Diabetes: Treating Wounds and Injuries.

Diabetes: Treating Wounds and Injuries

No matter how small or superficial a wound is, you should not ignore it if you have diabetes. If you stub your toe, get a blister from tight shoes, or nick your chin while shaving, you probably give it little thought. But if you have diabetes, you should seek proper treatment.

Knowing how to treat minor wounds will help you avoid infection and speed healing.

Why Diabetic Wounds Can Cause Problems

Diabetes is a chronic disease where your body can't use glucose, or sugar, the way it should. It can cause a number of complications, including some that make it harder for wounds to heal. These include:

• Nerve damage (neuropathy). When you have neuropathy, you may not feel the pain of a cut or blister until it has grown worse or become infected.
• Weakened immune system. When the body's natural defenses are down, even a minor wound may become infected.
• Narrow arteries. People with clogged arteries in their legs are more likely to develop wounds, have severe wound infections, and have problems healing. Narrowed arteries makes it harder for blood to get to the wound. Blood flow promotes healing, so anything that blocks it can make wounds more likely to become infected.

How to Treat a Diabetic Wound

If you have a wound, no matter how small, take the following steps to avoid infection and promote healing:

• Take care of the wound immediately. Even a minor wound can become infected if bacteria are allowed to build up after injury.
• Clean the wound. Rinse the wound under running water to remove dirt. Don't use soap, hydrogen peroxide, or iodine, which can irritate the injury. Then apply antibiotic ointment to prevent infection, and cover the wound with a sterile bandage. Change the bandage daily, and use soap to clean the skin around the wound. Inspect your wound daily for any signs of infection.
• See your doctor. Don't take any chances -- have your Podiatrist check minor skin problems or areas of redness before they turn into larger problems. Err on the side of caution,  It's far easier to treat a minor skin problem before it becomes serious. 
• Keep pressure off the wound as it heals. For example, if your wound is on the bottom of the foot -- a common place for diabetic people to develop calluses and blisters -- stay off it as much as possible so it will have a better chance to heal.

Foot Health Facts for Women

Women are more vulnerable to certain foot problems than men, mainly from years of walking in narrow-fitting shoes that squeeze the toes and from high-heels that cramp the forefoot and pose risks for arch and ankle problems. 

Foot and ankle problems commonly experienced by women:

Morton's Neuroma – a thickening of nerve tissue in the ball of the foot resulting from compression and irritation of the nerve, such as from wearing shoes that have a tapered toe box, or high-heeled shoes that cause the toes to be forced into the toe box.

Bunions – begin with a leaning of the big toe, gradually changing the angle of the bones over the years and slowly producing the characteristic bump. They are most often caused by an inherited faulty mechanical structure of the foot. Although both men and women can get bunions, the shoes worn by women sometimes make the deformity get progressively worse.

Heel Pain and Plantar Fasciitis – is most often caused by plantar fasciitis, although it may also be due to other causes. Although faulty foot structure is the most common cause of plantar fasciitis, in women it may result from wearing non-supportive shoes such as flip-flops and ballet flats.

Ankle Sprain – While anyone can sprain an ankle, women are especially vulnerable to this injury when wearing high-heeled shoes (especially on slippery surfaces), platform-soled shoes, or other improper footwear.

Cathy © 2009 Cathy Guisewite. Used by permission of Universal Press Syndicate. All rights reserved.

Osgood-Schlatter Disease Rehabilitation Exercises

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You can start stretching the muscles in the back of your leg using the hamstring and calf stretches right away. When you have only a little discomfort in the upper part of your lower leg bone (tibia), you can do the rest of the exercises.

• Hamstring stretch on wall: Lie on your back with your buttocks close to a doorway, and extend your legs straight out in front of you along the floor. Raise one leg and rest it against the wall next to the door frame. Your other leg should extend through the doorway. You should feel a stretch in the back of your thigh. Hold this position for 15 to 30 seconds. Repeat 3 times and then switch legs and do the exercise again.
• Standing calf stretch: Facing a wall, put your hands against the wall at about eye level. Keep one leg back with the heel on the floor, and the other leg forward. Turn your back foot slightly inward (as if you were pigeon-toed) as you slowly lean into the wall until you feel a stretch in the back of your calf. Hold for 15 to 30 seconds. Repeat 3 times and then switch the position of your legs and repeat the exercise 3 times. Do this exercise several times each day.
• Quadriceps stretch: Stand an arm's length away from the wall with your injured leg farthest from the wall. Facing straight ahead, brace yourself by keeping one hand against the wall. With your other hand, grasp the ankle of your injured leg and pull your heel toward your buttocks. Don't arch or twist your back. Keep your knees together. Hold this stretch for 15 to 30 seconds.
• Straight leg raise: Lie on your back with your legs straight out in front of you. Bend the knee on your uninjured side and place the foot flat on the floor. Tighten the thigh muscle of the other leg and lift it about 8 inches off the floor, keeping the thigh muscle tight throughout. Slowly lower your leg back down to the floor. Do 3 sets of 10.
• Prone hip extension: Lie on your stomach with your legs straight out behind you. Tighten the buttocks and thigh muscles of your injured leg and lift it off the floor about 8 inches. Keep your knee straight. Hold for 5 seconds. Then lower your leg and relax. Do 3 sets of 10.
• Knee stabilization: Wrap a piece of elastic tubing around the ankle of the uninjured leg. Tie a knot in the other end of the tubing and close it in a door.
  1. Stand facing the door on the leg without tubing and bend your knee slightly, keeping your thigh muscles tight. While maintaining this position, move the leg with the tubing straight back behind you. Do 3 sets of 10.
  2. Turn 90 degrees so the leg without tubing is closest to the door. Move the leg with tubing away from your body. Do 3 sets of 10.
  3. Turn 90 degrees again so your back is to the door. Move the leg with tubing straight out in front of you. Do 3 sets of 10.
  4. Turn your body 90 degrees again so the leg with tubing is closest to the door. Move the leg with tubing across your body. Do 3 sets of 10.
  Hold onto a chair if you need help balancing. This exercise can be made even more challenging by standing on a pillow while you move the leg with tubing.
  
  

Osgood-Schlatter disease

Osteochondrosis

Osgood-Schlatter disease is a painful swelling of the bump on the upper part of the shinbone, just below the knee. This bump is called the anterior tibial tubercle.

Causes, incidence, and risk factors

Osgood-Schlatter disease is thought to be caused by small injuries due to repeated overuse before the area has finished growing.

The quadriceps muscle is a large, strong muscle on the front part of the upper leg. When this muscle squeezes (contracts), it straightens the knee. The quadriceps muscle is an important muscle for running, jumping, and climbing.

When the quadriceps muscle is used a lot in sports activities during a child's growth spurt, this area becomes irritated or swollen and causes pain.

It is common in adolescents who play soccer, basketball, and volleyball, and who participate in gymnastics. Osgood-Schlatter disease affects more boys than girls.

Symptoms

The main symptom is painful swelling over a bump on the lower leg bone (shinbone). Symptoms occur on one or both legs.

The person may have leg pain or knee pain, which gets worse with running, jumping, and climbing stairs.

The area is tender to pressure, and swelling ranges from mild to very severe.

Signs and tests

Your doctor can tell if you have this condition by performing a physical exam.

A bone x-ray may be normal, or it may show swelling or damage to the tibial tubercle -- a bony bump below the knee. X-rays are rarely used unless the doctor wants to rule out other causes of the pain.

Treatment

Osgood-Schlatter disease will almost always goes away on its own once the child stops growing.

Treatment includes:

• Rest and decreasing activity when your child has symptoms
• Putting ice over the painful area two to four times a day, and after activities
• Ibuprofen or other nonsteroidal anti-inflammatory drugs (NSAIDs), or acetaminophen (Tylenol).

In many cases, the condition will get better using these methods.

Adolescents should be allowed to play sports if the activity does not cause too much discomfort. However, symptoms will improve faster if activity is kept to a minimum. Sometimes, a child will need to take a break from most or all sports for 2 or more months.

In the rare case where symptoms do not go away, a cast or brace may be used to support the leg until it heals. This typically takes 6 - 8 weeks. Crutches may be used for walking to keep weight off the painful leg.

Rarely, surgery may be needed.

Expectations (prognosis)

Prevention

Most cases get better on their own after a few weeks or months. Most cases eventually go away once the child finished growing.

Calling your health care provider

Call our office @ (302) 623-4250 to schedule an appointment if the symptoms do not decrease!

The small injuries that may cause this disorder are usually unnoticed, so prevention may not be possible. Regular stretching, both before and after exercise and athletics, can help prevent injury.

9 Interesting Facts About Children's Feet!!

The following is 9 interesting facts about children's feet that may address some of your concerns about how your child's feet develop: 

Whether your little one is the world's greatest living room performer or an expert sandbox engineer, she's constantly curious and always on the go! The early years of your child's life are a critical time to support growing bones and developing joints. It cannot be overstated the effect proper footwear has during the early years of your child's development.

Fact 1:It takes nearly 18 years for a child's foot to mature fully. During this time, you should make the effort to ensure that your child's shoes are the proper size so that proper growth can occur. 

Fact 2:In the first 10 years, your child's foot will grow a total of about 6-inches.
The greatest changes will occur in the first 3 years of life. 

Fact 3:Your child's feet are subjected to enormous stress not typically experienced by the average adult foot. In fact, the stress on a child's foot can be 3 times the stress experienced by adult feet. Our shoes are designed with padded footbeds to absorb this stress. 

Fact 4:Your child's bone structure will be fully developed in the first 24 months of life. 

Fact 5: Your baby's feet will grow faster during his first three years of life than at any other time in his life. That's why it is recommended that your baby's shoes be checked every 3 months from age 1 to age 3 to make sure that the shoes are the proper size! 

Fact 6: Your baby's foot contains more cartilage than bone. That's why children shoes come in various widths so the shoe does not restrict your child's normal foot growth. 

Fact 7: Your baby's foot arch is not fully developed for the first two years of life. 
Many children's arches are not completely developed until puberty. 

You may see at various times that your child's foot turns in or out, or may pronate due to the fact that the foot arch has not fully developed. In order to protect your child, good athletic shoes with appropriate arch supports, padded collars and footbeds, and good heel counters are recommended from ages
3 and older to protect your child from injury during their peak playing years. 

Fact 8:The toes on your baby's feet are proportionally longer than an adult's. 

Fact 9: Your baby's foot perspires two to three times the rate of an adult. We highly recommend cotton socks be worn and changed once during the middle of the day to reduce the chance of a foot fungus. 

During these critical years of development and activity, the design, construction, and fitting of children's shoes require special skill and attention. Many medical practitioners believe that the majority of adult foot problems stem from poor foot and shoe experiences over the course of a child's developmental years. Therefore, it is critical that proper shoe selection be made in these early years. 

7 Interesting Facts about Bunions!!!!

A bunion is a common foot deformity that many Americans have to deal with during their lifetime. Currently, podiatrists are the leading health care professionals for caring for this deformity. Bunions are a very unique foot problem with a specific population and appearance which you will see from the seven facts below. 

1) Bunion Definition - A bunion is a bony enlargement of the bone and surrounding soft tissue of the base of the big toe. This makes your foot look like you have a bump on the inside of the base of your big toe and also causes the tip of your big toe to angle toward the second toe.

2) Who gets Bunions - Bunions are more common in women. Bunions are also more common in western countries, with as much as 30% of the population of people of western countries having bunions. Interestingly, studies have shown that people from countries where shoes are not commonly worn by most citizens have a lower incidence of bunions then western countries, suggesting that bunions may be due to the shoes people wear. Bunions are also more common in older people, with a greater incidence of bunions with age.

3) Bunion Genetics - Many studies have shown that there seems to be a genetic link for acquiring bunions. This means that if someone in your immediate family has a bunion you have an increased chance of getting a bunion then the general population.

4) Bunion Symptoms - There are many symptoms that may lead people to think they have a bunion but the most common symptoms are as follows: A bony protuberance on the base of the big toe, red callused skin over the protuberance on the inside of the big toe, pain over the joint with the protuberance that worsens with pressure, and the tip of the big toe pointing toward the second toe.

5) Shoes leading to Bunions - It has been shown that narrow shoes, cowboy boats or high heel shoes can lead to bunions. This may explain why bunions are more common in women and also why they are more common in western countries where high heel shoes are more commonly worn.

6) Diagnosing a Bunion - If you think that you have a bunion and present with the symptoms above that indicate a bunion then go to a local podiatrist to have a bunion diagnosed for sure. A podiatrist will have a good idea if you have a bunion just by sight but they will also x-ray the area to confirm the presence of a bunion.

7) Bunion Surgery - If a bunion is so painful or so enlarged that it interferes with your quality of life then a treatment option is to get a bunionectomy. A bunionectomy is a surgical procedure commonly performed by a podiatrist that helps to straighten out the big toe. As with all problems, the sooner you catch it the easier it is to treat. Don't simply assume that surgery is required for a bunion. Bunions in very early stages can be controlled with non-surgical means that may even prevent the need for surgery in the future! The best thing you can do is visit with your podiatrist to see what the best options are.

Dr. Raymond A. DiPretoro is a podiatrist in private practice in Newark, DE. He is dedicated to maintaining the health and safety of the feet of his patients and educating the public on foot health. For more information about foot health and solving foot pain, please visit our website @  http://www.advancedfootandanklectr.com

Bunion Surgery Can Improve The Quality of Your Life!!

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Do you suffer from bunion pain?  Do your feet hurt in shoes, and does the rubbing against your big toe joint keep you from walking comfortably.  Does your big toe joint hurt when you bend it?  Our doctors can help.  We use tried and true surgical techniques that maximize your recovery speed while delivering accurate and lasting correction of the abnormal toe position.  After bunion surgery, our patients are able to wear shoes comfortably again, walk without big toe pain, and enjoy being active.  Most patients are back in shoes within 4-6 weeks, and many can actually bear weight during the recovery process using a special recovery boot.  Our doctors have corrected thousands of bunions, and have as many satisfied patients.  For more information, visit our website, or if you are ready to get rid of the pain give our office a call today!

Pain in the Ball of the Foot!!

Pain in the Ball of the Foot

Pain in the ball of the foot can have multiple causes, but is usually due to some issue with the way the foot is shaped. The ball of the foot is the place where the long bones of the foot (the metatarsals) meet the bases of the toes. This area endures a great deal of strain as the foot pushes off the ground during the motion of walking. This strain is increased even further when one's foot veers towards a flat structure or to a high arched structure. In either scenario, through differing reasons, the foot suffers through increased pressure to the ball of the foot, leading to injury of the tissue that surrounds the joints in the ball of the foot, the bones themselves, or the nerves that run in between the bones. The skin can even become affected by this increased pressure, as painful calluses can develop.

Treatment of pain in the ball of the foot involves first identifying what tissue is actually injured, and then identifying the underlying abnormality with the foot's structure. A combination treatment of inflammation-reducing medication and therapy, and increased structural support from arch support inserts and better supportive shoes is then initiated to relieve the pain. Treatment in the office is usually effective, with only a small number of people requiring surgical intervention to cure the underlying problem.

Don't let pain in the ball of the foot stop you from staying active. Call our office today so our doctors can cure this condition and get you back on your feet pain-free!