Diabetes- do you do a daily foot check?

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It is important that Diabetic monitor their blood sugar levels regularly, maintain an active lifestyle and healthy diet, but also, that they take care of their foot health!

 

People who have diabetes have a much higher chance of developing Neuropathy and vascular conditions, which affect the sensation in the feet and the ability to heal any wounds, which may occur. As a result it is important for Diabetics to follow a few guidelines to take care of their feet.

 

  • Annual foot health checks with a podiatrist (this can often attract a medicare rebate if the patient has a team care plan from their GP)
  • Ensure you have a good fitting shoe which has a large toe box to prevent rubbing and natural fibre shoes and socks

 

DAILY FOOT CHECK

  • Take a look at the bottom of your feet every day. If you can’t reach your feet to see your feet, use a mirror to look at the bottom
  • Ensure you dry your feet thoroughly especially between the toes. If you can’t reach your feet, you can put a portion of towel on a ruler and wipe between the toes)
  • Apply daily moisturiser to the heels (not between the toes)

WHAT TO AVOID

  • HEAT- Avoid Electric blankets, hot water bottles or heaters…. you can burn your skin without realising it
  • COLD- Avoid extreme cold and try to keep your feet warm
  • PRESSURE- Pressure can cause calluses and redness that can develop into ulcers. Ensure your shoes fit well without causing pressure spots or rubbing

Your Feet and Pregnancy

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Pregnancy takes a big toll on our bodies and can be quite uncomfortable for many women. Whilst some women have no trouble with their feet at all, many have pain and discomfort. Generally the pain resolves shortly after the baby arrives, but in some cases, the changes are long term. Here are a few issues you may have with your feet and some IMG_0602_2ways to alleviate some of the discomfort:

Sore Heels/Arches: With the additional weight of your baby, fluid and the placenta, a lot of extra load is placed on the feet. This extra load, coupled with the relaxin hormone, released in pregnancy can result in the muscles and ligaments supporting the arch of the foot to stretch and reduce the arch height resulting in a flat foot. Flat feet or excessive pronation (rolling in) can result in foot, leg and hip pain

Treatment: To prevent pain, there are a number of things you can do

  1. Choose supportive footwear. This doesn’t mean you have to wear orthopaedic shoes, but wherever possible, forego the heels or ballet flats for a shoe that holds your heel firmly in place and supports the arch and foot.
  2. Massage your foot: Rolling your foot along a ball when you are sitting down or a specialised foot roller, can stimulate blood flow and drainage away from the feet and minimise discomfort
  3. Temporary arch supports/orthotics- if the pain is very bad, it may be necessary to wear an insert in your shoe during the pregnancy to help maintain the arch and minimise pain
  4. Visit your Podiatrist- 9 months is a long time to have sore feet….. if the pain is getting worse, a podiatrist can help to relieve the pain and get you moving during pregnancy
  5. Alter your exercise program to include more low impact or no impact exercise such as swimming

Shoe size changes: There are many reasons that a pregnant woman’s shoe size can increase- Swelling of the feet, the effects of relaxin, extra load- but it is important to ensure that you accommodate the larger foot to avoid painful skin changes (corns and calluses), ingrown toenails or toenail thickening.

Swelling: There are number of reasons that a pregnant woman’s feet may swell and these are best discussed with your obstetrician. They may suggest compression stockings and elevating the feet whenever possible.

Callous and Corns: For the reasons listed above (extra weight, swelling etc), the foot may fit differently into shoes and take more pressure during walking. As a result to protect underlying vessels and nerves, the body will create thicker skin in the areas at risk. This thickening of the skin may become painful and your podiatrist can remove this for you.

 

 

Theres something white between my toes!

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Warning…. Icky picture to follow!

On Monday I saw toe patients with something sore and white between their toes. Both patients thought that it was tine (a good assumption) and had been treating it accordingly with anti fungal treatments with no success. What they actually had was a ‘soft corn’ or Helloma Molle between their toes caused by pressure between their 4th and 5th toes (the little toe and the one next to it).

So, how do you tell the difference, and how do you treat it?

Helloma Molle or soft corns are most commonly found between the 4th and 5th toes. They are white, painful and feel solid and as if there is a thickening of skin in the area. They often look white and can have a slight yellow appearance. They are painful to press on.

Tina between the toes is generally itchy, moist, white and sometimes with a red appearance. There is often splits in the skin which can cause pain.

Tina picture courtesy of Laminal.com.au

Tinea picture courtesy of Laminal.com.au

How to treat:

Tinea: an anti fungal cream that you can purchase at the pharmacy should treat the infection within a week.

IMG_0558

Helloma Molle or soft corn

Helloma Molle: A visit to a podiatrist to remove the ‘soft corn’ is generally pain free and can be achieved in one visit. Your podiatrist should also advise you on footwear and ways to prevent the corn from recurring.

 

Chilblains

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Given today is the coldest day of the year so far, I thought it was a good time to talk about Chilblains.

Chilblains Richmond Podiatry

Photograph Courtesy of Wikipedia

Chilblains present on the feet as patches of red, inflamed lumps on the skin that are often itchy or painful. Whilst you can get one chilblain at a time, it is more common to see several appear at once. Chilblains are caused by frequent and repeated exposure to cold then heat. This is because the blood vessels in the feet constrict (get smaller) in the cold and when exposed to heat very quickly, a rush of blood to the vessels can result blood leaking into the surrounding tissue causing a chilblain.

Symptoms

  • Red, swollen patches on the skin (these can even be blue or white in appearance)
  • Itchy sensation at the sight of the patches
  • Burning sensation on the skin
  • Dry skin in the area
  • Blistering or ulceration in extreme cases

Treatment

  • Parafin Wax baths can encourage better circulation to the feet and assist in healing the chilblains and preventing further chilblains developing. At Richmond Podiatry we have found this to be a most effective treatment
  • Whilst there are no creams to heal the chilblain Corticosteroid cream can be effective in reducing the itch

Who is most at Risk?

Chilblains can affect the heathy general population, however are more common in children and the elderly.

Patients with existing Circulation problems such as Diabetes and Raynaud’s Syndrome and smokers are most at risk.

Patients with Diabetes who develop Chilblains should see their podiatrist for treatment to ensure the Chilblain does not become ulcerated.

Tips to Avoid Chilblains

  • Stay Warm
  • Warm up gradually- avoid hot water bottles, electric blankets and direct exposure to a heat source
  • Avoid smoking

What is the Best Sports Shoe?

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Podiatrists are often asked “what is the best sports shoe?”, a seemingly easy question to answer. Or is it?

Best Running Shoes Richmond PodiatryEvery shoe is different, just like every foot is different

People often ask what is the best shoe. What will be the best shoe for you, may be very different to what will be the best shoe for me. I have very ‘flat feet’, so need a shoe which will help to prevent excessive pronation (rolling in), whilst you may require support in other areas. But even that is not enough information. The fit of a shoe can make a huge difference to how well it works for the individual and the level of activity, type of surface you usually run/walk on.

No one Brand of Shoes is the Best for all People

A lot of people hear about a brand of shoe that is rated as the best shoes for runners for example and rush out to buy that brand of shoe. Whilst many Podiatrists (myself included) will favour certain brands of shoes because the company has a history of excellent research and development and generally makes good shoes, the brand alone is not enough. Depending on the points above- fit, purpose and the type of foot, one brand and model of shoe could be inappropriate to you, where another brand that hasn’t been talked about as much, may be better for your foot.

Sticking with the same model of Shoe for pair after pair of sports shoes could be a mistake.

It is easy to get stuck on a model of shoes and stick with it. It fits well, looks good and feels good to wear, but over the years, Footwear companies may change the design and last of a shoe, keeping the same name, just as car manufacturers do. As a result the Asiics Kayanos you bought 2 years ago that were perfect for you, may not be so perfect in the latest model.

So, which are the Best Shoes?

Your Podiatrist can give you an idea of the brands they prefer, but at the end of the day, your sports shoe should be fitted by a reputable sports footwear store who can assess your feet, and match a shoe to you. You may pay less buying shoes online, but you are missing out on getting the best shoe for you.

School Shoes- how to choose the right ones for your child’s growing feet

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It’s Back to School Time and for many parents, a time to buy new school shoes.

Here’s a few tips for making sure you buy the right shoes for your child:

  • Try to purchase Leather shoes if you can afford to- the natural fibre will allow the children feet to breathe and will wear much better than synthetic shoes. 100% Cotton socks are always a better option too
  • Look for a shoe which is firm around the heel and ‘cups’ the heel. Make sure that the heel is not slipping at the back
  • A Leather lace up is always a good idea, but if that is not possible (i.e.. your child can’t tie their laces or won’t tolerate such a fashion travesty- as in the case of my niece), look for a Velcro or Mary Jane Style alternative that still holds the child’s foot firmly in the shoe
  • The sole of the shoe should be relatively firm, but bend well at the toe
  • Choosing the size: Allow a thumb width between the end of the Child’s big toe and the end of the shoe
  • Choosing the Style: If your Child is a very active Child, it is a good idea to choose a Sports-like shoe or one with a sports style sole

Which Shoes did my son start Prep with last week? The Ascent Junior…. It looks like a normal school shoe, but has the sole of a sports shoe and is endorsed by the Australian Podiatry Council. It also comes in half sizes which was a big plus for us given my son is halfway between 2 sizes.

If unsure, feel free to email us for advise or come into the rooms at the Epworth in Richmond. Call 9421 4116 or Book online

Choosing School Shoes- Richmond Podiatrist