthotics can also help to correct abnormal foot posture and motion that contribute to this often debilitating condition.

Hope this post has made the sports-news talk a bit more understandable, and be sure to visit us at .

Wednesday, February 3, 2010

Foot and ankle injuries will play a significant role in the upcoming Big Game

Several foot and ankle injuries will have their say in who wins this weekend’s Super Bowl between the New Orleans Saints and the Indianapolis Colts. Five players between the two teams were limited or held out of practice over the last week because of foot or ankle related injuries.

The most significant and talked about of these injuries is to Indianapolis Colts defensive end Dwight Freeney. Freeney suffered in inversion-type injury during the Colts January 24th win over the New York Jets and has been held out of participation since. Freeney’s injury has been diagnosed as a grade III sprain involving the anterior talofibular ligament and calcaneofibular ligaments of the right ankle joint. A grade III injury is a complete tear of the ligament with significant swelling and instability.

Freeney has slept in a hyperbaric chamber (to increase oxygen concentration in his blood and therefore oxygen delivery to the ligaments), as well as used ARP (Accelerated Recovery Performance, an electric stimulation machine designed to speed the healing process) to improve his odds of playing this Sunday. As of Wednesday Freeney says the ankle is feeling better and he will likely play, which would be incredible given the severity of his injury. If Freeney is able to play it will say a great deal about his ability to cope with pain as well as the impact modern medical technology can have on sports.

For those of us who are not professional athletes with access to hyperbaric chambers and a team of athletic trainers, the usual course of treatment is one to two weeks of a protective long boot followed by two more weeks in an Aircast. After the two weeks in an Aircast, physical therapy and a functional brace are recommended for a period of up to six months. Suffice it to say, it would be a while before most of us would be back trying to get around the offensive line and tackle the quarterback!

Make sure to check us out at