What is a diabetic to do to protect their feet from a sore that can lead to infection and amputation?

1. Inspect your feet daily. If you can’t see your feet, have someone else look at them every day for redness, cuts, swelling, blisters, bruising, or nail problems.

2. Wash your feet daily. Sounds simple, but many people do not bathe their feet daily. Make sure to clean in between your toes and dry them thoroughly.

3. Moisturize your feet daily. Again, a simple habit to get in to, yet most people fail to upkeep their skin every day. Diabetes can cause very dry, flaky skin, so extra moisture is needed.

4. Cut nails very carefully, and straight across. If you can see and reach your toes, be careful to cut your toenails carefully, taking time not to nick yourself or cut them too short. When in doubt, visit the podiatrist at least every 8 to 10 weeks. The podiatrist would rather cut your toenails for you than treat an infection caused by your own handiwork!

5. Never trim corns and calluses. And absolutely no corn or callus remover! The package says, “Do not use if you are diabetic” for a reason. Have the podiatrist trim them when they are thickened or red.

6. Wear clean, dry socks. And change them daily…..sounds simple, but you would not believe how many people don’t.

7. Avoid tight or bulky socks. Tight socks can reduce circulation to you feet and bulky socks can bunch up and cause a blister or sore. Check your socks before you put them on and remember that they do shrink with age. Replace them periodically.

8. Wear socks to bed. If your feet are cold, wear clean socks to bed. Never use a heating pad or hot water bottle, you can burn yourself before you realize it! You can warm the bed with a heating blanket, but turn it off before you go to sleep!

9. Shake out your shoes and inspect them before you put them on. I have taken everything from a pebble, piece of basket and a doll house chair out of the bottom of diabetic feet after they walked on them all day. Easy thing to avoid!

10. Keep your feet clean and dry. No puddle splashing or snow drifts for your feet!

11. Never, never, never go barefoot. Not even at home on carpet. You can step on something easily and get an infected puncture wound. Think tacks, sewing needles, even wiry dog hair can be a problem!

12. Take care of your diabetes! Multiple studies have shown the complications of diabetes can be diminished by keeping your sugars under control. Keep that HgA1c under 6 if you can. This is hard to do by yourself. Work with your doctor and nutritionist for optimal care. Communicate often with your medical team.

13. Don’t Smoke! Stop smoking if you do. Ever cigarette decreases the circulation to your feet and increases your chance of a non-healing wound.

14. Get periodic foot exams. The recommendations are to have a foot exam at least once a year by your doctor even if you have no foot symptioms. A trip to the podiatrist is recommended at least quarterly if you have neurop

The ankle and knee are also involved in the impact of running. Once the foot pronates to accommodate the surface, the ankle is positioned to allow the knee to move the body forward, the heel of the foot becomes the lever that helps in the propelling motion and ends with the toes leaving the ground. If any of these functions are misaligned, one or several painful conditions can develop. One of the most common problems that can have various effects on your feet, knees and ankles is over-pronation. You can tell if a foot over pronates in many cases just by looking at someone’s feet when they’re standing up. If they look like they’re “rolling inward,” chances are, they are overly pronated.

In a normal foot and ankle, there should be a certain degree of flexion, pronation and supination, which are necessary functions in the gait cycle. Excessive pronation is often the culprit in many of these condtions. However, it is not always the case and is sometimes misdiagnosed and often “treated” with custom-made orthotics or motion control shoes. The condition of over-pronation can actually be a lack of range of motion of the ankle, which causes the foot to over-pronate in order to compensate. If the foot and ankle are unable to bend back properly, it keeps the knee from propelling the body forward in correct alignment. The foot will then over-pronate, the knee will drift medially, and the hip will have to excessively rotate. When there is lack of motion somewhere in the body, naturally, another part of the body will compensate, but this will typically be accompanied by pain.

If the root of the problem is the range of ankle motion, and it is misdiagnosed as an over-pronation condition, you might be asking for more trouble. Often times, people will visit their doctor or even a shoe store in an attempt to get a solution to the problem. But without a full and comprehensive evaluation, the solution may come as custom-made orthotics or motion control shoes, which won’t actually solve the problem. In fact, it may exasperate it.

One way to gauge whether or not the over-pronation is caused by your foot or lack of ankle range is to stand with your feet apart about the width of your shoulders. Make sure your feet are pointing straight forward. Try and get into a squatting position with your knees bending at or below a 90-degree angle. The goal is to get into this position while keeping your heels on the ground and without your feet turning inward or outward. If you are unable to get into this position, the problem might be inflexibility in your ankles and not your feet. Before you attempt to correct such a problem, be sure to have a full and complete evaluation by a qualified doctor.

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As we age our muscles and tendons change, you can possibly experience a drop in your arches in your feet. If you are suffering from pain along the bottom of your foot you could be experiencing plantar fascia which is a form of tendonitis and can be very painful in itself.

You will be experiencing terrible pain, especially when you first get out of bed in the morning. As your foot warms up then the pain will slowly go away. Only to return after you have been sitting for an extended period or during the evening when you are resting after your busy day.

There are different ways to deal with the pain and discomfort and different things will be effective for certain people. Many people find that doing calf stretches will help the muscles in your foot, try stretching before you do any major walking or exercise. A good soak can help when you have finished your daily exercise routine. Some people actually experience relief by soaking their feet in cold water with some ice in it.

You will need to experiment to see what works for you and to do this remedy on a regular basis. Once you suffer from plantar fascia, it will always continue to be bothersome to you, so finding a solution will be very beneficial in keeping your feet healthy and pain free.

Other things you can do to keep your feet healthy, is to allow your feet to breathe properly. Wear a good quality pair of shoes with cotton socks and if you choose to wear sandals, again a good quality is imperative. When suffering from chronic foot pain you want to avoid flip-flops as these will tend to hurt your leg tendons more, due to the flipping action as you walk. A good supportive shoe is always recommended when dealing with foot pain.

Soaking your feet in a foot bath and massaging afterwards does wonders for the circulation in your feet. So if you remember to pay special attention to your feet and any discomfort you might feel, the discomfort is a warning before the actual pain comes along! You will then not have to deal with months of pain. Listen to what your feet are telling you!

Paul has been writing articles online for many years now. Spanning a whole range of subjects s

The foot is a complex structure and because of this, many things can go wrong or be negatively affected just by the type of shoes we wear. A woman who spends extended periods of time in high heels can end up with problems like bunions, corns, hammer toes and metatarsalgia. Not just that, but the calf muscle can actually shorten from the unnatural position with most of the body weight forced to the front of the foot. Heels are probably the worst type of shoe for your feet, but if shoes don’t have enough support or cause pain, then those are not good shoes for your feet.

Shoes are meant to protect your feet, not hurt them. Most people will sacrifice some comfort in the name of fashion, but this should not be done on a regular basis, but rather on occasion. Considering the ripple effect foot problems can have on other parts of your body, common sense should tell us to wear comfortable shoes, but there is a chance, that a good number of people don’t realize this, resulting in 75 percent of adults experiencing foot pain or problematic conditions.

Shoes that cause discomfort can result in ongoing problems in different parts of the foot including the ball, the heel and the arch. Many painful foot conditions can be remedied simply by wearing well-fitting, comfortable shoes. One of the problems is that not everyone knows what well-fitting shoes are. People have gotten so used to foot pain, that they believe that it’s normal. The truth is; the right pair of shoes should allow you to stand and walk comfortably for extended periods, unless you are already suffering from a painful condition.

One look at the wide variety of foot products in a pharmacy should tell you that a lot of people are suffering from foot pain. Everything from metatarsal pads, to cushioned insoles to gel heel cups are made to relieve some type of painful foot condition. A comfortable pair of sneakers is probably the best you can do for your feet. However, not everyone is able to wear these kinds of shoes to work or every day, but there are plenty of options on the market that would be suitable in a work environment that would still allow your feet the comfort they deserve.

What to look for? You want a pair of shoes that will allow your feet to be in a natural position including a little bit of wiggle room for your toes. There should be good arch support, especially if you suffer from flat feet. The fit should be comfortable and if you h

Foot cleanliness is an important part of keeping the body clean. Anyone who has ever walked barefoot can relate to that when the soles of the feet become soiled. However, even those who wear shoes all the time are still at risk for ‘soiling’ of the feet. This soiling comes not from dirt but from the natural shedding of the skin, combined with sweat residue, sock lint, or shoe debris if one does not wear socks. All of this material provides a good platform upon which bacteria and fungus can accumulate, and eventually this can cause skin infections. The most common infection seen in the skin is that from a fungus.

This infection is commonly called Athlete’s foot, and millions of humans (if not nearly all) suffer from this condition from time to time. While this condition is easily treated, the long term presence of fungus can distract the skin’s immune system and lead to the sneaking in of bacteria into the cracks and skin ripples that are found in Athlete’s foot. Bacteria is also present in soil and on walking surfaces exposed to other bacteria (like in kitchens and baths), and barefoot walking can potentially expose the skin to these organisms. Bacterial infections are not as benign as Athlete’s foot, and can enter the skin and spread up the foot into the body. For diabetics and others whose immune system is not as strong, these infections can pose a serious risk to the health of the foot and leg, and occasionally they result in an amputation if the infection is serious enough.

By washing the foot, especially in between the toes, the debris and soil that fungus and bacteria accumulates on is removed, and the skin is left with a healthy top surface. Vigorous scrubbing is not necessary, and can lead to skin irritation if one is too aggressive. Careful removal of soap residue is needed, as is the careful drying of the foot and toes to prevent skin irritation from lengthy water exposure.

Another important aspect of good foot hygiene is to keep the feet well moisturized. From time to time, especially in the winter, the foot skin will dry out. For some, this is a result of genetics or diseases which reduce the moisturization of the skin. With drier skin comes more cracks and crevasses that bacteria and fungus can use to enter the skin. Dry skin can also potentially painful cracks so deep that a wound develops. The practice of soaking the foot to either make it moister or to remove fungus or bacteria only makes this worse, as soaking depletes the skin of vital oils that help keep it moist. Some bacteria also thrive in foot baths, and frequent soaking can sometimes cause infections. The daily application of a good moisturizing cream to the feet can keep the skin moist and its surface smooth. It is important not to place the moisturizing cream in between the toes, as this area is at risk for fungus development that can also follow overly moist toe spaces.

Toenails are often ignored when foot hygiene is taken into consideration. Like every other part of the foot, the toenails need care and maintenance to prevent problems from developing. Nails that are too long are at greater risk of breaking off when the toe is stubbed. This can lead to pain, inflammation, and possibly infection of the skin around the nail itself. Nail damage can also lead to the introduction of fungus under the nail itself. The nail will become discolored, thickened, and misshapen from this infection. It is treatable, but a nail fungus infection requires a lot of time for eradication. Keeping the nails short can prevent some of this nail injury by reducing the likelihood of the nail lifting up during an injury event. In turn, this can reduce the chance that a nail fungus will develop. Although generally benign, nail fungus is still a chronic infection and should be avoided. However, not all changes to a nail’s color or appearance is simply a fungus. Any color change in a toenail should be evaluated by a foot specialist or dermatologist, as some skin cancers or body-wide disease appear as changes to a toenail.

When trimming nails, care must be taken not to cut too deep into the skin sides. The reason for this involves ingrown nails. Ingrown nails develop as a result of genetics or gradual pressure injury to a nail. Contrary to popular belief, they are not caused by cutting the nail, as the nail grows from the deep end of the toe, which is not affected by the way it is cut. However, by cutting the nail too short into the side of the skin, one irritates the skin. A reaction then develops which causes skin inflammation. The inflamed skin becomes irritated against the ingrown nail that did not previously bother it, and pain subsequently is felt. Infection can follow as bacteria becomes trapped within the swollen skin border. While this condition is easily and permanently treated in-office by a foot specialist, avoiding it by trimming the nails without cutting into the skin may be an easier option.

Properly fitting shoes are another consideration in foot hygiene. Shoes are worn for many reasons, although the basic reason for shoes is to protect the feet from the ground. This protection is at risk when one wears poorly fitting shoes simply for fashion or convenience. Shoes that are too tight, too narrow, or too shallow will cause skin irritation to occur where the shoe rubs the skin. If the irritated area is over a prominent bone, such as on the toes or sides of the foot, the skin may start a process to protect itself. This process leads to the formation of corns and calluses, which is simply a thickening of the top layer of the skin created to protect the skin. Corns and calluses can cause pain, and in some cases (especially in diabetics and the elderly) can lead to the development of wounds underneath them. By reducing the shoe pressure on the skin through the use of a properly sized and fitted shoe, the development of corns and calluses can be slowed or even eliminated.

When a shoe is worn that is too big for the foot, the foot will move and piston within the shoe during walking. This ultimately can lead to toenail bruising as well as foot pain. When purchasing shoes, one’s foot should be measured by a knowledgeable shoe clerk and the shoe fitted to that size, considering length AND width. A foot’s width is often ignored when purchasing shoes, especially given that many retailers have scaled back the selection of different widths in stock. In the long run, purchasing shoes at a quality shoe store that carries many widths is better that the convenience of a discount retailer that has more styles but less sizing variations. The style of the shoe needs to be considered as well. Someone with a wide foot due to bunions and flat feet should not be in a tight pair of pointed flats. Unfortunately, many people stubbornly refuse to change shoe types out of concern for fashion or the inability to change old habits.

As one can see, the importance of foot hygiene involves much more that just the act of keeping the foot free from dirt and odor. Keeping the skin and nails healthy prevents the development of infections, and keeping the skin smooth and comfortable prevents the development of painful lesions that can limit activity and the enjoyment of life. Making time for the foot during daily body care can pay off in a big way over the long run.

Dr. Kilberg provides compassionate and complete foot and ankle care to adults and children in the Indianapolis area