May
13
CDFE is a detailed, annual physical examination of your feet, combined with an educational and counseling session, performed on people with diabetes.
Why is it so important?
Nerve damage, poor circulation and trouble fighting infections, can make foot problems very serious for people with diabetes. The goal of the CDFE is to identify any changes in your feet, prevent problems and reduce the risk of amputations.
How Diabetes Can Affect the Feet
- Diabetic neuropathy. Because of the abnormal increase of blood sugar, nerves that supply sensation to the feet can be damaged. This decreases the feeling of pain in the feet.
- Diabetic vasculopathy. Diabetes can affect the blood vessels of the feet, causing them to narrow, and reduce blood flow to the feet.
- Structural changes. If the foot receives less nutrients and oxygen, the bones and joints will weaken, causing the foot to flatten or toes to curl, creating new pressure areas that could cause the skin to break down.
Why Should You Be Concerned?
Patients with diabetes are more likely than others to have problems with their feet. The American Diabetes Association reports that the amputation rate is 10 times higher in persons with diabetes, but these rates can be decreased 45-85% with a comprehensive foot care program.
To all our patients:
- Did you know that foot problems are a leading cause of infection in a diabetic?
- 20% of all diabetics admitted to the hospital, are admitted for foot infections
The American Diabetes Association’s “2010 Standards of Medical Care in Diabetes” statement on diabetic foot care “requires” an annual comprehensive diabetic foot examination to assess all lower extremity risk factors. To provide you with the best possible diabetic foot care, we are instituting these recommendations into our practice, effective immediately.
We are advising all of our patients with diabetes to schedule a Comprehensive Diabetic Foot Exam (CDFE), so that we can perform the necessary non-invasive testing examination to meet these requirements. (This exam should only take about 15-20 minutes)
This exam will not include the treatment of corns, calluses or nails.
Please remember to bring with you a list of all prescription medications that you are taking, and any shoes/insoles that have been provided through the Medicare Therapeutic Shoe Program. If you are not part of this program, please bring in shoes that you would typically wear.
You should of course continue to be monitored by your primary care physician, as your condition warrants, and as always, we will coordinate your foot care with your regular physician.
Thank you…
Jerold Fleishman, D.P.M • Timothy Downs, D.P.M. • Edward Carver, D.P.M. • Caroline Gauthier, D.P.M.
Apr
9
Footprints - Women’s Common Foot Problems
Filed Under Foot Health
Bunions are enlargements of the joint at the base of the big toe—the metatarsophalangeal (MTP) joint—that form when the bone or tissue at the big toe joint moves out of place. Bunions are a symptom of our foot’s development due to the way we walk, our inherited foot type, our shoes, or for other reasons. Although bunions tend to run in families, it is the foot type that is passed down—not the bunion. Since the MTP joint
carries much of the body’s weight while walking, bunions can cause extreme pain if left untreated. Podiatric medical attention should be sought at the first indication of pain or discomfort.
Stress fractures are tiny or incomplete cracks in a bone often caused by overuse. Stress fractures occur most frequently in the foot and ankle and can be caused by a number of factors. An unusual increase in activity causing strain in the foot (fatigue fracture) is one of the most common causes, while weak bones (insufficiency fractures), are caused by medical conditions such as osteoporosis, can also be a factor. Medications such as steroids can lead to stress fractures, as can a sudden increase in activity levels. All of these causes can and should be evaluated by your podiatrist when you notice pain or swelling, which are the
symptoms of a stress fracture.
A neuroma, also referred to as a “pinched nerve,” is a painful condition involving irritation and/or thickening of the nerve tissue between the toes,most commonly the 3rd and 4th toes. The condition brings on pain, a burning sensation, tingling, or numbness between the toes and in the ball of the foot. Your podiatrist can offer a number of treatment options for a neuroma.
Ingrown nails are a common ailment seen by podiatric physicians. An ingrown nail is one whose corners or sides dig painfully into the soft tissue of the toe, often leading to irritation, redness, and swelling. Usually,
toenails grow out straight, but sometimes one or both corners or the sides will curve and grow into the flesh. The big toe is the most common site for this condition, but other toes can also become affected.
Ingrown toenails may be caused by any one or more of the following: improperly trimmed nails, shoes that are too tight, trauma, and activities with repeated pressure on the toe (such as running or kicking). There are other causes as well, but this painful condition can usually be eased with one or two visits to your podiatrist’s office.
Women may also have a tendency to develop blisters, corns, calluses, and heel pain. All of these conditions can be treated by your podiatrist, and a number of treatment options are available. Once we all realize that our feet don’t have to hurt, life will be that much more enjoyable, ladies.
New Technology in Foot Care
Podiatric medicine and surgery are changing rapidly, as is all of medicine. Doctors of podiatric medicine now use the latest technology both in their offices and in the hospitals to diagnose and treat foot and ankle problems. These technologies are changing the face of medicine, and your doctor can provide you with more information.
Ultrasound for diagnostics – While x-ray is still in use in most podiatric medical offices, ultrasound is another diagnostic technique available to your podiatrist. This non-invasive technology allows better visualization of soft tissue structures such as tendons and even allows evaluation of joints in motion.
Orthotic scanning – In the old days, your doctor may have taken a plaster cast mold of your feet to fashion orthotics specifically for you. While this is still done successfully in some offices, new technology allows your podiatrist to scan your foot with an electronic device that captures the necessary data to construct your custom foot orthotics. The electronic scan is then evaluated by the podiatrist and sent to an orthotics lab for
processing. In just a few weeks, you’ve got a new pair of custom foot orthotics, molded and designed specifically to correct your particular condition.
ESWT – Non-invasive procedures like ESWT (Extracorporeal Shock Wave Therapy) are now available in the office or surgical center of your podiatric physician. Used to treat heel pain unresponsive to standard treatment options, ESWT can be used in several ways, and is usually administered with anesthesia. ESWT may be a treatment option to consider prior to proceeding with open surgery for chronic heel pain. ESWT has few complications that can be considered minor compared to those of open heel surgery. Ask your DPM for more information.
Surgical Implants – Knee and hip replacements are now common in medicine for the treatment and care of arthritic and painful joints. Many people are unaware, however, that there are joint “replacements” for the foot and ankle. For patients with arthritis and those with joint damage secondary to trauma, both high-grade plastic and metallic implants are being used to replace, joints in the foot and ankle. If you are dealing with the daily pain of an arthritic joint, ask your podiatrist about these implants. What’s next? Fungal toenails are very common and podiatrists treat this condition with an arsenal of weapons. However, currently under consideration by the FDA is a laser treatment that will resolve the fungus. Ask your podiatrist for more information on this promising new treatment.
Stretching before exercising is one way to make sure you are warmed up and ready to go.
• Consider purchasing new shoes for your new level of activity. It’s important to have your feet measured, and then choose an athletic shoe that fits your sport. Make sure to break in any new gear appropriately, and ask your podiatric physician for recommendations for your particular needs.
• Take care of your feet. Examine them daily for signs of blisters, corns, and ingrown nails. Take a few days off your new activity if you see signs of any of these problems.
• Visit your podiatrist periodically to discuss your foot and ankle concerns or just for a check-up before starting a new routine.
•Watch your sun exposure. As the weather improves and our feet are more exposed, it’s important to remember sun-screen. The tops of feet are one of the most commonly sunburned areas.
• Seek immediate care for any foot or ankle problems. Spring is a great time of year for renewal, but don’t let your over-eagerness get the best of you. Take the time to enjoy and take care of those two very important assets—your feet.
With spring on the horizon, we are all looking forward to warming up our bodies for increased activity levels. To make sure that your feet are fit for spring, we offer the following suggestions.
• When starting a new exercise routine, or when ramping up your current one, make sure to ease into that new routine.
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Click here to learn about New England Foot & Ankle of Chelmford, Newburyport
Jan
21
Friendly Footwear a Must for Those Who Work Standing Up
Work Footwear Products Recognized by the American Podiatric Medical Association
October 7, 2009
Bethesda, MD – The average American’s foot pain often gets in the way of daily activities. Perhaps no group suffers from chronic foot pain more than those who are constantly on their feet. According to the American Podiatric Medical Association’s (APMA) 2009 foot ailments survey , 44 percent of respondents said they spend at least four hours standing every day. Additionally, nearly 78 percent of Americans have experienced foot problems as a result of wearing uncomfortable or ill-fitting shoes.
"The excess strain put on the legs and feet of those standing for long periods of time can take a massive toll on the body—especially for those working in the health care community," said APMA President Ronald Jensen, DPM. "Without the proper footwear that provides necessary support to the ligaments and joints of the feet, these individuals are subject to a host of ailments that can lead to chronic problems such as metatarsalgia—a pain and inflammation in the ball of the foot.”
Excessive standing and walking on hard surfaces like concrete can also increase the incidence of foot problems. However, many footwear companies create products that are specifically made for those who “work standing up.” The following footwear products, designed specifically for those who make a living on their feet, have been granted APMA’s Seal of Acceptance. The Seal of Acceptance Program recognizes products which have been found beneficial to foot health and of significant value when used in a consistently applied program of daily foot care and regular professional treatment:
Crocs Work Shoes. The familiar, comfortable feel of Crocs is also available in a professional-looking shoe that conforms to workplace standards. Featuring a closed toe and heel design, as well as arch support and a foot bed that promotes circulation, the Crocs Work Shoe is a top choice for many health and service industry professionals across the country.
Dansko’s Acadia and Stapled Collections . Dansko’s new Acadia collection (pictured) features distressed leather uppers, a removable triple density molded EVA insole and slip resistant out-sole. With a lightweight base and lower profile, this collection is perfect for the active woman. Additionally, the company’s Stapled Collection features a rigid construction and key features that promote good foot health, including a rocker bottom and full arch support.
The Timberland Company - Timberland PRO. Timberland’s PRO Renova series of work footwear—which includes the Professional, Provider, and Caregiver (pictured)—is designed specifically for those at work in the health care community. The Professional Series features Timberland PRO Anti-Fatigue technology, a rocker profile, and an anatomically shaped oblique last for all-day comfort.
For a complete listing of work footwear products that have been awarded the APMA Seal, visit www.apma.org /workfootwear. For more foot health information, visit www.apma.org.
Founded in 1912, the American Podiatric Medical Association (APMA) is the nation’s leading and recognized professional organization for doctors of podiatric medicine (DPMs). DPMs are podiatric physicians and surgeons, also known as podiatrists, qualified by their education, training and experience to diagnose and treat conditions affecting the foot, ankle and structures of the leg. The medical education and training of a DPM includes four years of undergraduate education, four years of graduate education at an accredited podiatric medical college and two or three years of hospital residency training. APMA has 53 state component locations across the United States and its territories, with a membership of close to 12,000 podiatrists. All practicing APMA members are licensed by the state in which they practice podiatric medicine. For more information, visit www.apma.org.
