Between 30-50% of patients with diabetes have peripheral neuropathy. This is a nerve injury that prevents you from protecting your own skin by losing feeling. In addition, the nerve damage interferes with your muscles leading to deformities and difficulty walking. Pressure increases over these prominent areas leading to callus formation from repeated injury. Damage from the callus or injury leads to open sores or ulceration.

Your wound care treatment has included some form of “off-loading” by padding or casting. This is how we remove pressure from the open sore to allow the body to heal. Under the care of Dr. Geller you also had to remain in this cast or padding 4 weeks after healing to allow the scar to mature. To prevent return of the ulceration you will need protection from pressure on prominent areas.

You should be very proud of yourself. You have accomplished what more than 90,000 Americans failed to do this year. You saved your leg from amputation due from diabetic ulcer.

More than 90,000 people lost a major part of their foot or the entire leg to complications beginning as a wound on their foot. Some of these were not avoidable, but it is estimated that 64% of these could have been prevented with advanced wound care such as you have done.

Now our focus switches to prevention. You and your physician do not want you to experience anything like this ever again. You have most likely been treated using some form of cast or padding to keep the pressure off your foot and swelling down. Since this was necessary to heal the wound it should be no surprise that something will be needed to keep the wound healed.

Prescription shoes with custom-made inserts are used to cushion and protect the feet. You will have to wear these shoes with inserts everyday for quite some time. Every year your insurance will pay for new shoes. You should receive three pairs of inserts for these shoes to be changed every four months. The longer you stay healed and the better you control the callus formation the more flexible your shoe selection will become.

In some patients surgery was performed to correct deformity and decrease pressure. Even these patients have to wear the prescription shoes with insoles.

Dr. Stephen Geller, AZ Podiatrist

Hammertoes develop when the toes buckle under the pressure of walking on an unstable foot. When your foot pronates too much, the muscles work harder to support your arch. If your foot remains unstable the toes bend as muscles fight to prevent the arch collapsing while you walk. Left untreated the toes will stay curled leading to corns, calluses, and pain.

Early treatment is important. At Desert Foot Surgeons we perform a detailed examination including video gait analysis to identify the reason for the unstable arch. If you do not correct the true cause of the problem it will only return. Foot orthotics are used to stabilize the arch and prevent hammertoes in the early stages. Once the toes stay bent treatment involves changing the shoes that push on the painful toe or surgically straightening the toe.

Dr. Stephen Geller, AZ Podiatrist

If the shoe fits…How do you know?

Introduction

On average a person takes 3,000 – 5,000 steps per day, or roughly 4.3 miles. A 150 pound-person walking one mile exerts 127,000 pounds on each foot. That’s more than 540,000 pounds (273 tons) per foot in one day. By the time you are 35 years old the average person has walked 55,000 miles. With that much stress on our feet it is estimated that every person will suffer from foot pain or injury at some point in his or her lifetime.

As a podiatrist, the majority of people I treat have already experienced the pain or injury. I spend a great deal of time working with my patients to find shoes that are best suited for their needs. This doesn’t mean that foot surgery is not a necessary part of treatment, but I often tell my patients that it is easier to change the shoe than it is to change the foot. Even surgically corrected feet need a stable shoe before returning to walking. Changing shoes is often the first line of treatment.

In public the most common question I get is,

What are good shoes to wear?”

That’s not such a simple question to answer. First of all I usually know nothing of that person’s daily activities and usually have not examined their feet. Unfortunately that doesn’t stop people from showing me their feet in public places, but still there are many things to consider. What is your foot type, activity level, are you a pronator or supinator, do you have any deformities, is perspiration a problem, what’s the quality of the shoe materials, do you wear orthotics or not, and so on.

Advertising might make you want one brand of shoe so you can play basketball like LeBron James or run like Usain Bolt. Don’t be fooled, professional athletes possess special physical abilities that most of us don’t have. It is not the shoes that make them able to jump higher or run faster. Think of it this way. Usain Bolt wears his shoes for at most 200 meters, which takes him less than 20 seconds. His shoes are so uncomfortable that he has to remove them in order to run his victory lap barefoot.

Patients like to know what brand of shoe I use. The shoes I wear are comfortable for me and perform as I need, but that does not make them a good shoe for you.

Another problem is that there is no standardized sizing in the shoe industry. One company’s size 9 medium width is another company’s size 8 ½ wide. Knowing how a shoe is supposed to fit is more important than knowing what size you wear. But who teaches you that? If you were lucky enough to grow up without hand-me-downs you might have been shown by an educated shoe salesman or woman. Even so, most of us don’t receive any training in how shoes are supposed to fit.

If the shoe fits…How do you know?” was written for you.

In this report you will learn how to determine your foot type, what pronation and supination are, how to tell if the shoe fits correctly, the anatomy of a shoe, and how to care for your shoes.  You can download it here: (insert link to report)

Dr. Stephen Geller, AZ Podiatrist