Why Do Diabetics Need Special Shoes?

There’s a question that we get in our Blacksburg and Roanoke offices quite frequently – and that is, “Why is it that your diabetic patients require special shoes?”

To understand the answer to this question, one must first understand the diabetic foot. One big reason why it is important for any diabetic person to carefully monitor and control blood glucose levels is that when uncontrolled, many complications can arise. Some complications that are frequently seen in our office are nerve damage, decreased blood flow, and foot and joint problems. All of these problems can and do affect the feet.

Besides the bladder, bowel and stomach issues that can arise from diabetic neuropathy, poor sensation can have devastating effects on a patient’s feet without proper care and attention. Inability to feel pain, pressure or temperature can easily allow for rubs, blisters, burns and other injuries to go unnoticed.

Feet are sensitive and the blood supplying oxygen to the lower extremities may be reduced without you even being aware of it. The decreased oxygen delivery to the feet from poor circulation results in slower healing and nail growth.

Uncontrolled blood glucose levels can be inherently dangerous. “Rollercoaster” blood sugar levels can damage tissues and cells. An elevated blood glucose level can cause dehydration and dryness of the skin as well as promote the growth of bacteria and fungi (since sugars are a good food source for these organisms). Because of this, bladder, gum, and skin infections are common in our diabetic patients with high sugar levels. 

So, Why Special Shoes?

-          Proper shoes are the first line of defense against injury and infection.

-          Well fitting shoes are comfortable and allow proper circulation in the feet.

-          Proper shoes will allow your feet to breathe while still protecting them.

-          Proper shoes can prevent the development of ulcers, blisters and fungus.

How are these shoes different?

-         Deeper and wider to accommodate diabetic inserts, allow more room for feet, and reduce possible pressure points.

-         These shoes provide excellent support which is recommended for anyone buying shoes.

-         Most have a breathable fabric upper to promote good air circulation within the shoe.

-         Most are custom ordered for size or even custom molded to a patient’s foot.

-         The toe boxes are roomier to prevent pinching or squeezing the toes as well as to allow for more room for foot deformities.

-         Many are easily adjustable or have elastic which makes it easier to put on without making the shoe too tight or too loose.

-         Available with Velcro to make putting on shoes easier for patients with peripheral neuropathy who can not feel their fingers well enough to lace shoes. 

 

If you are interested in a pair of these shoes for a loved one or yourself, please give our office a call at (540) 808-4343!

From Flats to Stilettos, it's Agony of the Feet



I went to visit my boyfriend's grandparents the other week and his grandpa cut out this article from the Richmond Times for me!

The article describes how women will wear 5 inch stilettos to work throughout the week then will switch to flats or flip flops over the weekend. (Around these parts, however, with all the students it's more of wearing flats throughout the week and growing 5 inches taller on the weekend!) 

When conducting a study on the feet, it was found that "women who wore so-called 'high risk' shoes that lacked sound structure and support, including high heels, sandals and slippers, were more likely to complain about foot pain later in life."

Listed are some common problems associated with wearing heels (or frequently switching from heels to flats to heels):

• Bunions- Experts say bunions, when the big toe points toward the second toe causing a bump to appear on the outside edge of your toe, are partly genetic. Wearing pointy-toe high heels can make the problem worse.
• Hammertoes- Shoes that crowd the toes together can cause the second, third, fourth and fifth toes to become bent, like a claw.
• Corns- Thickened skin on the top or side of the toe.
• Neuromas- Pinched nerves that cause a burning sensation, tingling or numbness between the toes and in the ball of the foot.
• Heel pain- Plantar fasciitis commonly causes inflammation of the thick tissue on the bottom of the foot, which leads to pain in the bottom of the heel.

What it comes down to is if height is important to you, wear wedges instead of platform or high heels. I personally recommend Danskos (I wear them everyday!) however, they are an investment, but they will give you the height and the support you need.

Also, make sure to stretch, yes it may sound silly to stretch after removing your heels for the day, but it will help in the long run with pain, swelling and discomfort!
Here are some quick stretching exercises we recommend: Plantar Fasciitis stretches and Heel Pain stretches

You're Active! So Keep Your Feet Fit!

Are you a daily walker, a hiker or a triathlete? Any level of intensity in your daily activities can create any of the serious and common injuries below.

Let's take care of your feet together, because healthy feet are happy feet!

Heel Pain- the most common complaint from runners caused by inflammation of the ligament which holds up the arc, known as Plantar Fasciitis

Causes:

• Plantar Fasciitis is classified as an overuse injury, the same as tendonitis. Sudden increase of activities such as going on vacation, starting a new exercise routine or changing jobs can contribute.
• Wearing non-supportive footwear on hard surfaces puts abnorman strain on the plantar fascia and can also lead to plantar fasciitis. This is particularly evident when one's job requires long hours on the feet.
• During the summer months, we see an increased number of patients in our offices with plantar fasciitis due to walking barefoot or wearing flip flops. Obesity may also contribute to plantar fasciitis.

Neuromas- A neuroma is a thickening of nerve tissue that may develop in various parts of the body. The most common neuroma in the foot is a Morton's neuroma, which occurs at the base of the 3rd & 4th toes.

The thickening, or enlargement, of the nerve that defines a neuroma is the results of compression and irritation of the nerve. This compression creates swelling of the nerve, eventually leading to permanent nerve damage.

What Causes a Neuroma?

Anything that causes compression or irritation of the nerve can lead to the development of a neuroma. One of the most common offenders is wearing shoes that a tapered toe box, or high-heeled shoes that cause the toes to be forced into the toe box.

Tendonitis- The Achilles tendon is the largest tendon in the human body and is very strong, but is also the tendon we rupture most often. Everyone who is active can suffer from Achilles tendonitis, a common overuse injury and inflammation of the tendon.

Treatment depends on the degree of injury to the tendon, but normally includes rest, which may mean a total withdrawal from running or exercise for a week, or simply switching to another exercise, such as swimming, that does not stress the Achilles tendon.

Stress Fractures:

A stress fracture usually occurs in the feet and legs. They are more common in sports like running or jumping, because this type of activity forces 2-3 times the person’s body weight onto the lower limbs. The biggest symptom with a stress fracture is pain with tenderness and swelling that worsens with weight-bearing exercise.

Make sure to see a podiatrist so we can keep you active into your late, late years!