Understanding and Managing Foot Pain in Diabetic Patients

Written by Erica Halpern on March 23, 2023

Diabetes is a serious illness that affects people from all over the world. Type 1 or type 2 diabetes can lead to several complications, like heart disease, kidney problems, vision issues, oral health deterioration, and more. But one of the most common problems diabetes patients face is diabetic foot pain and other foot problems that can transform into serious complications when left unchecked.

Today’s blog will discuss the following:

The causes of diabetic foot pain
Diabetes-related foot complications
Diabetic foot pain treatment at a foot clinic
Self-care tips and at-home diabetic foot care

Person manages diabetes — Photo by Artem Podrez from Pexels

What Causes Diabetic Foot Pain?

The main culprit behind type 1 and type 2 diabetes-related foot pain is diabetic neuropathy. Diabetes patients struggle with four types of neuropathy, all of which cause nerve damage:

Peripheral Neuropathy: This is the most relevant categorization of neuropathy when discussing foot pain causes. It affects the lower extremities (feet and legs), arms and hands. It occurs when high blood sugar and triglyceride levels damage the nerves and tiny blood vessels in the circulatory system, causing poor blood flow. Symptoms include shooting foot pain, “pins and needles,” numbness, weakness and burning sensations.
Autonomic Neuropathy: This is similar to peripheral, except the nerve damage affects the body’s organs rather than the limbs.
Proximal Neuropathy: A rare type of nerve damage that causes severe hip, buttock, or thigh pain.
Focal Neuropathies: Rare singular/local (hence “focal”) nerve damage, typically in the hand, head, torso, or leg.

Diabetes-Related Foot Complications

Whether it’s numbness or pain, it is extremely important to pay attention to the warning signs your feet give when you have diabetes.

Moreover, your feet often fail to signal problems to your brain due to neuropathy. This means you also need to consistently inspect your feet and visit a foot specialist for an extra set of eyes and expertise (more on that later!)

If you don’t, debilitating complications with varying degrees of pain and discomfort may creep up. These include:

Skin changes like dry skin and cracked heels. This occurs due to nerve damage preventing your body’s natural oil and moisture production.
If you cannot feel cold, heat and other sensations on your feet, you may be unaware of a foot injury. This can lead to a worsening injury or infection if the skin is broken and you haven’t noticed.
Calluses are common in people with diabetes, and the more they thicken, the more likely they are to become an ulcer (open sores or lesions that will not heal).
Peripheral artery disease (plaque buildup in the arteries) can arise in diabetic patients. Like neuropathy, it reduces blood flow, so you don’t notice ulcers, infections and injuries. Aggressive infections and ulcers without treatment can lead to gangrene or amputations.
Edema (swelling): This is caused by nerve damage and the subsequent fluid buildup in the body’s lower extremities. Swelling can cause pain and mobility problems.

Diabetic Foot Pain Treatment at a Foot Clinic

Since diabetes impacts our feet, patients should find a chiropodist and schedule regular appointments. The general recommendation is no less than once yearly but more frequently if nerve damage is present.

Not only can foot specialists help with pain management, but consistent foot inspections are critical for spotting the beginning stages of a complication.

Some of the main ways chiropodists help with diabetic foot pain include:

Skin health assessments and maintenance
Foot assessments
Custom orthotics
Footwear recommendations

Skin Health Assessments and Maintenance

This is one of the most important jobs a chiropodist will do. They can notice signs of ulcer development, infections and other skin abnormalities. Chiropodists also perform regular diabetic foot care on diabetes patients, so they don’t develop ingrown toenails or fungal infections.

Foot Assessments

Your chiropodist will check your vascular (circulation) health via regular inspections. They will also check your foot temperature, look for swelling, and check the colour of your feet. They can also ask what type of foot sensations you’re feeling, like tingling, shooting pain or burning and proceed from there. This is included with Feet First Clinic’s diabetic foot care services.

Custom Orthotics

Orthotics make walking much easier, as they distribute body weight evenly across the foot while reducing pressure and friction and relieving the foot’s pressure points. They also help regulate your motion and correct any abnormal gait patterns you develop while struggling with foot pain. Chiropodists can provide orthotics via a thorough a biomechanical assessment.

Footwear Recommendations

Footwear modifications can help reduce diabetic foot pain, and the special shapes and designs of orthpaedic footwear can accommodate neuropathy symptoms more successfully than standard footwear. Diabetic patients often need deep shoes to support orthotics and to manage the discomfort and pain they experience when dealing with swelling. Diabetes patients also need footwear with little to no seams in order to reduce pressure points and friction against the foot. Companies such as APEX and Anodyne make shoes especially for diabetes patients.

Self-Care Tips and At-Home Diabetic Foot Care

Orthopedic slippers can help manage foot pain and allow you to move around your home more freely.
Soak your feet in a warm foot bath to ease stress and soothe aches and pains.
Try your best to regulate blood sugar levels to help fight nerve damage.
Inspect your feet and keep them clean. Note: do not try to get rid of calluses and other skin abnormalities on your own. Schedule an appointment with your chiropodist if you notice callus buildup or skin problems.
Keep on top of diabetes routines not directly related to your feet. This includes proper medication management and regularly checking your blood pressure at the local pharmacy and doctor’s office.
Light exercises and stretches can be beneficial for diabetic foot pain. For example, rolling your feet on a ball (or water bottle) or scrunching your toes to pick up a towel can strengthen your feet. And those are just two examples! Most foot stretches are easy to perform and relieve pain in different ways. Low-impact activities like swimming and walking can also be beneficial.

Come to Feet First Clinic for Diabetes Assistance

You shouldn’t have to manage a condition like diabetes on your own. And at our downtown Toronto foot clinic, you don’t have to!

Contact our office to book an appointment! Simply fill out the online booking form, or call us at 416-769-3338!

About Author: Erica Halpern

Erica is the operations manager at Feet First Clinic. Since 2021, she has been writing, researching and editing website and social media content. She also oversees Feet First Clinic’s daily and strategic operations to ensure the best possible experience for our clients. Her goal is to ensure patients are equipped with the knowledge and solutions they need to help with their pain.

Learn more about Erica Halpern

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February 7, 2020

At-Home Diabetic Foot Care

What is Diabetes? Diabetes is a chronic disease that occurs when the body is unable to either sufficiently produce or properly use insulin. Insulin is a hormone secreted by the pancreas to help cells absorb sugar from the bloodstream and use it as an energy source. When insulin is not adequately produced or properly used, it can result in elevated levels of blood sugar, called hyperglycemia. Hyperglycemia can cause deterioration of the body’s blood vessels, nerves and organs, most commonly the kidneys, eyes, and heart. Elevated blood sugars can leave a person more susceptible to slow healing wounds and infection, most commonly seen in the feet. Type 1 diabetes is an autoimmune disease where the insulin producing cells of the pancreas are attacked, resulting in an insulin dependent body. It is also known as juvenile diabetes and is usually diagnosed in persons under 40, most commonly children. People that are diagnosed with Type 1 diabetes require an external source of insulin daily. Type 2 diabetes is an acquired disease where the body does not produce enough insulin or does not properly use the insulin produced. It is most diagnosed in persons who are overweight or inactive physically, in individuals over 40 years old, but is now seen more in children and those under 40. Type 2 diabetes can either be insulin or non insulin dependent based on the severity and chronicity of disease. As of 2008-09, 2.4 million Canadians were living with diabetes. It is estimated that 90-95% of Canadians diagnosed with diabetes have Type 2 diabetes and 5-10% have Type 1. How Does Diabetes Develop? Healthy Diabetes Diet Diabetes development can be multi-factorial. There are many risk factors of type 2 diabetes, including inactive lifestyle, poor diet, family history, smoking, advanced age, or certain ethnicity. Risk factors of Type 1 diabetes are currently not well understood, though there may be a genetic disposition or an environmental trigger that may initiate the autoimmune response. Diabetes is normally diagnosed as either Type 1, or Type 2 and you cannot have both types of diabetes concurrently. Hyperglycemia can be gradually increasing before onset of diabetes, and symptoms may go undetected. Diagnosis is usually made with a plasma glucose test. Hyperglycemic symptoms include; frequent urination, increased thirst, unexplained weight loss. Other symptoms can include blurred vision, fatigue, and nausea. Since these symptoms can be associated with other disorders or disease, diagnosis of diabetes may be delayed. It is best to control modifiable risk factors that may lead to diabetes: staying physically active, eating a healthy diet and eliminating smoking. Why is Taking Care of my Feet Important? At-home Diabetic Foot Care Since diabetes can affect the blood vessels and nerves, the feet, situated the furthest from our nerve and vessel centre, are commonly affected in persons with long standing diabetes. As other diabetes related complications can arise, the feet can become more affected and more difficult to manage. Complications include deteriorating eyesight, and decreased flexibility. Decreased nerve function can reduce sensation in the feet, meaning small cuts and callus that may normally cause pain in a person without diabetes will go undetected. It is important to look at the feet regularly and immediately treat any developing callus or dryness to avoid foot wounds. Decreased healing ability means infection may be a cause for concern in persons with diabetes. The feet generally see more sharp instruments than other areas including nail clippers, and files or blades to remove callus and corns and therefore are at higher risk for small cuts. Taking care of feet in persons with diabetes are very simple and should become habit. The skin should be kept hydrated and elastic with use of cream and water consumption. All nails should be trimmed and filed to avoid any sharp corners. Avoid applying devices or items that are too hot or too cold directly to the skin. Inspect the feet daily. If the feet are difficult to see, a mirror can be used. A friend or family member is the most helpful. The person should be looking for any of the following: increased redness, swelling, blood, foreign objects, callus, corns, dry skin, or deformity (bunion, hammertoe). If any signs are seen, visit a physician or book an appointment with one of our foot specialists. A foot specialist is recommended for regular assessments every 6 months. If there are any concerns with the feet, regular foot care every month or 2 may be indicated. Who Needs to Worry About Diabetes? As of 2008, over 200 000 Canadians are diagnosed with diabetes every year. The increasing age of baby boomers and increased life span are contributing factors to the increase in diabetes diagnoses. The people most likely to be affected by diabetes are those in certain ethnic groups (first nations, African, Caribbean, south Asian and Hispanic), age groups (over 40), and higher weight groups. In 2017, approximately 2.3 million Canadians (7.3% aged 12 and over) have been diagnosed with diabetes. What Problems does Diabetes Cause for my Feet? Diabetes can affect the feet in so many different ways: the skin becomes drier, the muscles start to change where foot deformities can develop, and the nerves are affected where sensation is reduced. Detection of problems can become difficult and due to decreased healing time and increased rates of infection; problems can progress rapidly. Serious cases include undetected wounds, subsequent infection and possible amputation. Undetected wounds can paint a picture of uncontrolled diabetes, where multiple vital systems can be affected (kidneys, vessels, nervous) At every age group, mortality rates are two times those in persons with diabetes than those without. So, What Products Can I Use? For persons with diabetes, it is important to avoid products with acid as an ingredient. Creams with mild acid solution can irritate the skin and cause small wounds. Sharp objects such as nail clippers and foot files may be used in persons with controlled diabetes and with prior instruction from a professional. Feel free to use a daily cream and emollient to hydrate the skin. Be careful using product between the toes, as that area can accumulate too much moisture which can breakdown the skin. Foot soaks can dehydrate the skin, please consult with your doctor or foot specialist before engaging in foot soaks. Persons with diabetes may require shoes that are healthier for their sensitive feet. Shoes with soft foot beds that can reduce friction and increase shock absorption are ideal. Avoid shoes that have rigid seams or stiff out-soles. When wearing shoes, keep an eye out for any red marks on the skin, these are ones to discard or avoid as they can one day leave a wound or laceration. Will it Get Worse? Persons with diabetes may feel their feet are too hot or too cold and try to use hot or cold packs to alleviate the discomfort. Due to decreased sensation, these hot/cold packs can cause hot or cold burns on the skin. Be sure to protect the skin with a towel prior to using these types of warming/cooling packs, and test first on the hands as sensation is usually not as diminished in the hands. Never use hot water or hot packs – make sure the temperature is lukewarm. If you have dry skin, make sure to moisturize; do not use harmful files or electric devices to remove callus or dry skin. Contact your chiropodist as you may be prescribed a cream. Inspect the feet daily, checking for cuts, callus or redness and swelling. Where Can I Get Help? Who Can I Ask? A licensed chiropodist is trained to treat feet, especially in those with diabetes. They can prescribe special creams, and carefully and safely reduce nail problems and callus. They can help reduce pressures by recommending orthopedic shoes or prescribing custom made orthotics. They can improve mobility by offering specific exercises and stretches to keep you moving. And they are primary care practitioners who can monitor and inspect your feet for any new concerns. Persons with diabetes should have a foot specialist examine their feet at least every 6 months. If you have callus or nail problems, a visit to the chiropodist can be a more routine visit at around 2 months. Regular examinations and visits can prevent foot complications that can occur with diabetes. Consult your doctor who can refer a foot specialist in your area or call our clinic today!

December 19, 2024

The 5 Best Foot Exercises to Improve Circulation in Winter

As the colder months roll in, it's important to pay extra attention to your feet. Studies show that foot exercises in the winter can help prevent stiffness and pain by improving blood flow, and keep your feet feeling warm and energized. This is especially important for people with certain foot conditions. By incorporating simple exercises into your routine, you can keep your feet in better shape, even as the temperature drops. Keep reading for five of the best foot exercises to boost circulation and keep your feet healthy throughout the winter. Today We'll Learn The connection between blood circulation and winter foot care What foot conditions benefit the most from improved circulation The 5 best foot exercises to improve circulation in winter How these foot exercises improve blood flow The Connection Between Blood Circulation and Winter Foot Care The circulatory system, also called the cardiovascular system, is responsible for delivering nutrients and oxygen to every part of our bodies. Sufficient blood circulation is very important to the lower extremities, like the feet, ankles and legs, because it helps reduce the risk of muscle cramps and fatigue by removing waste products like carbon dioxide and lactic acid, while also supporting cell repair and overall function. Poor circulation can lead to swelling, numbness, and cold sensations in your limbs, hands and feet. It can also be connected to serious issues, like diabetes, which can lead to slow-healing wounds, infections, or even ulcers. Maintaining good blood flow in the feet, legs, and ankles is even more important during the winter because cold temperatures cause blood vessels to constrict, which reduces blood flow to the extremities even more than usual. This can make feet and ankles more prone to stiffness, pain, numbness, and feeling cold. Maintaining healthy blood flow via foot exercises helps improve mobility, soothes pain, and ensures the feet and lower limbs remain as strong as possible during the cold winter months. They also help people who simply want to keep their feet healthy and stay on top of their winter foot care. Blood Circulation Exercises for Feet: Conditions Treated Foot exercises and stretches that boost blood flow can help a wide range of conditions, including: Diabetic Neuropathy: Improved circulation might help your body’s circulatory system deliver oxygen and nutrients to nerve tissues. This can help with tingling, numbness and nerve damage. Edema (Swelling): Foot exercises stimulate the muscles that help the veins pump blood from your feet back up to your heart. This helps prevent fluid accumulation in the feet and ankles, which in turn reduces swelling in the lower limbs. Peripheral Artery Disease (PAD): A common condition that narrows the arteries that restricts blood flow. Foot exercises may alleviate pain and cramping while improving mobility and making walking easier. Raynaud’s Phenomenon: A condition in which extremities, like the hands and feet, are particularly sensitive to cold weather, causing the blood vessels to narrow (which then leads to poor circulation and all the other things we mentioned). Stretching and exercising the feet encourages blood flow, which can counteract the effects of Reynaud's. Varicose Veins: These are enlarged, twisted and sometimes painful veins. Exercises that strengthen calf and foot muscles may reduce blood pooling in the veins, while minimizing discomfort and clot risks. Plantar fasciitis: An overuse injury that causes inflammation in the plantar fascia and heel pain that comes and goes. Good circulation is essential to help your body heal injuries, so activities that boost circulation may decrease inflammation and speed up the recovery process. Arthritis: Increased blood flow delivers oxygen and nutrients to joint tissues, reducing stiffness and improving joint mobility. 1. Water Ball Roll https://www.youtube.com/shorts/eTffGEvK6Z8 How to do it: While standing, place one foot on the water bottle and press down gently. Roll the bottle back and forth under your foot, starting from the heel and moving to the toes. Use your body weight to adjust the pressure, ensuring it's comfortable but effective. Roll each foot for about 1–2 minutes. Focus on different areas, such as the arch and ball of the foot, to help relieve tension and boost circulation. For the best results, use a frozen water bottle. You can also use a tennis or golf ball, or a therapeutic massage ball. 2. Toe Splays https://www.youtube.com/shorts/gOwgyrmU6hM How to do it: While seated, plant your feet flat on the ground. Bunch your toes together by scrunching them inward, keeping the movement controlled. Press your big toe firmly into the ground while spreading the other toes as far apart as possible, holding before relaxing. Perform on both feet at the same time, or one foot at a time. 3. Toe Flex and Raises https://www.youtube.com/shorts/n46k32OZgco How to do it: Start in a seated position with your feet flat on the floor. Flex your toes upward towards the sky before flexing them downwards towards the floor. Repeat 10-15 times on each foot. 4. Pen Pick-Ups https://www.youtube.com/shorts/5PCZuM5E6RU How to do it: Stay seated. Lay three pens, or similarly shaped objects, in front of you--spaced apart evenly. Using your toes, pick up each pen and place it in a bowl. 5. Seated Toe Pulls https://www.youtube.com/shorts/7-XrzvpxETc How to do it: While sitting on a chair and cross one foot over the opposite knee. Pull your toes toward you and hold them in that position for 30-50 seconds. Repeat 2-3 times on each foot. How These Foot Exercises Improve Blood Flow Exercises like the water bottle roll boost blood flow by stimulating the muscles on the bottom of the foot. In more scientific terms, they target the plantar aspect (sole of the foot), which stabilizes the arch. It also releases tension in the plantar fascia, improving its elasticity and promoting better circulation in the surrounding tissues. This enhanced blood flow helps deliver oxygen and essential nutrients to the area, aiding in healing and reducing inflammation. Additionally, as the blood vessels dilate, the foot’s tissues become more flexible and less prone to tension. Toe splays, toe flexes and raises, and similar exercises activate the intrinsic muscles of the foot. These are located within the foot itself and include the toes, as opposed to the extrinsic muscles that originate in the lower leg and insert into the foot. These intrinsic muscles help control fine movements of the toes, stabilize the arch, and support balance. When they're activated during toe exercises, they stimulate the foot's blood vessels and promote better circulation. More specifically, working the toes can enhance venous return, which is the process by which blood is pumped back to the heart. The activation of these foot muscles also helps compress the veins, aiding in the movement of blood against gravity. By targeting the small, intrinsic muscles, these exercises help to balance the workload between the foot’s various structures, preventing overuse injuries in the larger, more externally located muscles. Strengthening these muscles can also improve overall posture and movement patterns, reducing the risk of misalignments or discomfort that may radiate through the legs and lower back. When the foot muscles are conditioned and have good range of motion, they allow for better shock absorption and energy transfer during activities like walking, running, and standing. This reduces strain on other parts of the body, contributing to overall musculoskeletal health. Furthermore, foot exercises like toe flexes, raises, and splays support better sensory feedback from the ground, enhancing proprioception—the body's ability to sense its position and movement. Improved proprioception helps with balance and stability, particularly in individuals who may be recovering from an injury or who experience frequent falls due to weakened muscles or poor circulation. By exercising the foot muscles, the brain receives clearer signals from the feet, which can enhance coordination and response times during daily movement. This can be particularly helpful for older adults or individuals with conditions that affect motor skills.

December 12, 2024

The Connection Between Flat Feet and Plantar Fasciitis

Flat feet and plantar fasciitis are closely linked, with flat feet often contributing to the development of plantar fasciitis. Both conditions can also lead to foot pain and mobility issues, and can worsen over time if not properly addressed. Today’s article will answer: What are flat feet? What is plantar fasciitis? What is the connection between flat feet and plantar fasciitis? How can I treat flat feet and plantar fasciitis? What are Flat Feet? Flat feet, scientifically called pes planus, is a condition where you have a very minimal or non-existent foot arch. It is one of three arch types, the others being a normal arch and a high arch. If you have flat feet, your entire sole is in constant contact with the ground when you aren’t wearing shoes. Most children naturally have flat feet but grow out of it as they get older. If you don't grow out of it by adulthood, it is called congenital flat feet. Some adults may also have normal arches that collapse. This condition, which may affect one or both feet, is sometimes called adult-acquired flatfoot or fallen arches (both commonly referred to as simply flat feet or flatfoot), and may be asymptomatic. However, it often results in discomfort, foot pain and biomechanical issues. Many people may not realize they have an abnormal arch or how it affects the rest of our body. That’s why it’s important to talk to a podiatrist or chiropodist whenever you experience foot pain. They can determine whether your pain is directly linked to your foot type and arch structure before offering the appropriate treatment. Causes of Adult-Acquired Flat Feet Common causes of adult-acquired flat feet are: Posterior Tibial Tendon Dysfunction (PTTD): PTTD is a medical condition involving damage, weakening, or inflammation of the posterior tibial tendon, which supports the arch of the foot. It is one of the leading causes of fallen arches in adults. Left untreated, PTTD can progress to foot arch pain and flat feet, often in only one foot. Aging: As you age, the ligaments, tendons, and muscles in your feet lose elasticity and strength. This natural wear and tear can result in the gradual flattening of the arch. Obesity: Extra body weight increases pressure on the feet, especially the arches. This additional load can accelerate the breakdown of the foot’s structures, leading to flat feet. Rheumatoid Arthritis: This condition can affect the joints and soft tissue in the foot, weakening the ligaments and structures that support the arch, and leading to its collapse. Injury or Trauma: Injuries to the foot or ankle, such as fractures or sprains, can damage the tendons or ligaments that support the arch. This can disrupt the foot's normal structure and collapse its arch. Pregnancy: Hormonal changes during pregnancy can relax the ligaments in the body, including those in the feet. This can cause the arch to flatten, often temporarily, but it may persist in some women after childbirth. Overpronation Flat feet are a structural issue. Think of a normal arch as an important component of a home; when it is lacking, your foot’s utility and functionality will be affected, as well as your mobility. This means you may subconsciously start walking in an abnormal way to make up for the absent arch and accommodate foot pain, which causes even more damage over time. For people with flat feet, this movement is called overpronation. When you overpronate, the foot rolls too far inward during walking or running, and becomes a consistent feature of your gait (your walking pattern). This leads to uneven pressure distribution which can cause pain and contribute to injuries in the feet, ankles, knees, back and hips. What is Plantar Fasciitis? https://www.youtube.com/shorts/rSKd2ztKWa8 Plantar fasciitis is technically an overuse injury. It targets the plantar fascia, which is a long, fibrous ligament (or band of tissue) that runs along the toes to the heel, connecting the bones of the foot. The plantar fascia also operates as a dynamic support mechanism for the foot’s arch, distributing forces evenly during movement. When overused, it may lose elasticity and develop microtears, typically near its attachment point at the heel. This then leads to inflammation, your body’s natural response to injury. If untreated, plantar fasciitis can lead to impactful gait changes, prolonged foot pain, and secondary issues in the knees, hips, or lower back. Plantar Fasciitis Symptoms Heel Pain (especially in the morning): This is a hallmark symptom. During rest, the plantar fascia tightens. When taking your first steps after waking, the tissue is suddenly stretched, leading to sharp pain. As the fascia warms up, the pain often decreases. Pain after prolonged standing or activity: Standing for long periods or engaging in weight-bearing activities places repetitive strain on the plantar fascia. This results in pain that often intensifies after the activity ends. Tenderness or stiffness in the heel area: The attachment point of the plantar fascia to the calcaneus (heel bone) is a common site for inflammation and microtears, leading to localized stiffness and tenderness, especially after inactivity. Swelling in the heel or arch: Inflammation from repeated stress might cause fluid accumulation in the affected area, causing visible or palpable swelling as the body tries to repair itself. Worsening pain with barefoot walking or unsupportive shoes: Walking barefoot or wearing shoes without adequate arch support increases strain on the plantar fascia. Foot arch pain: Inflammation of the plantar fascia can irritate nearby areas, causing burning or aching sensations along the length of the fascia in the arch of the foot. https://www.youtube.com/shorts/fTIAlew5T04 The Connection Between Flat Feet and Plantar Fasciitis Studies suggest that you are more likely to develop plantar fasciitis if you have flat feet versus a normal arch, making flat feet a top risk factor for plantar fasciitis. This is mainly because the foot and gait mechanics associated with flat feet put excess strain and pressure on the plantar fascia. In a normal foot, the arch acts as a natural shock absorber, distributing weight and reducing stress on the plantar fascia. However, since people with flat feet have a low or entirely absent arch, it disrupts this natural shock absorption from occurring. Overpronation also strains the plantar fascia, causing microtears and inflammation over time. Additionally, the misalignment caused by flat feet can lead to uneven weight distribution, increasing stress on the plantar fascia and exacerbating the condition. These factors can also place additional strain on surrounding structures, such as the Achilles tendon, which will worsen the overall tension in the plantar fascia. Additional Plantar Fasciitis Causes and Risk Factors Aside from people with flat feet, plantar fasciitis is also common in: Middle-aged Adults: Particularly those aged 40 to 60, as natural wear and tear over time can weaken the plantar fascia. Athletes: Runners, dancers, and those involved in high-impact sports are at increased risk due to repetitive stress on the plantar fascia. People with high arches: Having a high arch, the polar opposite of a flat foot, can also cause plantar fasciitis due to increased strain on the plantar fascia and excessive supination (when the foot rolls excessively outward during walking and running). People struggling with obesity: Carrying extra weight increases pressure on the plantar fascia, especially during standing or walking. Workers who stand for long hours: Healthcare workers, factory employees, restaurant staff, construction workers and more are at a higher risk due to the repeated strain from standing. Plantar Fasciitis and Flat Feet: Treatment If you’re looking for flat feet and plantar fasciitis pain relief, visiting a foot specialist, like a podiatrist or a chiropodist, is your best bet. These experts can provide education, treatment services, and “homework” ideas you can incorporate in your daily routine. Keep reading to learn ways you can manage both issues! Exercises and Stretches https://www.youtube.com/shorts/7-XrzvpxETc Performing light, simple and effective routines can help strengthen the plantar fascia and manage heel and foot arch pain. Here are some you can try: Seated toe pulls: Sit with one foot crossed over the opposite knee and use your hands to gently pull your toes towards you for 30 seconds. Repeat with the other foot. Towel pickups: Stand with your feet flat on the floor and a towel placed in front of you. Use your toes to scrunch the towel towards you, then relax. Repeat for 30 seconds, then switch feet. Calf raises: Stand on a step, rise onto your toes, then slowly lower your heel back down. Repeat for 8-10 reps, completing 3 sets. Read a more detailed article on the best exercises for plantar fasciitis. Proper Footwear Wearing the right footwear is essential for managing both flat feet and plantar fasciitis. The key features to look for include: Arch support: Arch support is the cornerstone of plantar fasciitis treatment. This will keep the plantar fascia properly supported and reduce strain. Arch support also provides stability and helps prevent the overpronation (excessive inward rolling of the foot) that can strain the plantar fascia. Cushioning: Helps absorb shock, reducing the impact on the heel and alleviating discomfort. Firm heel counter: Supports the back of the foot, preventing excessive movement and ensuring stability when walking or standing. Comfortable fit: Ensures the shoe isn’t too tight or too loose. You want to ensure shoes also provide ample space for the toes to prevent overcrowding. This reduces pressure points, allows for proper alignment (which is crucial for people with flat feet) and offers overall comfort. Midfoot support: Offers additional stability to prevent the arch from collapsing further, keeping the foot properly aligned and supporting a natural gait. Rounded sole front: A rounded toe or sole at the front of the shoe (like a rocker sole) encourages a smoother toe-off during walking. It can also promote a more natural, efficient gait by allowing the foot to roll more fluidly from heel to toe. Stability and motion control shoes: These are designed to address the unique needs of people with fallen arches and excessive overpronation to keep your feet in a neutral position during movement. They provide enhanced arch support while controlling foot and ankle motion with firmer midsoles and medial posts (a denser material on the inner side of the shoe), all the while reducing strain on the plantar fascia. If these features seem overwhelming and you’re having trouble finding the right shoes, our one-stop-shop Toronto foot clinic offers complimentary shoe fittings. Custom Orthotics Foot clinics can provide custom orthotics. These are tailored to your foot’s personalized shape, are designed specifically for you and can be worn with many shoe types. For people with flat feet, they provide arch support and reduce excessive pronation. This can help alleviate the stress placed on the plantar fascia, reducing the risk of developing plantar fasciitis and helping alleviate the symptoms of the condition itself. Shockwave Therapy https://www.youtube.com/shorts/nt1SgT9xrUM This is a non-invasive treatment for plantar fasciitis, and many other conditions as well! It takes minimal time and usually causes relatively little (if any) discomfort. Shockwave therapy works by transmitting low-intensity acoustic waves to the plantar fascia, which promotes healing. The process works by stimulating the body’s natural healing mechanisms, encouraging the repair of damaged connective tissue and the regeneration of cells in the affected area. Many studies find shockwave therapy to be an innovative, safe and effective treatment for plantar fasciitis. More Treatment Options for Plantar Fasciitis and Flat Feet: RICE method: Rest your foot, wrapped cold compression, and elevate the foot for 5 minutes then remove and wait 5 minutes for it to warm up then walk. This is a tried-and-true plantar fasciitis (and other injuries) treatment you can do from home! Joint immobilization: Temporarily restrict movement to allow the inflamed plantar fascia to heal. This can be done with taping, bracing and splinting, or with a boot cast. Heel cushioning. Reducing the pressure upon the heel from heel cushions Foot Assessment with Video Gait Analysis: Involves recording and analyzing your walking or running pattern to identify abnormal foot mechanics, like overpronation. Rolling a tennis ball or frozen water bottle under the foot: Another easy, soothing treatment method you can try at home.

December 5, 2024

Diabetic Foot Care in Winter: Special Considerations

Seasonal changes can significantly impact diabetic foot health. In the summer, heat and sweating can create challenges, while cold temperatures and wet weather during the winter present other risks. That's why diabetic winter foot care is so important. Today we'll talk about: You'll learn all about: The connection between diabetes and foot health The importance of diabetic foot care in the winter Our Foot Specialists' top tips for diabetic winter foot care The Connection Between Diabetes and Foot Health https://www.youtube.com/shorts/4P3UiDSFzr4 Approximately 800 million adults worldwide have diabetes. It isn’t often immediately recognized as a foot condition on its own, but a serious issue called diabetic foot (a broad term encompassing a wide range of problems) can occur. As a result, foot care should be a top health priority for people with diabetes. Reduced Blood Flow People with Diabetes are at risk of developing neuropathy. There are four types, with peripheral symmetric neuropathy (which affects the feet and hands) being the most relevant for diabetes patients. This condition develops when elevated glucose levels lead to a series of metabolic and vascular changes that impair nerve function. Over time, excess glucose triggers oxidative stress and inflammation, damaging the small blood vessels (microvasculature) that supply the nerves. Without adequate blood flow, nerves are deprived of oxygen and essential nutrients, resulting in their gradual deterioration. Reduced Sensation This damage primarily affects sensory nerves, which are responsible for transmitting pain, temperature, and pressure signals to the brain. This progressive loss of sensation makes it difficult for individuals to detect injuries or changes in their feet, such as cuts, blisters, or pressure points. These minor skin issues can turn to diabetic ulcers (open sores or wounds) when ignored. Reduced Immune Function Diabetes can also contribute to ulcer formation due to its impact on the immune system. High blood sugar levels over time impair the function of white blood cells, which are essential for fighting infections and promoting wound healing. When blood glucose levels are consistently elevated, it reduces the ability of these immune cells to properly respond to bacteria or other pathogens. This makes it more difficult for the body to prevent wounds that may develop on the feet - including minor cuts, blisters, pressure sores or even calluses - from getting infected. As a result, these small injuries are more likely to become infected, and ultimately lead to diabetic ulcers. The impaired immune function, combined with poor circulation and reduced sensation, creates a perfect environment for these infections and ulcers to progress, further delaying healing and increasing the risk of severe complications, such as deep tissue infections or gangrene. Why is Diabetic Foot Care Important in the Winter? Cold and wet weather can impact everyone's feet, but winter can have a more severe effect on people with diabetes. Cold Weather and Diabetes: Risk Factors Low temperatures: Cold air can reduce circulation by constricting blood vessels, particularly in the lower extremities, making it even more difficult for already-compromised vessels to supply the feet with sufficient oxygen and nutrients. This further impairs the body’s ability to heal wounds. Wet conditions: Snow, rain and sleet getting into your shoes and socks is a recipe for disaster for diabetics. You can develop blisters, sores and infections (which are all ulcer risks) when you let moisture build for too long. Dry skin: On the other hand, it is also not ideal for your skin to be too dry. By nature, cold air is very dry. Indoor heating makes the air even dryer by extracting humidity. The lack of moisture in the air dries out the skin - including the skin on our feet. This makes calluses form faster and can lead to issues like cracked heels. And since diabetes impairs the body's ability to heal dry skin and cracked heels, the cracks can easily split open, get infected and turn into a diabetic ulcer. Winter Foot Care for Diabetics Podiatrists and chiropodists strongly advise individuals with diabetes to take extra care of their feet during the winter months due to the increased risks posed by the elements. If you have diabetes, keep reading to learn the best tips for winter foot care - all recommended by the foot specialists at our Toronto foot clinic. Practice Skin Care https://www.youtube.com/shorts/1-Sf43woLLE Moisturizing your feet regularly is one of the most important steps to combat dry, cracked skin. However, our foot specialists also caution against using harsh creams full of chemicals and fragrances - especially if you have diabetes. Opt for medically respected products with natural ingredients, like Gehwol’s Lipidro and Dermal Therapy Heel Care, that replenish the natural amount of moisture in the skin while also healing cracks. Only moisturize your feet after thoroughly cleaning and drying. Check out this ultimate guide to moisturizing your feet to master four easy steps. While you're at it, check out the best foot hygiene routine. Perform Foot Stretches and Exercises Movement is one of the most effective ways to manage diabetic foot concerns and counteract the impact of cold weather on blood flow. Low-impact cardio exercises such as swimming and walking can assist people in managing blood flow and sensation loss, respectively. Removing the elements of competition and high strain exertion found in other sports, and focusing solely on safety and motion, is a great way to encourage activity. There are also targeted, low-impact and easy-to-perform foot stretches and exercises designed for people with diabetes. The goal is to stimulate blood circulation as much as possible while still considering any physical limitations. Below are three light exercises you can try from home, and while they may be hard to perform at first, practice makes perfect! Toe Curls: Sit with your back straight, feet planted, and use a towel to scrunch your toes and pull it toward you, repeating five times per foot. Figure Eights: Lift one foot while keeping the heel on the floor, move your foot in a "figure eight" motion, repeating five to 10 times per foot in each direction. Single Leg Lifts: Stand with feet shoulder-width apart, hands on hips, and lift your left foot straight out in front, keeping your leg straight and foot flexed, repeating five times per foot. To learn more about these exercises, check out the best stretches and exercises for diabetes. Practice Moisture Control Keep your feet reasonably dry as much as possible. This may mean changing your socks and shoes several times per day, and thoroughly drying your feet with a towel intermittently. While this can be annoying and easy to forget during the busy winter season, it’s important to stay on top of this with snow, sleet and rain posing an extra risk. It’s important to not go overboard with too much direct heat penetrating your feet. While cozying up by the fire is safe on occasion, excessive heat can cause even more damage to the nerves. This is due to reduced sensation in diabetic individuals, which makes it harder to notice high heat and burns. Below are the best ways to manage excessive moisture during the winter: Wear moisture-wicking socks. Change socks regularly, especially if they get wet. Use foot powders and deodorants. Choose breathable, well-ventilated shoes. Choose shoes made with waterproof fabrics, like GORE-TEX. This fabric uses a membrane with pores small enough to block water but large enough to allow sweat vapor to escape. This creates a waterproof yet breathable barrier, keeping feet dry and comfortable. Dry feet thoroughly with a towel after washing, especially between toes. Avoid tight shoes that trap moisture. Consider insoles with moisture-absorbing qualities. Keep feet clean and dry before bed. Perform Foot Inspections At-home foot inspections are a good diabetic foot care measure in the winter (and in general) because they help identify potential issues like cuts, blisters, or signs of infection early, when they're easier to treat. Check for cuts, blisters, or sores: Examine the entire surface of your feet for any visible signs of injury and skin perforation. Look for changes in skin color or temperature: Check for any redness, swelling, or areas that feel unusually warm or cold. Check your toenails and between toes: Look for ingrown toenails, cracked toenails and fungal infections, Try Diabetic Socks Compression stockings are a great way to enhance blood flow to the legs and feet, but they are not recommended for people with diabetes since they can do the opposite and restrict blood flow too much in the arteries. Instead, ask a podiatrist or chiropodist about diabetic socks and if they might work for you. They have several benefits, which are especially useful in the winter, including: Antimicrobial treatment which prevents bacterial and fungal growth. Slightly cushioned footbed for extra comfort and protection. Loose, non-binding top band which rests comfortably around the ankles or calves, allowing more circulation. Moisture-wicking and stretchy material. Smooth toe area to prevent blisters and other skin irritation. Choose the Right Footwear https://www.youtube.com/shorts/R7GV0GbKhvQ For diabetes patients, wearing proper footwear in the winter is essential for maintaining foot health. Orthopedic shoes are an excellent choice, as they offer extra cushioning, arch support, depth, elasticity, adjustable straps and ample room to reduce pressure points and prevent blisters or sores. High-quality winter footwear can also be effective, provided it offers warmth, water resistance, and moisture control properties to keep feet dry and comfortable. Here is what you should pay attention to: Waterproof materials: As you already know, materials like GORE-TEX help maintain dryness by utilizing a membrane with microscopic pores. These pores are small enough to block water molecules, but large enough to allow vapor from sweat to escape. This technology effectively prevents external moisture, like snow or rain, from penetrating the footwear, keeping feet dry. The breathability of GORE-TEX also ensures that perspiration from the feet can escape, which prevents a buildup of moisture inside the shoe. This combination of waterproofing and breathability is essential for preventing cold and damp feet Adequate insulation: This is crucial for maintaining warmth in winter footwear as insulation helps lock in warm air and retain body heat. Look for insulated winter shoes and boots that also let you maintain moisture control. And remember to let your feet air out after sweating in your boots all day to avoid excessive dampness. Non-slip soles: For better traction on icy or slippery surfaces to avoid falls. Cushioning and arch support: To provide comfort and reduce strain on the feet, especially when walking for extended periods. Roomy toe box: To avoid friction and pressure on the toes, preventing blisters or sores. Breathable lining: To allow moisture to escape and keep feet dry, reducing the risk of infections. Adjustable closures: To ensure a secure fit without restricting circulation, particularly important for those with swelling or neuropathy. In addition, custom orthotics can provide personalized support, improving foot alignment and alleviating pressure, further reducing the risk of diabetic foot complications. Visit a Foot Specialist https://www.youtube.com/shorts/qR3s05lUwyc Our top tip for managing diabetic feet in winter? Book an appointment with a foot care provider, like a podiatrist or chiropodist, at a foot clinic. At Feet First Clinic, our chiropodists are trained to: Offer comprehensive education on how cold weather can affect diabetic feet. Provide skin and nail care. Provide wound care. Offer custom orthotics services: assessments, casting, fittings and follow-up guidance. Thoroughly inspect your feet and pinpoint potential issues (this can be difficult to fully achieve at home, since diabetes also affects eyesight). Help you understand what winter boots or shoes you should wear, which you can then browse for at our store. A member of our staff can guide you through our options with a complimentary shoe fitting. Discuss the benefits of products like diabetic socks, orthopedic slippers, moisturizers, and more, which you can then purchase at our store. Contact our Toronto foot clinic to learn how a foot assessment can be your first step toward healthier, happier feet this winter!

November 28, 2024

Why You Shouldn’t Ignore Foot and Ankle Swelling: Potential Causes and When to See a Specialist

Whether caused by an injury, circulation problems, or a chronic condition, foot and ankle swelling shouldn't be ignored. In this blog, we'll explore potential causes of swelling, when it might be a sign of something more serious, and how seeing a foot specialist at a Toronto foot clinic can help you get back on your feet. What is Foot Swelling? https://www.youtube.com/shorts/dFZVG-2ymxY The medical term for foot and ankle swelling is called edema. This term can also be used for swelling in other body parts. It is an accumulation of fluid leaking from small blood vessels into the tissues of the foot and ankle. This causes the area to appear puffy or enlarged. Swelling in the feet often occurs because of circulation issues, injuries, infections, or underlying health conditions. The lower extremities are especially vulnerable to swelling because gravity naturally pulls fluids downwards. The body’s circulatory and lymphatic systems typically manage this fluid, but when they’re not functioning optimally, fluid retention can occur. Your body’s inflamatory response to foot and ankle injuries, hormonal changes (pregnancy, etc.) and increased blood volume can also lead to swelling. Edema in the feet can range from a mild inconvenience to extremely distressing and debilitating. It can affect your gait pattern (the way you walk), make buying shoes that fit almost impossible, and coincide with other uncomfortable symptoms. You shouldn’t ignore foot and ankle swelling, even if you think you know the cause. This is because: It can get progressively worse It can signal a health condition you weren’t aware you had It can be a sign that a foot injury is more serious than you thought It can lead to other complications It may require prompt treatment Causes of Swollen Feet and Ankles There are numerous causes of swollen feet and ankles. Some are mild and going away over time, while others are more severe and debilitating and may require consistent assessments and check-ups with either a physician or a foot specialist, like a chiropodist or podiatrist. If you notice swelling within your feet that is new then discuss with with you physician. Common causes of foot and ankle swelling include: Injury. Sprains, fractures, and strains can cause localized swelling due to inflammation in the injured tissues. To protect yourself, check out the best ways to prevent foot injuries. Infections. Conditions like cellulitis, a bacterial skin infection, can lead to swelling, redness, and warmth in the affected area. Venous insufficiency. This is a term for damaged vein valves and in some circumstances be caused by deep vein thrombosis (DVT) or malformation in the leg veins. General venous insufficiency is common especially as we age. Poor blood flow from the legs back to the heart causes fluid buildup, leading to swelling in the lower legs and feet. Lymphedema. Blocked or damaged lymphatic vessels prevent fluid drainage, causing chronic swelling, often in one leg or foot. Heart, kidney, or liver disease. These conditions can disrupt fluid balance in the body, leading to retention in the feet and ankles. Pregnancy: Increased blood volume and pressure from the growing uterus can cause fluid accumulation, especially in the lower extremities. Prolonged standing or sitting. Sitting in one position OR standing for extended periods can cause fluid to pool in the legs and feet due to gravity. Office workers, restaurant servers, cooks, flight attendants, and more can experience mild swelling simply due to their occupation. Gout. Gout is a type of arthritis caused by high levels of uric acid in the blood, leading to the formation of urate crystals in joints. The result is intense burning pain, redness, and swelling, particularly in the big toe. Improving your diet may be able to help with flair ups. Diabetes: The top of the feet and ankles can swell due to nerve damage caused by diabetic neuropathy. Diet. High sodium diets can cause excessive swelling in the legs. Signs Your Swollen Feet and Ankles May be Serious https://www.youtube.com/shorts/dD0T2wUUFdQ Below are some coinciding symptoms that may be tell-tale sign of a health condition. As always, if anything is new, then to see your physician rather than to leave it: Burning sensation. Persistent burning in the feet along with swelling could indicate nerve damage. Redness and warmth. Swelling accompanied by redness, warmth, and tenderness may signal an infection, such as cellulitis, that needs attention. Sudden onset of swelling. Rapid or sudden swelling in one leg could indicate a blood clot or deep vein thrombosis (DVT)s. This condition requires urgent care. Pain: Severe pain along with swelling, especially after an injury, may point to a fracture or ligament damage. Swelling in one foot only: Sometimes localized issues can indicate a more severe and specific problem. Shortness of breath or chest pain. These symptoms can indicate heart or lung issues, like congestive heart failure, and requires immediate medical help. Skin Changes: Discolored, tight, or shiny skin over swollen areas may suggest lymphatic or circulatory issues needing evaluation. Red toes or dark blue skin can signify peripheral artery disease, coronary heart disease, high blood pressure and more. Persistent or worsening swelling. Swelling that doesn’t improve or worsens over time could be a sign of an underlying health condition that needs treatment. When to See a Podiatrist or Chiropodist: Treatment https://www.youtube.com/shorts/IryRcL4JPjI You should always see a physician or foot specialist if you’re experiencing discomfort in any capacity. Remember: foot issues are not “normal.” Because foot and ankle swelling is usually caused by an underlying medical condition, you should first see your family doctor. They can refer you to the appropriate specialists and run the necessary testing to determine what is causing the swelling. Your treatment options may target edema directly, or they may target the underlying health condition. Once you determine the underlying cause of the foot swelling, a foot specialist or foot clinic can provide solutions to manage and accommodate the condition, so you can live your life as comfortably as possible. Below are some services a foot clinic can offer to help foot and ankle swelling: Compression Socks Compression stockings are a great option for venous insufficiency, pregnancy, fatigue-related swelling, and sometimes even underlying health conditions like lymphadema. They reduce swelling by promoting blood flow and limiting fluid buildup in the lower extremities. A common myth is that they are clunky, noticeable medical devices that clash with your clothing, but they are actually quite fashionable and sleek. Most people will not even realize you are wearing them. You can get standard knee-high socks or even pantyhose, depending on how your activities and how you want to dress them up. You can get a prescription from a physician, and then stop by our Toronto foot clinic, where our certified fitters can measure you and help you select the best stockings for you. As compression stockings can be contraindicated for some conditions (like diabetes and periphery artery disease), it's strongly recommended that you first visit discuss compression stockings with your family doctor if you have any underlying health concerns. Orthopedic Footwear Orthopedic shoes can accommodate swelling by offering several key features designed to provide comfort and support: Adjustable straps and laces. Many orthopedic shoes come with adjustable fastenings that allow for a customizable fit, accommodating changes in foot size due to swelling. Wide toe boxes. These shoes often have a wider, more spacious toe area, which helps to prevent pressure on swollen feet and allows room for expansion. Elastic materials. Some orthopedic shoes are made with elastic or stretchable fabrics, allowing them to gently conform to the shape of the foot and adjust to fluctuations in swelling throughout the day. Extra depth. Orthopedic shoes often have a deeper design, providing more room for foot swelling and preventing tightness that could worsen discomfort. By combining these features, orthopedic shoes can help manage swelling while providing the support needed for optimal foot health. Diabetic Foot Care https://www.youtube.com/shorts/4P3UiDSFzr4 If your edema is caused by diabetic neuropathy or periphery artery disease, diabetic foot care at a foot clinic should be a part of your monthly routine. At a diabetic foot care appointment, your chiropodist will monitor your foot health. They'll examine your feet to check for sensation, circulation, and check for any potential causes for concerns - like disease progression and worsening circulation issues. Routine diabetic foot care also involves wound and nail care, diabetic foot education, and more. While these practices don’t directly target swelling, they are all interconnected and help reduce the risk of complications that can worsen swelling. Biomechanical Assessment If your swelling coincides with an injury and other chronic foot pain, a biomechanical assessment and gait analysis with a chiropodist can help. A chiropodist can then diagnose any underlying muscular or biomechanical issues that are causing or contributing to the foot pain, and make treatment recommendations like custom orthotics. Additional Swollen Foot and Ankle Treatments RICE Method The RICE method is an acronym for a popular at-home treatment routine for acute foot injuries: rest (avoiding activities that strain the foot), ice (applying cold packs to reduce swelling and pain), compression (using bandages, tape, compression socks, and more to limit swelling), and elevation (raising the foot above heart level to help drain excess fluid). If you're Treatments That Target Underlying Health Conditions When foot swelling is linked to serious underlying health conditions, treatments aim to address the root cause and prevent further complications. For example, conditions like heart failure, managing the condition with medications can help reduce fluid retention and ease swelling. In cases of kidney disease, doctors may adjust medications and recommend dietary changes to help the kidneys function more effectively, reducing the build-up of excess fluid in the body. In some lymphatic conditions, such as lymphedema, may be treated with specialized therapy, including manual lymph drainage to help encourage the movement of fluid away from the swollen areas. Compression therapy is also helpful for lymph conditions. Each treatment is tailored to the specific health condition causing the swelling, and addressing the underlying issue can significantly reduce or even prevent the recurrence of swelling. Regular monitoring and early intervention are key to managing these conditions effectively. https://youtube.com/shorts/2mS-9D7LHq4?si=bOOBryZI6ne5VrtP

November 21, 2024

Why Do Older Women Get Bunions?

Bunions can target anyone, but they are more common in older women due to factors like foot anatomy and footwear choices. Luckily, there are ways you can prevent and manage bunions to the best of your ability, especially if you work with a chiropodist or podiatrist. Let’s explore everything there is to know about bunions, including the reasons why older women are more at risk for developing bunions. https://youtube.com/shorts/sXF8lWHad0g?si=w38l2AbSdGSpctbC This article will answer: What are bunions? Who's at risk? Why are older women at risk? How do you treat bunions? How do you prevent bunions? Do I need bunion surgery? What Are Bunions? Bunions are toe deformities in which the big toe shifts towards the second toe at an angle. This causes the joint at the base of the big toe (the first metatarsophalangeal joint, or MTP joint) to protrude outwards, forming a bump that can become swollen, tender, and uncomfortable. The MTP joint bears a lot of pressure while walking or standing, which can worsen the bunion over time. As the condition progresses, people with bunions often experience pain and difficulty wearing certain shoes. Another related condition common in older women is hallux rigidus, where arthritis or stiffness affects the big toe joint, limiting its movement. Hallux rigidus may not cause the same protrusion as bunions (it's usually seen on top of the joint), but it can still lead to pain and difficulty moving the toe. Many people may think that hallux rigidus is the same as a bunion, but they are different - the scientific term for bunions is hallux (abducto) valgus. Causes of Bunions: Who's at Risk? While bunions aren't typically caused by one thing alone, there are several risk factors that contribute to the likelihood of developing bunions. All these risk factors either weaken or cause extra strain on the MTP joint. These include: Age: Bunions can start to form as young as 30, but they are commonly associated with seniors and become more debilitating and noticeable with age. Some studies suggest 1 in 3 people over the age of 65 have a pronounced bunion, many of them being women. Genetics: Bunions are partly genetic because foot shape and structure, often inherited traits, can increase the risk of developing them. People with certain foot shapes—particularly flat feet—are more prone to bunions because this structure creates imbalanced pressure on the big toe joint. Wearing ill-fitting footwear: Frequently wearing narrow, tight, or high-heeled shoes that squeeze the toes can push the big toe inward, contributing to bunion formation. Pointed, unstready high-heeled shoes with very thin heels (like stilettos) are extra risky. Having Rheumatoid arthritis: Conditions that affect joint health and increase inflammation, such as rheumatoid arthritis, can lead to bunion formation. Previous foot injuries: Tendon tears, or having broken a bone in the past, can increase risk. Why are Older Women at Risk? Senior women are more likely than other groups to experience painful bunions for a handful of reasons: Older people are more susceptible to joint-wear-and-tear and other foot conditions like osteoarthritis (which is caused by wear-and-tear on the joints, and is commonly associated with age). And pre-existing joint issues make you more prone to bunions. Many older women have a history of wearing ill-fitting shoes with cramped toe boxes and unsteady high heels for decades. Tight shoes and high heels put extra strain and pressure on the MTP joint. The collective effects of this pressure accumulate over time and, compounded with other age-related risk factors, can accelerate, contribute to or exacerbate the formation of bunions. Women may have weaker connective tissue in their feet. This will reduce the big toe's ability to withstand the force and pressure of our movement. Bunions can worsen during menopause due to hormonal changes loosening ligaments and flattening the feet, making them more vulnerable. This can also happen during pregnancy and have long-lasting effects on the feet. Menopause can also affect bone density, which can accelerate joint degeneration, weaken joints, and therefore aggravate bunions. Bunions in Older Women: Treatment If you are struggling with bunion pain, visiting a foot specialist, like a chiropodist or podiatrist, at your local foot clinic can help. There are many solutions available that target the foot pain and mobility issues associated with bunions, while decreasing pressure on the big toe joint. While bunions cannot be reversed (without surgery), by strengthening your feet and reducing pressure on the big toe, you can manage the bunion growth so that it doesn't get worse. Bunion Exercises and Stretches https://www.youtube.com/shorts/H3SogJ8FIas A chiropodist or podiatrist may suggest some bunion exercises and stretches. These are great for both prevention and treatment, mostly target the toes, are easy to memorize, and accommodate seniors. The exercises may feel awkward at first, but you’ll get used to them in no time. Here are five easy-to-learn exercises you can incorporate into your daily routine to help manage bunion discomfort: Toe Circles Grip your big toe and move it in circular motions to maintain joint mobility. Do 10 circles in each direction per foot. Toe Stretches Use your fingers to press your big toe down and hold for 30 seconds, then stretch it in the opposite direction for another 30 seconds. Repeat 5 times on each foot. Towel Grip and Pull Place a towel on the floor and use your toes to scrunch and pull it toward you. This helps strengthen the small muscles in your feet. Toe Curls and Spreads Curl your toes down tightly, hold for a few seconds, then spread them wide. Repeat this motion 10 times per foot to improve flexibility and strength. Toe Resistance Exercises View this post on Instagram A post shared by Feet First Clinic (@feetfirstclinic_) Use your fingers to apply light pressure against your big toe in various directions, pressing up, down, and sideways. Hold each for 10 seconds. Repeat 5 times on each foot. You can also wrap a resistance band around your big toes and then spread your feet apart while keeping your heels planted, as shown in the video above. Other bunion treatment options provided by a foot specialist include: Footwear recommendations: We'll get more into this later, but opt for shoes with a wide toe box that give your toes enough room. You should also look for features like cushioned insoles and good arch support to reduce pressure on the bunion. Custom orthotics: A foot specialist will assess your feet and design custom orthotic insoles tailored to your feet. Orthotics work by reducing pressure and force on the big toe joint, which will then reduce bunion pain and help prevent the bunion from getting worse. Custom orthotics for bunions provide support and help realign the foot, redistributing pressure away from the bunion. You can then put the orthotics into your footwear and go about your daily activities with less pressure on the big toe. Shockwave therapy: This treatment uses powerful acoustic pulses to reduce pain in the affected area by increasing blood flow and triggering a process that helps the body heal injured tissue. While shockwave therapy doesn't target the bunion itself, it helps with the tight muscles and ligaments around the bunion, which reduces pain and pressure on the joint. Bunion devices: These devices help realign the toes to varying degrees. Silicone toe separators are great for when you're walking around at home, whereas ultra-thin bunion aligners fit comfortably in most footwear and are great for athletic people. For more significant correction, rigid bunion splints help stabilize the joint. Therapeutic taping: A foot specialist can apply therapeutic tape to provide support, reduce pain, and help correct the alignment of the bunion, allowing for better mobility. Shoe stretching: If your shoes are too tight, professional shoe stretching can help relieve pressure on the bunion, making footwear more comfortable. https://www.youtube.com/shorts/8g43ZWreZ1g Best Bunion Prevention Tips There isn’t much you can do about your genetics or age, but you can be mindful about other lifestyle factors to manage bunion formation. Wearing the Right Footwear The best preventative measure you can take to try and avoid bunions is wearing the right shoes for your feet. You should be especially vigilant about finding shoes that are wide enough for your toes to rest comfortably and wiggle without crowding and overlapping. Ideally, your shoes need between ⅜” to ½” of space between the end of your longest toe and the front of the shoe. You can try an at-home test to see how wide your feet really are before visiting your Toronto foot clinic for a shoe fitting that will help you find the perfect fit. Toe space is the biggest factor for bunion prevention, but there are many other things to consider when finding the right shoes. Check out the best footwear for healthy feet to learn what else you should look out for. Try to avoid high heels, only wearing them for special occasions. Even then, opt for healthy heel options. Heels shouldn’t be too high or too thin—look for a block, shorter heel or wedges instead. Your shoes also shouldn’t be severely pointed and squish your toes together. Additional Bunion Prevention Tips: Regular exercise and a good fitness regimen will help keep your muscles strong. Strong muscles reduce strain on the joints, which will then make you less susceptible to joint degeneration and wear-and-tear as you age. In addition, a healthy conditioned lower body and core helps with alignment and weight-bearing, meaning your big toe won't need to work as hard when you move around. Since having a previous injury can be a risk factor, practice healthy foot injury prevention and FALL prevention. If you notice early signs of bunion formation, such as redness or swelling around the big toe joint, consult a foot specialist promptly. You should also consult a foot specialist if you have any family members with bunions, notice any issues with your alignment, have flat feet, or any other biomechanical concerns, as faulty biomechanics increase strain on the big toe joint. Excess weight can put additional pressure on your feet, increasing the risk of bunion development. Maintaining a healthy weight can help reduce this strain. Do I Need Bunion Surgery? Seniors may be more likely to seek a surgical consult after living with bunions for a longer period than young people, and trying other non-invasive treatment options with a podiatrist or chiropodist first. That said, these days there are more non-surgical treatment options than ever before and your chances of needing a surgery are still somewhat low. Surgeries are typically recommended for older women or any individual who experiences significant pain or functional limitations; surgeries are not usually performed solely for cosmetic reasons. At FeetFirstClinic you will start with a full foot assessment to determine the severity of your condition and your foot specialist will form a treatment plan with you. https://www.youtube.com/shorts/XZUfVhny5pY

November 14, 2024

3 Tips to Prevent Winter Foot Injuries

Foot injuries can increase in cold weather, so it’s important to learn how to minimize your risk, practice fall prevention, and navigate slippery conditions. Not only that, but cold weather can cause muscle stiffness to worsen, making your feet more vulnerable than they were during the warmer months. Today we’ll talk about 3 safety tips—recommended by the foot specialists at our Toronto foot clinic—to prevent winter foot injuries. 3 Tips to Prevent Winter Foot Injuries Wear The Right Shoes Try Warm Ups and Foot Exercises Wear Supportive Insoles 1. Wear The Right Shoes The wrong winter boots can lead to numerous foot injuries. While fashion may be your top priority, you shouldn’t sacrifice protective and supportive features just for looks (plus, you can find fashionable and comfortable shoes at our Toronto foot clinic). Winter footwear should have good shock absorption and be made with waterproof materials. Avoid pointed toes and high heels in the winter—these features are a recipe for slips and falls! https://youtube.com/shorts/R7GV0GbKhvQ?si=NhfPArwoRH1Vnt1q Stability And Motion Control Shoes Did you know there are different foot types, and your foot type can determine what shoes you should wear? For example, people with flat feet need extra stability or motion control features built into their shoes to help correct varying degrees of overpronation (when the ankle rolls inward during movement). A foot specialist, like a podiatrist or chiropodist, can assess your feet and tell you what type shoes you should be wearing: Stability Shoes Purpose: Stability shoes are aimed at those with mild to moderate overpronation (the inward rolling of the foot when walking or running). Features: These shoes typically have a supportive structure and posting around the arch and midsole to help guide the foot through a natural gait cycle and promote natural foot motion. Motion Control Shoes Purpose: These are designed for people with severe overpronation, providing maximum support to prevent excessive inward rolling of the foot. Features: Motion control shoes are more rigid and structured than stability shoes, with reinforced areas in the midsole. How does this link back to winter foot safety? If you have flat feet, especially if you’re a senior, and your feet overpronate, your hips, knees and ankles can weaken and become more painful and vulnerable due to years of walking with an abnormal gait. If you don’t have strong feet and joints, icy conditions become that much more threatening. Both stability and motion control shoes can help prevent winter foot injuries by providing extra support and control in conditions where icy, wet, or uneven surfaces make slips and strains more likely. Keep in mind these should also have solid traction performance! https://youtube.com/shorts/AfuPpZv2LP4?si=WV3KZ4alGqWZLlyP Traction Performance High traction performance in shoes (thick, rubber soles with grooves) is essential for winter injury prevention. It prevents slips and falls, which are especially common on icy or wet surfaces. Without reliable traction, even the smallest patch of ice can turn into a serious hazard, causing the foot to slide out from under the body and throwing balance off entirely. This can lead to falls, which are a primary cause of winter injuries, including sprains, fractures, and ligament tears in the foot, ankle, or knee. Good traction provides a stable, controlled grip on unpredictable surfaces, allowing each step to connect firmly with the ground. This stability reduces the risk of unexpected slips and ensures that the foot can maintain contact without sliding, even on slippery patches. People who enjoy running during the winter months should particularly focus on finding running shoes with traction. Many brands, like Saucony or ASICS, design shoes for this purpose. You can also add on ice cleats or cramp-ons to your footwear for extra grip when running on icy surfaces. When looking for traction performance, keep in mind that no shoes are built for traction on ice (although some may fare better than others). Only ice cleats or cramp-ons will provide proper grip on ice. 2. Try Warm-ups And Foot Exercises Before going for a run, warm up your feet and lower extremities with a nice, healthy stretch or foot exercise. This will prepare your feet for pounding the pavement (or snow) and give them an added layer of strength and protection. Runners should be doing this year round as part of their foot care routine, not just during the winter! These routines are not just for runners! Quite the opposite, in fact; they help people with mobility constraints and inflamed, weakened and damaged muscles/joints just as much as they do athletes. People with arthritis in the feet, plantar fasciitis and other conditions can help reduce their risk of winter injuries by strengthening their feet. For example, arthritis can lead to joint pain, stiffness, and reduced range of motion, making it challenging to maintain balance on slippery or uneven surfaces. On the other hand, plantar fasciitis involves inflammation of the plantar fascia, the ligament that runs along the bottom of the foot. The discomfort may lead to altered walking mechanics, such as favoring one foot over the other, which can compromise stability and increase the risk of falls. Stretches and exercises should target the intrinsic (small, stabilizing muscles located within the foot) and extensor muscles (primarily found in the lower leg), and your ankles. Your routine should include a variety of movements that target as many muscle groups as possible. Here are a few easy, effective stretches and exercises you can start today: https://www.youtube.com/shorts/gOwgyrmU6hM Toe Splays: While seated or standing, spread (or "splay") your toes as wide apart as possible, holding for a few seconds, then releasing. Repeat this 10–15 times per foot. Toe Flex and Raise: Stand with toes planted and lift the heels off the ground. This exercise strengthens the lower leg and foot muscles, improving balance and stability on icy surfaces. Ankle Circles: Sit or stand and slowly rotate each ankle in circles, first clockwise and then counterclockwise. This helps increase ankle mobility and flexibility, which can reduce the risk of sprains. Seated Hamstring Stretch: Sit on a chair, extend one leg straight in front. Lean forward slowly until you feel the stretch in your hamstring. Hold for about 30 seconds. In addition, click here for part 1 and part 2 for the best exercises for arthritis, and here for the best exercises for plantar fasciitis. https://www.youtube.com/shorts/AsuUXJYnUmQ The Importance of Balance We all know the direct link between losing your balance and sustaining an injury. We also know that people with disabilities or conditions that impact mobility need to be extra vigilant. With every step, strong balance allows you to react as quickly as possible to unexpected changes in winter terrain and surfaces, which will keep you safe. Here are two simple foot exercises that focus on improving balance: Single-Leg Stands: Stand on one foot for 20–30 seconds, then switch. This exercise builds balance and strengthens the muscles around the ankle, reducing the risk of falls on uneven surfaces. Heel-to-Toe Walk: Walk in a straight line, placing the heel of one foot directly in front of the toes of the other. This exercise improves balance and strengthens stabilizing muscles. 3. Wear Supportive Insoles Winter footwear is typically built for the elements - not for comfort. Therefore, it can be very difficult to find a supportive winter boot that will also protect your feet from winter weather. Fortunately, if you wear a supportive insole with your footwear, you won't need to sacrifice comfort for function. There are two types of supportive insoles you can wear with winter footwear: customer orthotics and over-the-counter insoles. Custom Orthotics Custom orthotics are designed to fit the unique contours of an individual's feet, helping to redistribute pressure and provide the necessary arch support. This is especially beneficial for individuals with flat feet or other conditions. Add winter to the mix, and this becomes even more crucial. By optimizing foot alignment, custom orthotics help maintain stability and balance, allowing individuals to navigate slippery surfaces with greater confidence. Custom orthotics can be made to fit in winter boots or winter running shoes, to keep your foot supported in all scenarios. They can even come in half-lengths to accommodate dress shoes for when you’re leaving the office and heading to your car (slippery sidewalks are everywhere in winter, so you can’t be too careful!). They provide cushioning that absorbs impact and reduces strain on the joints, particularly the ankles and knees, which are crucial during winter activities like walking, shoveling snow, or participating in winter sports. To learn if you can benefit from custom orthotics, you can consult a foot specialist like a chiropodist or a podiatrist. Check out these resources on custom orthotics to learn even more: 5 Ways Orthotics Can Be Customized for Maximum Comfort and Support The Role of Orthotics in Supporting Foot Health and Correcting Alignment Understanding Different Types of Custom Orthotics: How to Choose the Right Support for Your Feet https://www.youtube.com/shorts/IBXAXoUouFY Over-the-Counter Insoles Over-the-counter insoles, like Superfeet, are also a great option to upgrade your winter footwear. Superfeet insoles have a deep heel cup, pronounced arch and a rigid, durable structure. They come in a variety of arch heights and cushioning levels to accommodate many foot conditions, like high arches, flat feet, plantar fasciitis and more! Whereas custom orthotics are custom-designed to your foot, Superfeet come in standard sizes and designs (each representing a different colour). They therefore can be more economical than custom orthotics. If you're interested in Superfeet insoles, bring your winter shoes to our Toronto foot clinic. You can then try different Superfeet options to see which one works best for you. Different insoles feel different in different shoes, so we strongly recommend trying on your Superfeet with your winter shoes before purchasing them.

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