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March 2022

Diabetes can affect foot health and cause peripheral neuropathy, a condition where the central nervous system is damaged and signals from the brain to one’s feet do not work properly. This can cause inflammation and lead to numbness, tingling, and increased sensitivity in the feet, as well as more severe problems like foot ulcers and infections. Changes in lifestyle and diet can help keep blood sugar and weight in a target range that will help prevent nerve damage and neuropathy. Following diabetic food guidelines and eating at regular intervals are key to controlling diabetes and side effects like peripheral neuropathy from developing. It is also important to check your feet frequently to look for cuts, swelling, or other abnormalities. Having your feet checked regularly by a podiatrist when you have diabetes can help you stay on top of your foot health and prevent more serious complications from developing.

 

Diabetic foot care is important in preventing foot ailments such as ulcers. If you are suffering from diabetes or have any other concerns about your feet, contact Dr. Gary Cesar from Michigan Foot and Ankle Center. Our doctor can provide the care you need to keep you pain-free and on your feet.

Diabetic Foot Care

Diabetes affects millions of people every year. The condition can damage blood vessels in many parts of the body, especially the feet. Because of this, taking care of your feet is essential if you have diabetes, and having a podiatrist help monitor your foot health is highly recommended.

The Importance of Caring for Your Feet

  • Routinely inspect your feet for bruises or sores.
  • Wear socks that fit your feet comfortably.
  • Wear comfortable shoes that provide adequate support.

Patients with diabetes should have their doctor monitor their blood levels, as blood sugar levels play such a huge role in diabetic care. Monitoring these levels on a regular basis is highly advised.

It is always best to inform your healthcare professional of any concerns you may have regarding your feet, especially for diabetic patients. Early treatment and routine foot examinations are keys to maintaining proper health, especially because severe complications can arise if proper treatment is not applied.

If you have any questions please feel free to contact our offices located in Lansing and Mt. Pleasant, MI . We offer the newest diagnostic and treatment technologies for all your foot and ankle needs.

Read more about Diabetic Foot Conditions
Tuesday, 29 March 2022 00:00

Diabetic Foot Conditions

According to the American Diabetes Association (ADA), diabetes is a condition that affects approximately 23.6 million Americans.  Around 750,000 new cases are diagnosed each year, and the disease’s most common form, Type 2 diabetes, makes up for 90 to 95 percent of these cases.  Type 2 diabetes is especially prevalent among older Americans, those who are obese, and those who lead sedentary lifestyles.

Complications of the disease may lead to several foot and ankle-related conditions.  The loss of nerve sensation, or neuropathy, can cause diabetics to lose feeling at the bottom of the feet and therefore leave them unaware of pain, pressure, and heat.  Decreased circulation is another complication of diabetes that can slow down the healing of wounds and injuries; this can lead to the development of foot ulcers.

To prevent foot ulcers from forming, diabetics should examine their feet every day for small cuts and wear shoes that curtail pressure.  Constant monitoring for the risk factors associated with ulcer formation can allow for early detection and therefore lessen the possibility of ulcers or, even worse, amputation.  The removal of calluses and ingrown toenails should be left to the podiatrist to avoid improper removal and possible infection.

Diabetic patients may also experience foot deformities due to complications in their feet, such as limited joint mobility, muscle atrophy, and decreased fat padding.  These complications can increase pressure in certain areas of the foot, which in turn can cause certain deformities, such as hammertoe, to form.  Another deformity, Charcot foot, develops due to the collapsing of microfractures in the bones of the feet.  The resulting deformity is a foot that is flattened and wider in appearance.

To help minimize pressure and prevent the development of these diabetes-related foot and ankle conditions, your podiatrist may consider using orthotics or special shoes.  Charcot foot may be treated using walkers, custom orthotic insoles, or non-weight-bearing or rigid weight-bearing casts or braces.  In more serious cases, surgery may be considered to treat more developed deformities.  Ulcers can be further cared for with the help of proper diet, medication to control glucose, intensive wound care, and infection treatment.

Tuesday, 22 March 2022 00:00

Vascular Testing in Podiatry

In foot care, vascular testing may be required in the diagnosing and treatment of certain podiatric conditions. Vascular testing is particularly relevant for patients with high-risk diabetes, poor circulation, peripheral artery disease (PAD), and chronic venous insufficiency (CVI). Procedures typically involve the examination of blood vessels throughout the body for blockages or buildup.

Vascular testing is very important for the diagnosis of various conditions, including peripheral artery disease and chronic venous insufficiency, as these conditions can greatly affect one’s quality of life and cause pain in the lower limbs. Circulatory problems in the feet and ankles can reflect issues throughout the body, making testing of the blood vessels pertinent.

Testing methods vary between practitioners and can be specific to certain foot and ankle problems. Modern technology has brought about the ability to perform vascular testing using non-invasive methods, such as the cuff-based PADnet testing device. This device records the Ankle-Brachial Index (ABI)/Toe-Brachial Index (TBI) values and Pulse Volume Recording (PVR) waveforms. Contact your podiatrist to determine what vascular testing is available for your needs.

If your podiatrist suspects that you may have peripheral artery disease (PAD), they will most likely perform a vascular test called a duplex ultrasound. Duplex ultrasound uses two modes of ultrasound: 1) traditional ultrasound to create images of your blood vessels based on sound waves bouncing off them, and 2) doppler ultrasound to estimate the speed and direction of blood by recording sound waves that reflect off it as it flows. Duplex ultrasound is non-invasive and painless. Your podiatrist will spread gel on the skin of the area(s) to be tested, and then wave a transducer wand which emits the sound waves and records the echoes that are reflected. For more information about duplex ultrasound, ask your podiatrist.

Vascular testing plays an important part in diagnosing disease like peripheral artery disease. If you have symptoms of peripheral artery disease, or diabetes, consult with Dr. Gary Cesar from Michigan Foot and Ankle Center. Our doctor will assess your condition and provide you with quality foot and ankle treatment.

What Is Vascular Testing?

Vascular testing checks for how well blood circulation is in the veins and arteries. This is most often done to determine and treat a patient for peripheral artery disease (PAD), stroke, and aneurysms. Podiatrists utilize vascular testing when a patient has symptoms of PAD or if they believe they might. If a patient has diabetes, a podiatrist may determine a vascular test to be prudent to check for poor blood circulation.

How Is it Conducted?

Most forms of vascular testing are non-invasive. Podiatrists will first conduct a visual inspection for any wounds, discoloration, and any abnormal signs prior to a vascular test.

 The most common tests include:

  • Ankle-Brachial Index (ABI) examination
  • Doppler examination
  • Pedal pulses

These tests are safe, painless, and easy to do. Once finished, the podiatrist can then provide a diagnosis and the best course for treatment.

If you have any questions, please feel free to contact our offices located in Lansing and Mt. Pleasant, MI . We offer the newest diagnostic and treatment technologies for all your foot care needs.

 

Read more about Vascular Testing in Podiatry
Tuesday, 15 March 2022 00:00

Treatments for Sever’s Disease

Sever’s disease, despite its name, is actually an injury. Common in active children between the ages of 8 and 14, Sever’s disease refers to the inflammation of the growth plates in a child’s heels. This causes heel pain that can make walking, running, and jumping difficult. Sever’s disease is treated conservatively, through simple and noninvasive methods. If your child has Sever’s disease, they should rest their injured foot as much as possible, limiting any high impact activities that can put pressure on the foot. Inflammation can be reduced by applying ice to the injured heel and taking non-steroidal anti-inflammatory medications. Stretching the calves gently can help increase flexibility and improve recovery. You can protect the heel by wearing comfortable shoes ,or orthotics, and resume normal activities slowly and carefully to avoid re-injury. For more information, please consult with a podiatrist.

Sever's disease often occurs in children and teens. If your child is experiencing foot or ankle pain, see Dr. Gary Cesar from Michigan Foot and Ankle Center. Our doctor can treat your child’s foot and ankle needs.

Sever’s Disease

Sever’s disease is also known as calcaneal apophysitis, which is a medical condition that causes heel pain I none or both feet. The disease is known to affect children between the ages of 8 and 14.

Sever’s disease occurs when part of the child’s heel known as the growth plate (calcaneal epiphysis) is attached to the Achilles tendon. This area can suffer injury when the muscles and tendons of the growing foot do not keep pace with bone growth. Therefore, the constant pain which one experiences at the back of the heel will make the child unable to put any weight on the heel. The child is then forced to walk on their toes.

Symptoms

Acute pain – Pain associated with Sever’s disease is usually felt in the heel when the child engages in physical activity such as walking, jumping and or running.

Highly active – Children who are very active are among the most susceptible in experiencing Sever’s disease, because of the stress and tension placed on their feet.

If you have any questions, please feel free to contact our offices located in Lansing and Mt. Pleasant, MI . We offer the newest diagnostic and treatment technologies for all your foot and ankle injuries.

Read more about Sever's Disease
Tuesday, 15 March 2022 00:00

Sever's Disease

Sever's disease, also known as calcaneal apophysitis, is a medical condition that causes heel pain in children’s feet while they’re growing. Sever's disease occurs most commonly in boys and girls between the ages of 8 and 14.

Sever's disease occurs when the child’s growth plate, or the calcaneal epiphysis, an area attached to the Achilles tendon, is injured or when the muscles and tendons of the growing foot do not keep pace with bone growth. The result is constant pain experienced at the back of the heel and the inability to put any weight on the heel. This forces the child to bear weight on their toes while walking. When a toe gait develops, the child must change the way they walk to avoid placing weight on the painful heel. If this is not properly addressed, this can lead to further developmental problems.

The most common symptom of Sever's disease is acute pain felt in the heel when a child engages in physical activity such as walking, jumping or running. Children who are active athletes are among the group most susceptible to experiencing Sever's disease. This is due to the extreme stress and tension placed on their growing feet. The rolling movement of the foot during walking or running and obesity are both additional conditions linked to causing Sever's disease.

The first step in treating Sever's disease is to rest the foot and leg and avoid physical activity. Over the counter pain-relieving and anti-inflammatory medications can be helpful for reducing the amount of heel pain. A child with Sever's disease should also wear shoes that properly support the heel and the arch of the foot. Consider purchasing orthotic shoe inserts which can help support the heel and foot while it is healing. Most patients with Sever's disease symptoms report an eventual elimination of heel pain after wearing orthotic insoles that support the affected heel.

Sever's disease may affect either one heel or both. It is important for a child experiencing heel pain to be examined by a foot doctor who can apply the squeeze test. The squeeze test compresses both sides of the heel in order to determine if there is intense pain. Discourage any child diagnosed with Sever's disease from going barefoot as this can intensify the problem. Apply ice packs to the affected painful heel two or three times a day for pain relief.

Exercises that help stretch the calf muscles and hamstrings are effective at treating Sever's disease. An exercise known as foot curling has also proven to be very effective at treating Sever's disease. When foot curling, the foot is pointed away from the body, then curled toward the body to help stretch the muscles. The curling exercise should be done in sets of 10 or 20 repetitions and repeated several times throughout the day.

Treatment methods can continue for at least 2 weeks and as long as 2 months before the heel pain completely disappears. A child can continue doing daily stretching exercises for the legs and feet to prevent Sever’s disease from returning.

Wednesday, 09 March 2022 00:00

Are You Suffering From Ingrown Toenails?

If left untreated, an ingrown toenail can lead to more serious concerns, such as an infection. Knowing proper nail care can help in the prevention of an ingrown toenail. Give us a call, and get treated!

Stress fractures are small breaks in the bone that are caused by repetitive stress. They typically occur due to overuse, forcing the bones of the foot or ankle to continually absorb the full impact of each step taken. Stress fractures can also be caused by abnormal foot structure, osteoporosis, bone deformities, or wearing improper footwear during exercise.

Stress fractures are common for individuals whose daily activities cause high levels of impact on their feet and ankles. Those who run, play tennis or basketball, or practice gymnastics tend to experience these fractures more frequently. Anyone is susceptible to this problem, though. Individuals who are normally sedentary and suddenly begin an intense, high impact workout may sustain stress fractures. This is because their muscles are not yet strong enough to handle and cushion the intensity of their activity. Osteoporosis may also cause someone to get stress fractures, because the disease weakens an afflicted person's bones and makes it easier for them to break down.

Pain from stress fractures typically occurs in the general area of the fracture. Pain can also manifest as “pinpoint pain” or pain that is felt when the site of the injury is touched, and can be accompanied by swelling. It may occur during or after activity, and it may disappear while resting and return when standing or moving. Engaging in any kind of activity, high impact or otherwise, will aggravate the pain. If the intensity of the activity increases before the stress fracture has properly healed, it can cause a full fracture.

Treatment can vary depending on the individual and the degree of injury. The primary way to treat a stress fracture is to rest the hurt foot. Some fractures will heal quickly with only a little bit of rest, while others may require a long rest period and the use of crutches, immobilization, or physical therapy. Under certain circumstances, surgery may be required to install support pins around the fracture to assist in healing.

If you are undergoing a new exercise regimen in running or some other kind of high impact activity, set incremental goals on a weekly basis so you can build up muscle strength. Make sure to wear supportive shoes to better protect you feet.

If you begin to experience any symptoms of stress fractures, you should stop exercising and rest. If the symptoms persist, consult with your podiatrist. Remembering these tips can help you prevent stress fractures to your foot and ankle, and allow you to continue living normally.

Tuesday, 08 March 2022 00:00

What Is a Navicular Stress Fracture?

One of the foot’s 26 bones is called the navicular bone, which sits just in front of the ankle on the top of your foot. A stress fracture of the navicular bone is commonly the result of explosive and repetitive action of the feet, especially during running fast or jumping. During activity, the navicular bone may be squeezed between the two bones in front of and in back of it, causing stress. Symptoms of a navicular stress fracture are an ache in the midfoot area, including the inside of the arch, and pain if you press on the bone. This discomfort may subside once activity is stopped and the foot rests, but is likely to recur when the action starts again. If you have pain when flexing your foot upward, you may have a navicular fracture. A visit to a podiatrist for diagnostic imaging tests is a good idea. Treatment options, depending on the severity of the injury, include a walking splint, a full cast, or surgery. 

Activities where too much pressure is put on the feet can cause stress fractures. To learn more, contact Dr. Gary Cesar from Michigan Foot and Ankle Center. Our doctor can provide the care you need to keep your pain free and on your feet.

Dealing with Stress Fractures of the Foot and Ankle

Stress fractures occur in the foot and ankle when muscles in these areas weaken from too much or too little use.  The feet and ankles then lose support when walking or running from the impact of the ground. Since there is no protection, the bones receive the full impact of each step. Stress on the feet can cause cracks to form in the bones, thus creating stress fractures.

What Are Stress Fractures?

Stress fractures occur frequently in individuals whose daily activities cause great impact on the feet and ankles. Stress factors are most common among:

  • Runners                                  
  • People affected with Osteoporosis
  • Tennis or basketball players
  • Gymnasts
  • High impact workouts

Symptoms

Pain from the fractures occur in the area of the fractures and can be constant or intermittent. It will often cause sharp or dull pain with swelling and tenderness. Engaging in any kind of activity which involves high impact will aggravate pain.

If you have any questions please feel free to contact our offices located in Lansing and Mt. Pleasant, MI . We offer the newest diagnostic and treatment technologies for all your foot and ankle needs.

Read more about Dealing with Stress Fractures of the Foot and Ankle
Tuesday, 01 March 2022 00:00

Sesamoiditis

Sesamoiditis is a condition that affects the joint that is just behind the big toe in the area known as the ball of the foot. It is most common in younger people and people who have just begun an exercise program. Since the sesamoid bones are like a pulley controlling the big toe, they can rub against each other and cause a gradual onset of pain. Pain may also be caused by the inflammation of tendons surrounding the bones. If ignored, sesamoiditis can lead to other, more serious problems such as severe irritation and fractures of the bones.

The cause of sesamoiditis is sudden increase in activity. The ball of your foot acts as a springboard to help you lift off when you are jogging or running. Sudden increase in the use of these bones or the tendon that controls them can cause irritation. The tendon then begins to develop inflammation and the joint begins to swell. People with smaller, bonier feet or those with a high arch are typically more susceptible to this condition.

Sesamoiditis is fairly simple to diagnose since the symptoms have a gradual onset rather than a sudden impact. The symptoms begin with slight irritation around the joint shortly after the increase in activity. The discomfort eventually turns to pain with light swelling and possibly redness. Although redness or bruising are rare, this may be a symptom. After each session of exercising, the aggravated joint becomes more irritated and increases into a very intense throbbing.

Treatment for sesamoiditis can vary depending on the severity of the situation. However, treatment is almost always approached in a noninvasive way. For a case that is just beginning the doctor may recommend a very strict rest period that will limit the activity allowed on the joint. If you must be active, a recommendation for as modified shoe or insole, along with bandaging and immobilizing the big toe will be made to ensure that pressure is not placed on the joint. For severe cases, it is typically recommended that the joint and the big toe be completely immobilized to allow adequate time to heal. Ice and an over the counter anti-inflammatory may can help with the pain and discomfort while you are at rest.

When you return to your regular exercise activities, it is recommended that you use an insole that will allow even distribution of impact to your entire foot, rather than just the balls of your foot. This will prevent further aggravation of the injury.

 

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