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November 2015

Monthly Archives

A daily walk is important in winter too

A 30 minute daily walk is excellent for your physical and mental health. It improves cardiovascular fitness, helps reduce body fat, strengthens muscles and bones, improves balance and reduces stress and anxiety. Walking is great for everybody but it is particularly beneficial for seniors, people who are trying to lose weight and anyone who hasn’t participated in an exercise program for some time.

During the spring, summer and fall it is relatively easy to get out for an invigorating daily walk. However, during the winter, when the snow, ice and freezing temperatures set in it is tempting to stay indoors. Snowstorms and cold weather alerts aside, it is important to continuing your walking regularly throughout the winter or you will lose all of the fitness you have gained during the warmer months.


Living with diabetes – extra tips

As I mentioned in my last blog (include link to Living with diabetes – selecting shoes), purchasing properly fitted, supportive shoes is very important but you need to do even more if you want to avoid painful foot wounds that can lead to serious complications.

Check your shoes daily to see if any small stones or foreign objects are caught inside. Also carefully examine the top, heel and toe of your shopic shoees to make sure they haven’t broken down or worn. Damage to the shoe (as shown in the image to the left) changes the fit which can cause a bad sore to develop even after just one day of wear. One patient of mine was wearing good diabetic shoes but her shoes were loose at the heel so they moved up and down creating a sore. The patient thought it was just a small sore and didn’t treat it. However it became infected and eventually she had to have her leg amputated.

Also make sure you wear seamless, moisture-wicking socks and change them daily. Sock seams can put pressure on your foot so if you have reduced sensation in your feet they are best avoided. Moisture wicking socks will keep your feet dry and further reduce risks of sores as they won’t “pill” and rub.

pic toes

Cut your toenails square, leaving a bit of nail over the toe as shown in this image. This will help prevent ingrown toenails which can lead to infection. As people living with diabetes have a decreased ability to fight infections, preventing infection is easier than curing it.

 

If a sore develops – it doesn’t matter how small – stop wearing the shoe that caused the wound and treat it immediately with antibiotic or silver nitrate cream. Keep pressure off the wound until it heals. If the wound is on the bottom of your foot, a Canadian Certified Pedorthist can create a device to re-distribute the pressure on your foot that will allow the wound to heal. Be patient – it can take up to five years for a sore to heal on some feet due to poor circulation.

Most importantly, keep your sugar under control by staying active, eating well and taking your medications. Better sugar control decreases the rate of side effects like peripheral neuropathy, loss of sensation which in turn will reduce the likelihood of foot injuries and complications. If you are living with diabetes you have to take extra care of your feet but if you are vigilant, follow my tips and work closely with your Canadian Certified Pedorthist your diabetes shouldn’t slow you down.

By Jim Pattison, C. Ped (C), Prince Albert, SK


Living with diabetes – selecting shoes

If you’re living with diabetes you need to pay careful attention to shoe selection and fit as your feet are highly susceptible to injury and poorly fitting shoes are one of the leading causes of foot wounds.

Here are some tips to help you select shoes that won’t damage your feet:

pic 1 When you are shoe shopping, take the insole out of the shoe and stand on it. There should be a thumb width between your longest toe and the end of the insole. If any part of your foot is hanging over the insole the shoe is too short or too narrow for you (like the photo to the left).

Conversely if insole is showing under the edges of your foot, the shoe is too wide for you. People who have reduced sensation in their feet often choose shoes that they can feel, which means they buy shoes that are 1.5 to 2 sizes too short. Shoes that are this small put extra pressure on their feet they can’t afford to have!

pic 2

 

If you look down at your feet past your shin and see your second toe, your foot is “straight”. This means you need to buy a shoe that is pretty much straight on the inside like the one shown in the photo to the left.

 

However, if you can see your third or fourth toe while looking down, your foot is “inflared” which means you should look for apic 3 shoe where the toe is turned in at the front. If you wear a “straight” shoe when your foot is “inflared” your fourth and fifth toes will hang over the side of the insole which will cause it to wear earlier on the outside and break down sooner than it should. I have seen people whose toes fall over the outside edge when they walk because their shoes do not support them.

 

In addition to looking for shoes that match your foot shape, you should pay attention to shoe construction. Flat seams are best as they will reduce irritation. Shoes that have right sides sewed together like pant seams (like the one shown below), will likely irritate your foot. Also carefully feel the heel to make sure there isn’t any extra fabric that will rub.

pic 4

 

 

 

It is always advisable to shop for shoes later in the day when your feet are at their biggest. However, if your feet tend to swell or you find your shoes are too tight at the toes, look for extra depth shoes as they will provide your feet with the room they need.

Do not buy any shoes unless they feel comfortable when you first try them on. Shoes don’t need to be “broken in,” they should be comfortable from the start. To be extra sure your new shoes won’t injure your feet, start by wearing them a couple of hours a day and slowly increase the time they are on your feet. This is not to break the shoes in, but to confirm that they fit perfectly. If they rub or pinch they are going to give you an injury that may take months or possibly years to heal.

By Jim Pattison, C. Ped (C), Prince Albert, SK


Living with diabetes – foot care

If you’ve recently been diagnosed with diabetes it is important to take your diabetes seriously from the start. I’ve seen too many patients who have been living with diabetes for years and wish they’d been given this advice earlier.

As a foot expert I am most concerned about how diabetes affects the feet, and diabetes has a big impact on feet. Over time, diabetes can cause diminished, or total loss of, sensation in the feet which can lead to foot ulcers. These ulcers can develop into serious wounds which can dramatically impact your mobility and even lead to amputation.

Fortunately foot ulcers are easier to prevent than many other diabetes-related problems. The best way to prevent diabetes-related foot problems is to make foot inspection and care a daily habit:

• Wash your feet daily and dry them well, especially between your toes. Look closely for any redness or blisters as even small wounds can become infected.

• If you discover a wound (no matter how small), rinse it with water and a mild soap. Apply antibiotic cream and bandage it.

• If the sore is still there the next day, go to your doctor. You might not think it is a medical emergency, but it needs to be checked!

• If you have difficulty moving or bending, purchase a mirror on an arm to inspect your feet. If you still can’t check your feet, ask a family member or nurse to check for you.

• In addition to conducting daily foot checks, have your feet examined by your family doctor at your annual medical checkup.

If you have diabetes, a small foot wound can quickly become a serious complication that may have life changing consequences. Protect yourself by making foot care part of your daily routine.

By Jim Pattison, C. Ped (C), Prince Albert, SK