Total Care Podiatry

The power of the pump is like no other. It has the ability to instantly change a woman’s mood and give her a confidence that exudes sexiness from every pore. Even men love a well-heeled woman. Stilettos just make an outfit look sexy.

The right shoe can even reshape your body from head to toe. Heels lengthen your figure and make you look slimmer. Wearing high heels changes the way you stand because they throw your weight forward onto your toes, causing your back to arch slightly and creating an instant butt lift (hence the reason why men love stilettos).
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Steps to Healthy Summer Feet

If you’re like most people, you take 8,000 to 10,000 steps a day. Here are some tips on how to keep your feet in good shape, especially during the warmer months:

1. Sunny days and warm nights may encourage wearing flip-flops, but it’s a good idea to get the kind made of high-quality, soft leather to minimize the potential for blisters. Make sure your foot doesn’t hang over the edge, and beware of irritation where the toe thong fits. It can lead to blisters and infections. Don’t wear flip-flops to play sports, do yard work or walk long distances.

2. Keep your feet healthy with a waterproof, oil-free sunscreen every time you wear sandals outdoors.

3. Dr. Kathleen Stone, president of the American Podiatric Medical Association, said, “Pampering and grooming your feet promotes good foot hygiene and should be done frequently to contribute not only to your foot health in warmer weather but also to your body’s overall health.” Try soaking your feet for at least five minutes in a bucket of cool water.

4. Use a foot file or pumice stone to gently smooth the skin around the heel and the balls and sides of your feet.

5. Gently push back cuticles with a cuticle pusher or manicure stick. Cuticles provide a protective barrier against infection and should never be cut.

6. To prevent fungal infections, and viruses that cause warts, wash your feet daily with soap and water, drying carefully, especially between the toes.

7. Change your shoes regularly.

8. Avoid walking barefoot, particularly in public showers and locker rooms. Bare feet are exposed to plantar warts and athlete’s foot.

9. To prevent hot, sweaty feet and foot odor, rub cornstarch or roll-on antiperspirant directly on the soles of your feet.

10. Use a nail clipper to cut toenails straight across. Then, use an emery board to smooth the nail edges by filing in one direction without drastically rounding the edges. When toenail edges are rounded, it increases the chances for painful ingrown toenails.

11. Consult a podiatrist if you have any foot pain or other problems affecting your feet. Podiatrists, Dr. Stone said, are uniquely qualified to diagnose and treat conditions of the foot and ankle.

A new study led by York University researchers finds that young athletes with Type 1 diabetes may experience a marked decrease in performance as a result of their blood sugar levels.

The study, published in the International Journal of Pediatrics, reports that participants’ athletic prowess was sapped by low blood glucose, a condition known as hypoglycemia. Their cognitive abilities also declined as a result.

“Physical activity itself is unfortunately one of the factors that can cause this dip in blood sugar to occur,” says lead researcher Michael Riddell, associate professor in York’s School of Kinesiology & Health Science, Faculty of Health.

“Parents tend to get quite concerned about this, understandably so,” says Riddell, who was diagnosed with the disease at age 14 and regularly engages in competitive sports. “They wonder, ‘should I have my child enrolled in sports at all? Is vigorous activity safe?’ Our results show that those with diabetes can compete on equal ground, provided they learn to manage their condition.”

The study is the first to examine these interactions in a real-life setting. Researchers outfitted participants with 24-7 glucose monitors during a week-long diabetes sports camp at York University, testing their skills in tennis, basketball or soccer at various times during the day and recording blood sugar levels. Participants, who ranged in age from 6 to 17, were even monitored as they slept using this new technology. Data for the study was recorded during last summer’s camp; it will run again this year starting July 19.

Researchers found that sport skill performance was highest when blood glucose values were in a “normal” glycemic range. During hyperglycemia – or elevated blood sugar – results were only slightly reduced. This occurred nearly universally across all participants, however results suggest the degree to which one’s sport performance deteriorates depends on the individual.

“Some subjects showed only minor reductions in performance with hypoglycemia while others showed much greater impairment,” Riddell says. “This could be related to the level of blood glucose concentration, the rate at which glucose drops, and the individual’s capacity to maintain focus in the face of all these factors.”

Regular exercise is known to be beneficial for people with diabetes, but can make glycemic control challenging. This balance is even more difficult to achieve in adolescents, as insulin requirements are influenced by fluctuating nutritional intake, physical activity levels, and the rhythms of other anti-insulin hormones. Adding to the confusion is that the symptoms of low or high blood glucose are often masked by exercise, because they’re so similar: increased heart rate, sweating, shakiness, fatigue and dehydration.

“Any obvious issues with performance – poor passing, failed free throws and serves – that are really out of the ordinary should be a warning sign to check blood glucose levels and add carbohydrates,” Riddell says. The best way to boost blood sugar levels is to consume about 15-30 grams of a fast-acting carbohydrate, such as dextrose tablets, juice or a sports drink. “These are rapidly absorbed and immediately replenish the very small reserve of glucose normally found in the blood stream,” he says.

Incidents of moderate to severe hypoglycemia were common on the evenings following sports camp participation. However, researchers found no evidence that a bout of nocturnal hypoglycemia influences sport skill performance the following day. Cognitive testing also showed that participants’ reading ability was lower during episodes of hypoglycemia, as was the ability to distinguish and name colours.

Riddell notes the importance of conducting this type of field research, as opposed to lab-based studies. “Actually playing a sport involves different cognitive processing, reaction time and motor skill performance,” he says.

The paper:
“Blood glucose levels and performance in a sports camp for adolescents with type 1 diabetes mellitus: A field study” is co-authored by Dylan Kelly, a McMaster University undergraduate student under Riddell’s supervision, and Dr. Jill Hamilton, pediatric endocrinologist, The Hospital for Sick Children, University of Toronto.

The research was supported by the Natural Sciences and Engineering Research Council of Canada (NSERC), Medtronic Canada and Can-Am Care.

Source:
Melissa Hughes
York University

Article Date: 16 Jul 2010 – 0:00 PD

The alarming increase of morbidly obese diabetics is causing more new cases of a debilitating foot deformity called Charcot foot.

Charcot foot can make walking difficult or impossible, and in severe cases can require amputation.

But a surgical technique that secures foot bones with an external frame has enabled more than 90 percent of patients to walk normally again, according to Loyola University Health System foot and ankle surgeon Dr. Michael Pinzur. Pinzur, one of the nation’s leading surgeons who treat Charcot foot, describes the device in the journal Hospital Practice.

The device, called a circular external fixator, is a rigid frame made of stainless steel and aircraft-grade aluminum. It contains three rings that surround the foot and lower calf. The rings have stainless-steel pins that extend to the foot and secure the bones after surgery.

The fixator “has been demonstrated to achieve a high potential for enhanced clinical outcomes with a minimal risk for treatment-associated morbidity,” Pinzer wrote. Pinzur treats about 75 Charcot patients per year with external fixators. Most of these patients are diabetics.

Charcot foot can occur in a diabetic who has neuropathy (nerve damage) in the foot that impairs the ability to feel pain. Charot foot typically occurs following a minor injury, such as a sprain or stress fracture. Because the patient doesn’t feel the injury, he or she continues to walk, making the injury worse. Bones fracture, joints collapse and the foot becomes deformed. The patient walks on the side of the foot and develops pressure sores. Bones can become infected.

The obesity epidemic is increasing the incidence of Charcot foot in two ways. The excess weight increases the risk of diabetic neuropathy, as well as the risk that patients with diabetic neuropathy will develop Charcot foot.

There has been an alarming increase in morbid obesity among diabetics. About 62 percent of U.S. adults with Type 2 diabetes now are obese, and 21 percent are morbidly obese, according to a 2009 study by Loyola kidney specialist Dr. Holly Kramer and colleagues published in the Journal of Diabetes and its Complications.

Morbid obesity is defined as having a body mass index (BMI) greater than 40. For example, a person who is 5-foot, 10-inches tall and has a BMI of 40 weighs 278 pounds.

Traditional surgical techniques, in which bones are held in place by internal plates and screws, don’t work with a subset of obese Charcot patients. Their bones, already weakened by complications of Charcot foot, could collapse under the patient’s heavy weight.

A common treatment in such cases is to put the patient in a cast. But bones can heal in deformed positions. And, it is difficult or impossible for obese patients to walk on one leg when the other leg is in a cast. Patients typically have to use wheelchairs and are confined to the first story of the house for as long as nine months. And after the cast comes off, they must wear a cumbersome leg brace.

By contrast, patients who are treated with an external fixator often are able to walk or at least bear some weight on the treated leg. The device is attached to the leg for only two or three months.

A 2007 study by Pinzer, published in Foot & Ankle International, demonstrated the benefits of the external fixator. Pinzur followed 26 obese, diabetic Charcot foot patients who had an average body mass index of 38.3. After surgery to correct the deformity, the foot bones were held in place by the external fixator. A year or more later, 24 of the 26 patients (92 percent) had no ulcers or bone infections and were able to walk without braces, wearing commercially available shoes designed for diabetics.

Pinzur is a professor in the Department of Orthopaedic Surgery and Rehabilitation at Loyola University Chicago Stritch School of Medicine.

Source:
Jim Ritter
Loyola University Health System

If you habitually wear high heels during the week, you may have found that switching to flats for the weekend results in calf and heel pain. Researchers have found that wearing high heels can cause changes to occur in the length of the calf muscle fibers and the Achilles’ tendons that increases the risk of stiffness and pain.

Professor Marco Narici of the Manchester Metropolitan University recruited a group of 11 heel wearing volunteers (two inches or higher for five days a week or an average of 60 hours a week) and 9 non-heel wearers to study their feet and legs with MRI and ultrasound. The women ranged in age from 20 to 50 years old, with an average age of 43.

While the MRI did not reveal any difference in the size of the calf muscles between the two groups, an ultrasound found the length of the muscle fibers to be 13% shorter in those who regularly wore high heeled shoes. The women who wore high heels also had 22% thicker Achilles’ tendons, which attaches the calf muscle to the heel.

Wearing heels cause the foot to point down more than normal. Changing this angle, such as when women switch to flats, causes the calf muscles and tendons to lengthen, increasing tension, reducing the ankle’s active range of motion, and causing discomfort and pain. Shorter tendons and muscle fibers also impacts a woman’s ability to walk fast and run and may increase risk of injury.

Brendon Brown, president of the Australasian Podiatry Council, suggests that women who consistently wear high heels should give themselves a break. “Don’t wear high heels to and from the train station, for example. Strap into a lower pair of heels,” he says.

Also, high-heel wearing women should also perform stretching exercises to prevent the fascicle fibers and Achilles’ fibers from shortening. Dr. Carol Ewing Garber, PhD and exercise physiologist at Columbia University, suggests the following:

• While sitting, loop a resistance band around the top of your foot (a belt or towel works too). Gently pull back on the band while pushing against it with your toes.
• Stand on a step, facing up. Keep your toes on the step and slowly lower your heels until you feel your calf muscles stretching.
• Slowly make a circle with your toes, alternately flexing and pointing your foot.
• Try to pick things up with your toes. (This will help strengthen your feet.)

Courtsey of Geelong Advertiser -  Nick Wade

June 30th, 2010

GEELONG forward Tom Hawkins has been reassured his imminent return from a delicate foot injury poses little long-term threat to his career.

Hawkins last week made the call to take a punt and play on this season, ending weeks of speculation about when, or if, he would return this year.

The 21-year-old yesterday revealed he had just started kicking again on his troublesome right foot for the first time since discovering the hot spot a month ago.

Hawkins has not yet set a comeback date, but Cats coach Mark Thompson yesterday declared the youngster in line to return as early as next week.

The emerging forward maintained he was “not too worried” about any threat of further or long-term damage, after a series of meetings with Geelong’s medical staff who placed all future ramifications on the table.

Even if he is to suffer a relapse of the injury upon his return, Hawkins said he has been assured it would not be career threatening.

Hawkins said the acid test for his recovering foot was how it responded to an increased training workload over the coming days.

“It’s not too far away, I don’t quite know yet how far away it will be, but I’m just monitoring it and seeing how it responds to running on the track,” Hawkins said.

“Hopefully I get out there soon, but I haven’t yet put a deadline on when I’ll come back.”

Once the problem was isolated, Hawkins was given the power to make the final call based on the best available information the club could provide.

He said he no longer feels pain in his foot and will build his running and training over the next week in an attempt to return as soon as possible.

“It’s been a pretty well-judged decision in the end (to play on this season) and obviously we’ve got great people at the club giving me all the options,” he said.

“It’s not like it’s this great big risk or if something happens I’ll never play again, it’s a pretty well-educated decision, so I think we’ve done the right thing so far.

“(The injury) can happen to anyone, the foot’s healing well, I’ve been pretty happy with how it’s gone.”

“It’s now just a matter of getting out there and seeing how it responds to training, so hopefully I’m not too far away.”

Hawkins admitted his latest foot injury had been a frustrating hurdle to overcome, given he was just starting to assert his influence on matches through a rotating ruck role.

But he remains upbeat, despite suffering a similar injury two years ago that short-circuited his second year of AFL football.

“But that’s what happens in footy, you can get struck down pretty quickly,” he said.

“I’m not too worried about it really, I’m pretty happy.”