Rare Diabetes Foot Complication Becoming More Common

Few people with diabetes know about the limb-threatening foot condition, or its warning signs

As diabetes rates soar nationwide, a rare diabetic foot complication is becoming more prevelant. This condition is called Charcot foot (pronounced SHAR-co). This condition involves a sudden softening of the foot’s bones which can trigger an avalanche of problems, including joint loss, fractures, collapse of the arch, massive deformity, ulcers, amputation and even death.

As the foot’s structure collapses, the bottom of the foot can become convex, bulging like the hull of a ship. But diabeteic patients frequently do not feel any pain because they have severe nerve damage in their lower extremities and do not feel these changes occurring.

Every person with diabetes should know the Charcot foot warning signs: A red, hot, swollen foot or ankle. Several other dangerous conditions, such as deep vein thrombosis and acute infections, share these symptoms. A red, hot, swollen foot or ankle requires emergency medical care.

The American College of Foot and Ankle Surgeons (ACFAS) estimates less than one percent of people with diabetes develop Charcot foot. But nationwide, the College’s 6,000 members say they’re noticing more Charcot cases as more Americans develop diabetes.

Charcot cannot be reversed, but its destructive effects can be stopped if the condition is detected early. People with diabetes play a vital role in preventing Charcot foot and its complications. Diabetes patients should keep blood sugar levels under control. This has been shown to reduce the progression of nerve damage in the feet. People with diabetes should also inspect both of their feet every day, and get regular check-ups from a foot and ankle surgeon.

For more information on Charcot foot and other diabetic foot conditions, visit the ACFAS consumer Web site, FootHealthFacts.org or contact my office at 440-946-5858.

Achilles Tendon Surgery Helps Prevent Diabetic Foot Ulcers

Diabetic patients frustrated by hard-to-heal, infection-prone ulcers on their feet could benefit from a common, minimally invasive surgical procedure to relieve tightness in their Achilles tendons.

The Achilles is the largest tendon in the human body, connecting the calf muscles to the heel bone. As we age, the tendon naturally tightens. However, diabetes exacerbates the process as increased blood sugar levels deposit glucose in the collagen of the tendon, greatly reducing its elasticity and making stretching almost impossible.

A tight Achilles inhibits ankle movement, forcing diabetic patients to place excessive pressure on the front of the foot. Pressure normally absorbed by the ankle has to go somewhere else and the forefoot gets most of it, heightening the risk for ulcer development underneath the toe joints.

Foot sores or ulcers are a common complication of diabetes. They result from sensation loss or neuropathy, which deprives diabetes patients of their ability to feel pressure or pain in the lower extremities. Therefore, even the slightest cut, blister or wound can develop into a diabetic foot ulcer. Such wounds can cause tissue and bone infections and can result in loss of a toe, a foot, a leg or even a life.

Published research has shown that surgery to lengthen the Achilles tendon in a diabetes patient can help prevent ulcer recurrence.

Lengthening occurs by making three small, pinpoint cuts to loosen and stretch the tendon. This helps restore ankle flexibility and relieves forefoot pressure. The procedure allows diabetes patients who keep their blood sugar under control to walk more normally and may lower their risk for redeveloping foot ulcers.

For further information about diabetic foot conditions, please contact our office for a consultation, 440-946-5858.

Old ankle sprains come back to haunt Baby Boomers

Many Boomers who have suffered ankle sprains in their younger years could be at risk for more serious damage as they age and try to stay active. It is estimated that one in four sports injuries involves the foot or ankle, and a majority of them occur from incomplete rehabilitation of an earlier injury.

Pain is not normal in the ankle, even if you're just getting back into shape.

Swelling is another symptom these previously-injured Boomers may experience. Both amateur and professional athletes often mis-understand how serious a sprain can be, and they rush back into action without taking time to rehabilitate the injury properly.

A sprain that happened years ago can leave residual weakness that isn’t noticed in normal daily activity, but subjecting the ankle to rigorous physical activity can further damage improperly healed ligaments, and cause persistent pain and swelling. Anyone hoping to regain past athletic fitness, it’s recommended that you have that old ankle injury checked out before becoming active once again.

Some sprains are severe enough to strain or tear the tendons on the outside of the ankle, called the peroneal tendons. Research shows that more than 85 percent of athletes who had surgery to repair a torn peroneal tendon were able to return to full sporting activity within three months after the procedure.

Peroneal tendon tears are an overlooked cause of lateral ankle pain. Although surgery for athletically active patients shouldn’t be taken lightly, surgical repair of the peroneal tendons is proving to be very successful in helping athletes with serious ankle problems return to full activity.

Persistent pain and tenderness after a sprain, especially if the individual felt a ‘pop’ on the outside of the ankle and couldn’t stand tiptoe, might be a warning sign that the tendon is torn or split. The injury is best diagnosed with an MRI exam.

If you or someone you know is in need of further information or an evaluation of the foot/ankle, plese call our office, 440-946-5858, we are here to help.

Surgical Procedure Can Correct Crossover Toe, Keep Seniors Active

Crossover toe is a common foot problem that can inhibit physical activity for older Americans, but out-patient surgery can correct the deformity and keep senior citizens active and on their feet.

Individuals with hammertoes, bunions or a second toe that extends beyond the big toe are most susceptible to developing crossover toe as they age.

It’s a common problem among older people in which the second toe gradually moves across the big toe. It can be painful and, therefore, difficult to walk comfortably or pursue an active lifestyle.

The first symptom of crossover toe is pain in the ball of the foot. A tear in the joint makes the second toe unstable. It falls out of alignment and eventually drifts.

Doctors normally check the ball of the foot for a possible plantar-plate tear when an older patient complains of pain in the area. Pre-existing forefoot problems combined with normal wear and tear or possible trauma can cause the plate to tear over time.

If the pain persists and the toe starts to drift, surgery is recommended to suture the plantar plate or replace it through a tendon-transfer.

Surgery to correct crossover toe is an outpatient procedure performed with a local anesthesia. Patients with bunions or hammertoes are advised to have those deformities corrected during the surgery. Recovery time is about six weeks.

If you're an older adult with persistent pain in the ball of your foot, it's in your best interest to see a doctor, therefore give our office a call to set-up a consultation.

Heel Pain in Youth Athletes: A Warning Sign

Indoors and outdoors, youth athletes stay active year-round in competitive sports, and for many of them heel pain has become “just another part of the game,” however heel pain, should be diagnosed promptly because it may be a warning sign of a serious foot problem.

Heel pain occurs frequently in children ages 6 to 14 as their feet grow and the heel bone develops. As children become more active in sports they increase their risk for growth-plate injuries and subsequent heel pain. This is especially true at back-to-school time when surgeons see an increase in middle and high school athletes experiencing heel pain with football and soccer seasons simultaneously underway.

New bone forms in an area behind the heel, known as the growth plate, and cartilage is vulnerable to severe inflammation from strain or stress. With repeated stresses and strains from overactivity, the heel becomes very painful.

Even though growth-plate trauma is the leading cause of heel pain in young people, this condition can be difficult to diagnose. Parents should be concerned if a child has pain in the back or bottom of the heel, limps, walks on the toes, or seems to have difficulty participating in normal recreational activities. This condition is diagnosed via a thorough examination of the child’s feet and legs and possibly medical imaging tests to rule out other serious causes of heel pain, such as bursitis, tendonitis and/or fractures.

In most cases, mild or moderate heel pain can be treated successfully with shoe inserts to soften the impact on the heel, anti-inflammatory medications, stretching and physical therapy. In severe cases, the foot and ankle will be immobilized in a cast and, in some instances, surgery may be necessary.

If your child is experiencing heel or foot pain, please call our office to set-up a consultation, 440-946-5858, to allow your child to play with no pain.

Back to School Shoe Shopping

The sounds of school bells, slamming locker doors and students clammering into classrooms are being heard once again. With the start of a new school year, parents are eagerly seeking a wide array of school supplies and new fashions for their children. One of the most important purchases on a parent’s back to school shopping list is a new pair of shoes. With the numerous styles and fashions of shoes, several important factors must be considered:

-Children’s feet change with age: Shoe and sock sizes may change every few months as a child’s feet grow.
-Never hand down foot wear: Just because a shoe size fits one child comfortably does not mean it will fill another the same way. Also, sharing shoes can spread athlete’s foot and nail fungus infections.
-Examine the heels of your child’s shoe. Children may wear through the heels of shoes quicker than out-growing shoes themselves. Uneven heel wear can indicate a foot problem that should be evaluated by a foot/ankle physician.
-Shoes that do not fit properly can aggravate the feet: Always measure a child’s feet before buying shoes and watch for signs of irritation.
-Always buy for the larger foot: Feet are seldom the same size.
-Buy shoes that do not need a “break-in” period: Shoes should be comfortable immediately. Also, make sure to have your child try on shoes with socks or tights, if that’s how they will be worn.

If you do notice a problem with your child's feet, please do not hestitate to give our office a call and set-up a consultation, 440-946-5858.

Another Victim to Achilles Tendon Tear

Another well know person, falls victim to an Achilles tendon rupture. Punter Reggie Hodges of the Cleveland Browns, one of the AFC's best last season, tore his Achilles tendon last Tuesday during traning camp and will be out for the season. Team president Mike Holmgren said he will have surgery later this week.

If you or someone you know suffers from pain in the Achilles tendon area and possibly has a traumatic injury, please feel free to contact our office and set-up a consultation, 440-946-5858. We always have emergency slots!