The Foot In Diabetes

Type two diabetes is now so common, it is almost as though we have become complacent about this. The incidence is rising in most places despite public health interventions are trying to take care of the obesity crisis that is supporting the diabetes issue. Diabetes has a number of complications which join collectively to put the feet at considerable risk from complications. These complications vary from a slight infection up to the more severe complications like a need to amputate a limb due to a spreading infection or dead tissue. The complications associated with all forms of diabetes have an impact on a wide variety of tissues within the body.
In terms of the foot, diabetes impacts the blood supply and therefore any problems for the foot is more prone to be serious because there is inadequate good circulation to permit healing to occur. Diabetes also damages the nerves, so that if there is some injury, either major or minor like a blister, then no pain is felt, so the foot continues to be traumatised resulting in the much more serious. The body has numerous functions to battle infection, but in diabetes the reaction to an infection is much more sluggish compared with those not having diabetes. Diabetes may also affect the eye and while the eyes are quite a distance from the feet, appropriate vision is required to see any problems that may have happened to the foot so it may be dealt with. Even the kidney disease that frequently occurs in diabetes impacts wound healing once the injury has been done and the presence of disease in the renal system may affect which drugs, for example antibiotics, may be used and sometimes that range can be very restricted.
It is for all these reasons, and many more not brought up, that those with diabetes have to take special care of their feet. They have to examine them routinely to make sure that there is no injury and if there is an injury they have to get medical attention promptly. Most importantly, they need to be regularly managed by a foot doctor.

Cuboid Syndrome

The cuboid is a smaller cube shaped bone on the lateral side of the foot around about the center of the foot. The bone is a little bigger than a common gaming dice. The bone participates in three joints and operates as a lever for the tendon of the peroneus longus muscle to pass under. Since this is a strong muscle it can move the cuboid bone too much if it is not secure and strain those joints that the bone is a part of resulting in a ailment known as cuboid syndrome. This is probably one of the more common causes of pain on the outside of the foot, generally in athletes. The pain commonly begins quite mild and is located around where the cuboid bone is on the outside of the foot. The pain is only at first present during activity. If the exercise levels are not lessened the problem will most likely progress and then show up after exercise in addition to during. From time to time the pain can radiate down into the foot. Although this is the commonest reason for pain in this area, there are others like tendinopathy and nerve impingements.

The main management of cuboid syndrome is relief of pain. This is normally done with a reduction in exercise levels and the using of low dye strapping to immobilise and support the cuboid. Mobilisation and manipulation is frequently used to fix this condition. Over the longer term foot orthoses may be required to control the movement and support the lateral arch of the foot. This helps make the cuboid more stable so it is an efficient lever or pulley for the tendon to function around. Generally this approach works in most cases. If it doesn’t there are no surgical or more advanced treatments and a further reduction in activity amounts is usually the only option.

Cracked Heels


Cracks in the epidermis at the back of the heel are frequent, are painful, and do not appear very good. They happen when the fat pad beneath the heel expands out side to side beneath the foot and the dried-out skin cracks or splits to create a heel fissure. A great way to fully understand them is to use the example of a tomato being squashed. When you apply force to the tomato to squash it, the skin around the tomato cracks as the insides forces outwards. So it is with the heel. As bodyweight compresses the fat under the heel it stretches out sideways from underneath the heel, it tries to tear the skin around the perimeter of the heel. If this succeeds or not is going to depend on how supple and strong that the epidermis is. If the skin is dry, thicker or callused, it will tear quickly. If the skin is thicker with a layer of callus, that skin will crack easily and put a strain on the healthy skin below that will become somewhat painful, sometimes bleeding. Every step that is taken with further open the split and prevent it from getting better. This is more prevalent in those that use open heel type shoes, as a closed in shoe can help keep the fat pad beneath the heel in position and help avoid or lessen the effects of this.

The most effective short term relief of cracked heels is to have the callused skin cut back by a podiatrist and then use tape to hold the edges of the crack together so that it can heal. The long term prevention of cracked skin around the heel ought to be clear from the process that was explained above. To begin with, weight loss will help decrease the problem, but this is a long term concern. To help stop the fat pad beneath the heel from broadening out sideways and trying to split the skin, a closed in shoe needs to be worn and in some cases the use of deep heel cup orthotics can help. A foot doctor should really be seen regularly to debride any thick callused skin. Creams ought to be used regularly to keep the skin supple so that it does not fissure. The use of filing tools to maintain the thick skin in check can also be used.

Chinese Foot Binding

There is a historic technique from rural China which involved the binding of the feet of female children to prevent them from growing. It was a brutal process and was debilitating and disabling to the feet. It was carried out as a smaller sized foot was considered an attractive feature in the female and a higher dowry can be asked for by the family for the bride-to-be when the feet had been bound. There was a considerable market in these rural communities for the ornamental and finely crafted shoes that these girls would need to wear because of the smaller and deformed feet. More than 100 or so years ago cultural pressures began to mount to ban the practice and this generally was successful and it is not done any longer. The practice had to stop as it was so disabling and painful for the child. When they became an adult, the damage had been done and there is not much that could be done to manage the suffering and deformity. Having said that, you will still find many elderly woman still living that had their feet bound when they were little girls.

You will find theoretically parallels to this practice of chinese foot binding that may be seen nowadays. A number of experts try to link the practice these days of females who force their feet into the high heel shoes as being the same as the foot binding. In rural China the practice was all about the female doing something that pleases the male, no matter the outcomes in terms of pain and deformity. The practice today of wearing tight fitting high heel shoes by females has consequences in the terms of foot disability and foot pain. It is also apparently done in the context of the female doing something which is pleasing to the eye of the man. There is some disagreement if the connection between the two practices really do warrant the type of evaluation that they have been put through.

Barefoot Running

Running without shoes had been all the rage not long ago however interest in it and the number doing it have dropped of considerably. It was a craze that continued for several years and was mostly influenced by social media commentary. It was a short lived trend towards barefoot running that took off around 2009 with a lot more interest in running free of running shoes. It was touted in numerous books, blogs and magazine articles and Youtube Videos thhtbarefoot running was more natural, that it was a more economical method to run and that you got significantly less injuries running that way. Many runners tried barefoot running as an alternative to using running shoes and interest in it peaked about 2013. The sales of minimal or barefoot running shoes furthermore peaked at around that time, getting to nearly 10% of the running shoe market.

After that original attention and peak interest in barefoot running and minimalist running shoes have been steadily decreasing. Runners lost interest in running barefoot. The sales of the minimalist running shoes have been dropping steadily since around mid- to late 2013. The believed advantages for it failed to eventuate to many runners who tried barefoot running but, needless to say, those who touted barefoot running simply claim that those runners were doing it incorrectly. When the scientific data accumulated, the advantages weren’t just there. All of the injury rate reports were showing that the risk of injury was the same had you been running in footwear versus running without shoes and the majority of of the running economy investigations were also showing that generally there weren’t any systematic advantages.

While some runners, who’re rather vocal, still do their running without footwear the big market shift has now been towards the maximalist running shoes with the Hoka One One running shoe being the innovator in that group of running shoes. It has now reached the stage where the Hoka’s now outsells the entire group of minimalist running shoes giving an obvious sign of the popularity of cushioned running shoes compared to barefoot running.

Plantar Fasciitis

Plantar fasciitis has become the prevalent complaint which affects the feet. As a result of how widespread it is, there are so many pretending to be experts about it online giving out harmful advice on what to do about it. The characteristic signs of plantar fasciitis are soreness in the heel that is worse when getting up from rest, in particular first thing each morning.

Plantar fasciitis is an issue with the plantar fascia (which is a strong ligament which supports the mid-foot of the foot) once the cumulative weight applied to the plantar fascia is higher than what the tissues can carry. Because of this there are only two main reasons for plantar fasciitis: the cumulative load is simply too high or the tissues are too weak. The stress is elevated by body weight, restricted leg muscles, activity amounts and biomechanical reasons. The tissues being too prone is caused by nutritional deficits and genetic factors.

The sensible solution to improve from plantar fasciitis is to lessen the strain and increase the capacity of the plantar fascia to take the load. You reduce the force by slimming down, using strapping in addition to foot supports, as well as stretching the calf muscles. You increase the capability of the plantar fascia to accept the load through ensuring the dietary status is satisfactory and perform gradual loading activities for the plantar fascia. You can’t do anything at all about the genetics. It is really that easy and there is no necessity for plantar fasciitis to become such a huge problem that it is.

The problem with the therapy of plantar fasciitis and all the tips being given on the web for this is that the natural history of plantar fasciitis is to get better by itself eventually. Just look into the placebo groups in the clinical studies on different treatments for plantar fasciitis; they do improve. Eventually could be a long time and it is sore, so they still need to be addressed rather than wait until it improves. This means that, it doesn’t matter what therapy is used, a particular percent will likely become better regardless as a result of that natural history. Which means that bad remedies persist as they all do manage to help some, when in reality they didn’t help any. Those who appear to be effectively treated with that treatment probably will propose that it is useful. This also implies that the treatments that ought to be used are those which have been shown to result in superior results than just the natural history. Because of this we won’t become misled into believing a therapy will work when in reality it might not work any better than the natural history. You should be cautious taking any recommendations on the internet for almost any medical problem.

The Spring Loaded Enko Running Shoes

The most recent entrant in to the running shoe marketplace is a unique shoe from Enko. These unique athletic shoes from France were initially promoted in late 2014 and created via a crowd financing project at Indiegogo at the beginning of 2015.

This footwear features mechanical spring loaded pieces which are included in the sole. This particular design provides the shoe with additional shock absorption and energy return. This is believed to help increase comfort along with running economy. The springs are interchangeable and are calculated depending on the weight of the athlete. Data supplied by Enko report that the gains provided by the shock absorbers when it comes to mechanical energy is somewhere between 6% and 14% according to the pace of the athlete.

It is not apparent if the Enko footwear will likely be broadly used at this point, however, some issues have been expressed concerning the structure and how it may affect the running biomechanics.

Austin Bunionectomy Surgery for Bunions

Bunions, or more accurately, hallux valgus or hallux abducto valgus occurs in numerous shapes or forms. The condition is one of an enlargement of the great toe or hallux joint of the foot (bunion) and an pointing over of the great toe sideways toward the smaller toes (abduction and valgus). They become painful due to arthritis like symptoms from the deviation of the big toe or hallux and also from strain on the lump of the bunion from the footwear. They’re one of the most frequent reasons for pain in the feet and are caused by a mixture of inherited attributes, weak biomechanics and also shoe fitting problems. Whilst there are non-surgical options like pads, splints, adequate shoe fitting, exercises and pain alleviation medication that can be used, they cannot make the bunion go away nor align the bunion in the longer term. Usually surgery is the only long term means to fix bunions or hallux valgus. Nonetheless, unless the actual cause of the bunion has been dealt with at the same time there exists a risk that it may occur again.

There are numerous joints and bones mixed up in development of bunions and each case is different as differing degrees of each bone and joint are involved. This means that the surgical correction has to be directed at the bone or joint that is involved. If the big toe joint is just involved, then a simple removal of the enlarged bone is perhaps all that is needed. If the angle of differing bones are a issue, then a wedge needs to be taken out of the bone and the bone reset. There are so many different approaches to undertaking that and it’s been believed that this condition has more surgical options for it in comparison to all other conditions!

The Austin bunionectomy is just one kind of surgery. This procedure involves taking off the lump of bone and taking a v out of the head of the 1st metatarsal to realign it and maintain it in position with a screw so it can heal. A special shoe or boot will have to be worn throughout the first few weeks following the procedure and return to your normal shoes after around 4 weeks. It usually requires around 8 weeks to return to full activity levels after this procedure.

The new Metarun running shoe from Adidas

The ASICs Corporation is one of the most well-known and widely used athletic shoes available on the market. Like every running shoe brand they always innovate to maintain that market leading position. Asics currently have a variety of athletic shoes with different versions in an attempt to meet the requirements of a wide range of athletes. Each of those models is often updated. Asics recently created a different model to the range, the Metarun. Very little was at first known about the footwear, simply a taster online video on the Asics website and a countdown clock ticking down to a unveiling on November 12 2015. When the clock arrived at zero a tweet was dispatched by the company to a video that revealed further information and the website was refreshed with more on the Metarun. Asics certainly claiming that this is their best ever athletic shoe.

The running shoe goes against the current tendencies of less gadgets and features in running shoes, adding several designs which have patents attached to them. The midsole, termed FlyteFoam, is their lightest and most sturdy midsole material. They discuss “organic fibers” for the highest level of cushioning. The shoe gets its stability from the patented AdaptTruss which is a carbon reinforced adaptive stability system. The “Sloped DUOMAX” is a dual density midsole which is expected to change easily to dynamic motion of the runner. The upper features a glove-like, one-layer Jacquard Mesh as well as MetaClutch exoskeleton external heel counter with a built-in memory foam. There is also a X-GEL hybrid high-tech gel in the midsole to assist shock absorption.

Is it their finest running shoe ever? Time will tell. Runners will vote with their feet once they test the Metarun. There was a little bit of hype in social media before the launch. The Metarun won’t be available until late November and they are going to be expensive and just available in restricted release.

The Foot in Ankylosing Spondylitis

Ankylosing spondylitis is a long-term inflammatory joint condition that usually affects the vertebrae, but could affect all joints in the body and several other organ systems. The name ‘ankylosing’ means a fusing of the joints and ‘spondylitis’ means the spine. The disease impacts on about 0.1-0.2% of the population and does affect males more often. It generally simply begins as an ache in the lower back which is really no different in signs and symptoms to almost every other common low back condition so is typically treated as such. Generally, this treatment will probably not work and other methods get used. Inevitably, when some other symptoms occur in additional joints there might be more investigation bringing about the proper diagnosis of ankylosing spondylitis. This process could take up to a decade before the diagnosis is made. The standard approach to treatment for this is to use drugs to deal with the inflammatory process inside the joint along with physiotherapy to help keep the spine mobile and flexible.

Ankylosing spondylitis affects the foot often. One way is that the joint inflammation process can affect the joints in the feet and cause symptoms there. Heel spurs or plantar fasciitis is quite common in those with this disease. This type of heel pain isn’t the typical one that you get because it is part of the disease process, consequently tends not to respond effectively to the conventional methods of dealing with heel pain. Like the joint inflammation that impacts the joints in the foot, the treatment is primarily directed at the drugs that reduce the inflammatory response. The other way that ankylosing spondylitis impacts feet are indirect. Because the major symptoms of the disease are in the spine, the lower as well as upper back become very limited in motion, so people that have ankylosing spondylitis tend to have difficulties bending over to reach their feet. Because of this they cannot even perform basic things like cut their own toe nails or self-care for their feet. They’re also going to have issues managing different conditions that impact the foot. They will often need to see a podiatrist frequently for foot care and maintenance of foot health and for the regular management of any foot conditions that might occur.