Archive for March, 2010
Diabetic shoes for diabetic feet in Nacogdoches and Carthage Texas
Posted by: | CommentsThe diabetic shoe bill provided through Medicare is a great program. This bill provides diabetic patients on Medicare an opportunity to get one pair of shoes and three sets of inserts annually. Like all Medicare programs, there are abuses of this coverage by providers, suppliers and patients but overall I find it rewarding to prevent future severe foot complications in situations where the shoes are needed. Not all patients qualify for the shoe bill. Diabetic patients who have diabetes with peripheral vascular disease, neuropathy, a history of amputation or many variances from these basic qualifiers are allowed to participate. My blog today is not so much about the program’s operations but more about the shoes provided.
The primary purpose of the program is to provide shoes that reduce pressures on the foot and therefore reduce the risk of ulcerations that often times lead to infections and amputations. In my book, this is a worthy goal. However, if I am allowed to rant a bit today, I feel that too often diabetic shoes are made so soft and “squishy” (lol) that patients begin to have additional problems with their feet. Particularly those patients who happen to have the qualifying conditions to get the shoes but are still very active. It is almost like walking around on pillows all day or spending many hour walking the beach barefoot.
Our feet need some help. Particularly when they have spent a lifetime in a supportive environment such a good leather lace-up shoe with an arch support or when arthritis has begun to show itself. To take that foot, and then one day put it in a soft foam-like upper with a heat mold-able plastic insole (plastazote) gives the foot little help and leads to fatigue, contracture of the lesser toes trying to stabilize the foot and can ultimately increase pressure in some spots.
My request for each of you considering diabetic shoes is to make sure they are as supportive as possible considering your foot condition and as functional as possible considering your activity level. If you are active it is very likely you will need additional arch support in your new shoes and not just cushions! I’m talking about semi-rigid plastic, cork, felt and many other material options that will help you propel more efficiently and reduce stress and strain.
Be sure to find an expert in diabetic shoes and ask questions about the shoes that are being made for you because they should help your foot situation…not make it worse.
Plantar Fibroma – Bump on the Bottom of the Foot
Posted by: | CommentsSince so many people suffer with plantar fasciitis many people have heard of the plantar fascia. I like to describe it as the support for our arch and it is fairly prominent along the bottom of the foot when we lift the big toe (hallux). Today I write about a fibrous lesion of the plantar fascia that can spontaneously form but is often associated with an injury. Most patients present to my podiatry practice simply stating that there is a new bump on the bottom of their foot.
Plantar fibromas are benign tissue tumors or growths on the plantar, or bottom surface of the foot. Unlike plantar warts, which grow on the skin, these grow deep inside on a thick fibrous band of ligaments, called the plantar fascia. The presence of the tumor can cause pain or pressure on other parts of the foot structure that can lead to other foot problems.
Nonsurgical measures used in treating plantar fibromas often fail to provide adequate relief of symptoms. However, there is a new approach using topical Verapamil that I find very interesting. At the same time, surgical correction can lead to further complications, such as plantar nerve entrapment or larger and recurrent fibromas that may be worse than the original problem.
Therefore, in my practice we take the conservative approach first and try to support the foot without irritating the fibroma itself. “Bumps” on the bottom of the foot are not normal and should be properly diagnosed and addressed. Hopefully, this post eases concerns that surgery is the only option. Let’s talk about it!
Nacogdoches Podiatrist Installs New Header Photos in Blog
Posted by: | CommentsJust a quick note. I have added some new photos in the header just to jazz things up. These are from some family vacations and I’m sure I’ll add pictures as I go. When our new grandson was born, I realized I needed a new camera and with that I got a new hobby! I hope you enjoy them. Thanks!
More Fun Foot Facts from Mark E. Sowell, DPM
Posted by: | CommentsMore Fun Foot Facts:
The American Podiatric Medical Association says the average person takes 8,000 to 10,000 steps a day. Those cover several miles, and they all add up to about 115,000 miles in a lifetime—more than four times the circumference of the globe.
There are times when you’re walking that the pressure on your feet exceeds your body weight, and when you’re running, it can be three or four times your weight.
Foot Pain is Not Normal – Basic Footcare Guide – Sowell Podiatry
Posted by: | CommentsBasic footcare guidelines:
Heel Pain in the Young Athlete – Sowell Podiatry – Nacogdoches
Posted by: | CommentsEvery year I see a dozen, or so, young athletes that are having problems when playing. Typically they are running on their toes to avoid heel pressure and play explosive sports with increased heel pressures. Of course these children need to be assessed and properly diagnosed to rule out more severe conditions, but I want to discuss calcaneal apophysitis today as spring begins!
We can often learn a good deal about a particular medical condition if we understand the terminology used in its description. The term, calcaneal, refers to the heel bone while apophysitis describes an inflammation of the heel’s growth center in a child. A calcaneal apophysitis is a condition usually seen in young athletic or physically active children of the age group 8-15. The heel is painful with running or jumping, is usually not swollen visually or discolored, and seems to get progressively worse without treatment. A parent will often bring in a child because of limping during game play along with complaints by the child of discomfort in and around the heel.
Most authorities seem to agree that this condition results from acute or chronic (repetitive) trauma to the heel at a time of vulnerability due to natural growth periods. It should be noted that the heel area of the foot is under normal circumstances, not highly vascularized or well supplied by blood circulation. This means that the area of the foot will heal slower and might be subject to increased risk of injury. Acute trauma refers to a sudden impact or blow to the involved site while repetitive trauma involves cumulative stress over an extended period of time. The bottom line is similar however, with trauma to the growth plate area of the heel being the culprit.
The management of a calcaneal apophysitis condition involves protection and support of the heel in order to allow for normal developmental growth. This can be accomplished by padding the heel of the shoe, wearing protective cups, and in some cases to even further reduce weight-bearing by casting and or crutches. Often I’ll recommend alternating NSAIDs and applying ice before and after activity. The continuance of athletic competition during treatment is an issue that is largely dependent upon how the child responds to therapy initially. In most cases, where the symptoms reduce early on with treatment, the child might continue with physical activity. On the other hand, if the symptoms persist well into the therapy period, then reducing or eliminating continued physical activity might be necessary. This condition in most cases, can be readily managed once identified and properly treated and almost always resolves over time.
