Diabetic Foot care: Top Ten Ways to Help Your Feet
By: Doctor Douglas M. Childs

Many foot problems are related to Diabetes. In fact, the complications of Diabetes often lead to wounds, infections, and even amputations. Here are a few helpful suggestions to help keep your feet healthy:

1.       Don’t use pumice stones, medicated pads or files on your feet. Diabetes can cause a loss of sensation or numbness in the feet called neuropathy. The incorrect use of these tools and pads often leads to infections and even amputations. Call your podiatrist if you notice something on your feet that requires attention.

2.       Wear Proper Shoes: Shoes and socks that fit properly can prevent foot problems. They can also keep existing problems from getting worse. When buying shoes, make sure that the toe box is roomy enough to allow you to wiggle your toes. Avoid open-toed or open-heeled shoes. Choose soft, padded socks with seams that don’t pinch or irritate your feet. Before putting on shoes or socks, inspect them for anything that could rub against your feet. In some cases, Diabetic shoes may be needed. Ask your podiatrist if you qualify for shoes through Medicare.

3.       Check your feet daily:  Inspect your feet and toes every day for cuts, blisters, redness, swelling, calluses, or other problems. Use a mirror (laying a mirror on the floor works well). Notify your health care provider of any problems.

4.       Check for Swelling: It may be a sign of poor blood flow or infection. Swelling may also be arthritis or even related to heart disease.

5.       Get Your Circulation checked. You should get your circulation checked at least once a year. Non-Invasive tests can be done in the office to check for problems. Symptoms of poor circulation or PAD may include dull or cramping pain in your calf muscle or legs when walking, cold feet, loss of hair to the toes, or shiny skin.

6.       Get Your Vitamins:  Thiamine, Folic Acid, B6 and B12 all help to fight neuropathy. These vitamins are important in preventing numbness in the feet, but can become deficient due to some diabetic medications as well as with increased age.

7.       Get rid of that dry skin:  Dry, cracked skin leads to fissures and even wounds. Apply lotion daily, but not between your toes.

8.       Quit Smoking:  Diabetes is related to reduced blood flow to the skin and feet. If you smoke, you dramatically increase your risk of gangrene or Peripheral Arterial Disease (PAD).

9.       Exercise: Exercising daily can help the blood flow into and out of your feet, as well as your flexibility. Special exercises for feet, as well as walking, swimming, and biking are good types of exercise. Call your doctor if exercising is uncomfortable, or if you notice warning signs such as redness, burning, or tenderness during or after exercise.

10.   Control Your Diabetes:  A good foot care program includes controlling your diabetes. Eat a healthy, balanced diet, monitor your blood sugar levels, take prescribed medications, and exercise daily. Regular checkups by your health care team can also help to control your diabetes. The most important thing you can do for yourself is to keep your blood sugars as closely controlled as possible, get regular exercise and keep your weight under control.
Diabetes doesn’t have to lead to serious foot problems. Your health care team can work with you to keep your feet healthy and treat any problems that occur. But remember:  keeping your feet fit takes effort and commitment from the most important team member-you.

Routine Diabetic Foot Care Examinations performed by a Podiatrist are an important part of your health. Preventing problems is much easier that dealing with the problem later. An annual visit is recommended for all diabetics, but more frequent check-ups are often needed based on whether or not you have major risk factors, such as poor circulation, foot deformities (like bunions or hammertoes), or loss of sensation.  If you are due for an exam, give Orlando Foot & Ankle Clinic a call at 407-423-1234.

Preventing Sports Injuries in your Child
By: Tara Fussell, DPM

It’s that time of year again.  School is back in session and fall sports are in full swing.  For many parents it means shuffling kids to and from practice and cheering with pride watching their “Home Team” compete. 

Unfortunately there is a growing epidemic of sports related injuries in children and teens.   According to the national Centers for Disease Control and Prevention (CDC), high school athletes, alone, account for an estimated two million injuries, 500,000 doctor visits and 30,000 hospitalizations every year. The high rate of youth sports injuries is fueled by an increase in overuse and trauma injuries and a lack of attention paid to proper injury prevention. Fortunately more than half of all sports injuries in children are preventable.

Young athletes typically sustain two types of injuries while participating in sports: an acute injury such as a blunt trauma or fall or overuse injury that occurs from small repetitive injuries overtime.  Examples of overuse trauma include stress fractures, tendinitis, tennis elbow and swimmer’s shoulder.

Injuries can occur due to improper training, technique, equipment or predisposing medical conditions.

Simple steps can help your child to prevent sports injuries.

Always seek medical advice before your child participates in athletics.  Have your child receive a thorough sports physical.  Proper screening can identify health conditions that place your child at risk for injury.

Encourage your child to warm up properly before any physical activity, including practice, play and game-time.  This involves stretching muscles to release tension and help prevent injury.  Many children want to skip this important step.  Parents, coaches and team captains should model this behavior and lead a team together in this important step.

Cooling down is just as important as warming up.  Cooling down after an activity allows your child’s heart rate to gradually return to it’s resting level.   Compliance with cooling down can be increased if it done as a team after each practice and game.

Make sure your child and receiving proper instruction on technique from their coaches and trainers.  Most overuse injuries occur because of improper training or technique.

Make sure your child is wear proper fitting equipment, clothing and shoe gear for their activity.  Something as simple as ill-fitting equipment and shoes can cause injury.  Seek medical and professional advice if you have questions regarding your child’s equipment and shoe gear.

Encourage your child to listen to their bodies and to take a break when needed.  A child’s growing body needs time to rest and recover from rigorous physical activity.  If your child plays sports year round have them mix up activates and have periods of rest. 

If you child is complaining of an injury or pain don’t wait to seek medical advice.   “Toughing it out” or playing through pain can not only make an injury worse but mark the end of a sport season.  An injury evaluated and treated earlier can prevent serious complications and get your child back to his or her activity sooner. 

Here at the Orlando Foot and Ankle Clinic we are using the latest technology to treat sports injuries and enable athletes to return to the sports they love sooner.

Heel Pain: You Don't Have to Live With It
Written By: Dr. Childs

Your heel pain may have started days, weeks or even months ago. Maybe at first you felt a dull ache that went away. Now, you may have intense pain every day. Maybe it is worst with your first step in the morning, or it may get worse as they day goes on. In any case, heel pain can make walking or exercising unbearable, but you don’t have to live with it.
Causes
Heel pain is a common problem that affects people of all ages. There are many causes including injuries, excess weight, or the way your feet and legs move. If your heel moves too little or too much, it can cause other parts of your foot or leg to function incorrectly. Over time, this stress from poor foot function can lead to tearing of ligaments or tendons in the heel. For some people, daily use is enough to weaken these tissues. For others, a direct injury or sprain can cause the problem. In all cases, being overweight or walking barefoot can aggravate these problems.  Treatment goals are designed to reduce this abnormal pull on the ligaments and tendons.
Plantar Fasciitis
Plantar Fasciitis is the most common cause of heel pain. The plantar fascia is a ligament that runs from your heel bone to the ball of your foot.  Inflammation of this ligament is what causes the pain. The bottom of your heel may hurt when you stand. The pain usually lessens after you walk a few steps, but may return over time. Over time, prolonged inflammation may cause tearing, scar tissue formation, and even a heel spur.
Treatment of this condition is designed to reduce the inflammation, pain, and swelling of the ligament. Initially, you may be prescribed stretching and icing exercises, medications, or special inserts for your shoes. The right footwear is important as well. Going barefoot and wearing flip-flops are major causes of heel pain. Generally running or walking shoes with laces and a rigid arch are best. You should also get rid of any shoes that are heavily worn down as they are often more harm than good. As part of your treatment plan, your podiatrist may suggest certain types of footwear or arch supports that are best for your foot type.
Plantar Fasciitis usually responds to conservative care, and less that 5-10 percent of people that have heel pain ever need surgery.  In fact, if your heel pain has not gotten better, it may be because you don’t have the typical plantar fasciitis. Other causes of heel pain include Achilles tendon problems, stress fractures, chronic instability of the ankle, and even nerve problems such as nerve entrapment syndromes. Check with your podiatrist if the pain persists to make sure you don’t have one of these other problems.
Chronic Heel Pain
Chronic heel pain is pain that has not gone away over 6 months. Usually when someone has plantar fasciitis for a prolonged period of time, or has had an injury from trauma or overuse, they often develop scar tissue like changes to the plantar fascial ligament. Runners are especially prone to this. In these cases, the patient no longer has plantar fasciitis, but in fact really has plantar fasciosis. In cases of plantar fasciosis, there is no inflammation present, but rather degeneration of the ligament has occurred. This is the point where many people are forced with the decision to either live with the pain or have surgery. However, there is another minimally invasive option.
A New Treatment Option: TOPAZ
If you have suffered with heel pain and thought you were limited to either being stuck with the pain or having  painful surgery, you may have another option called TOPAZ.  TOPAZ is a quick, simple and minimally invasive medical technique available for the trearment of tendons and fascia. The TOPAZ microdebrider utilizes patented Coblation technology designed to specifically treat tendons and fascia. The TOPAZ MicroDebrider is the only radiofrequency device indicated for the debridement of soft tissue and has been performed in over 85,000 cases. The procedure is a single application and requires no incision. The technique has been associated with quick return to daily activities allowing for significant improvement in patient outcomes.Since obtaining original FDA clearance in 2002 and expanded indications for tendonotomy in 2005, TOPAZ has offered a minimally invasive alternative for thousands of patients for the treatment of tendons and fascia.
If you are interested in discussing your heel pain or want more information about the TOPAZ procedure, call Orlando Foot and Ankle Clinic at 407-423-1234.

Orlando Foot and Ankle Clinic is proud to announce that Dr. Shane was awarded Preceptor of the Year from Florida Hospital.Voted by the graduating residents, this award is presented to a private physician who allocates regular times to teach and encourage growth, challenging the residents' thinking process for best medical care, while at the same time role modeling sound practice management behavior.