Palmetto Podiatry Associates Resources

A diagnosis of diabetes can be unsettling. An important component of diabetic health is proper foot care. Diabetics are at an increased risk of complications from improper foot care. The following will help to ensure you are maintaining proper foot care:

• Check your feet every daily. Inspect all areas of your feet, including between your toes and the soles of your feet. It is important to take notice of any cuts that do not heal, sores, redness, swelling or cracked skin. Pay attention to how these areas change. It is important to contact our office if you notice any signs of infection or if something just doesn’t seem quite right. Also, be sure to let us know if you are experiencing pain in the calves while walking or exercising.
• Pay special attention to water and surface temperatures. Since some diabetics may experience loss of feeling in their feet, it is important to exercise caution so as not to accidentally burn your feet. Be sure to always wear protective footwear. Check the temperature of bath/shower water by testing with your elbow. Additionally, refrain from using over-the-counter formulations of corn and callous removers. These may cause chemical burns.
• Avoid restrictive garments or accessories. If you notice indentions where socks, pantyhose, girdles, or other items have been, they are most likely too tight. Prolonged use of these items may cause swelling. This does not apply to compression stockings or hosiery prescribed for you by your physician.
• Avoid trying to care for thick nails, callouses, and corns at home. These conditions should be cared for by your podiatrist.
• When purchasing shoes, be sure that they are not too tight. Shoes that fit properly should not feel tight or restrictive. The toebox should adequately accommodate the full width of your foot. Again, be sure to always wear protective footwear. DIABETICS SHOULD NEVER GO BAREFOOT.
• DO NOT SMOKE. Smoking decreases circulation to the feet and prolongs healing time. Smoking also increases your risk for other serious health problems. Please contact your physician to discuss options for smoking cessation.

1. Maintain the sterile dressing for at least 24 hours.
2. Begin soaking 24 hours after the procedure. Keep the foot dry until then.
3. Using a clean basin, dilute one tablespoon of Epsom Salt in warm water. The water does not have to be hot.
4. Soak the affected foot for about 15 minutes. After soaking, pat the foot dry with a clean towel or some gauze. Allow to air dry.
5. Cover the area with a Band-Aid or similar dressing. After five days you may begin to use Bactroban ointment on the wound.
6. It is very important to leave the toenail area open to air at times. This is generally done in the evening. It is also very important to keep the toe covered with a Band-Aid whenever you are wearing shoes, as this will help prevent infection.
7. Following a permanent or partial toenail removal, you are to continue soaking the foot until all drainage has stopped. This may be anywhere from two to three weeks. Soak twice a day for the first week, then once daily during the second week. For a non-permanent removal, seven days of soaking is sufficient.

Please be advised, if you have had a permanent or partial toenail removal, it is not unusual to have some increased pain and redness after the procedure. It is also normal to have clear or blood tinged drainage on the Band-Aid for two to three weeks after the procedure. THIS IS COMPLETELY NORMAL.

Heel pain syndrome (heel spur of plantar fasciitis) is an inflammatory condition of the heel. Tightness of the heel cord (Achilles Tendon) and plantar fascia contributes to its cause. Although medication, injections and pads will help the condition, the key to recovery is an exercise program that stretches the heel cord and plantar fascia.

To achieve the best results, perform each of these exercises twice daily for a total of 10 minutes each time.

1. Lean forward against a wall with your feet flat on the floor. Place one foot in front of the other, lean forward toward the wall and hold the stretches for at least 20 seconds.
2. Sitting down with the knees straight, pull foot backwards toward your face using a rope, towel or band. Lean backwards with your upper body, relaxing your leg muscles and hold for at least 20 seconds.

1. Bunion surgery is painful.

This is perhaps the most common misconception. In fact, most patients will describe mild to moderate pain for 2 or 3 days following their procedure. In some cases oral pain medication may be used prescribed and in other cases medicines like Ibuprofen and Naproxen are sufficient.

2. Bunions are caused by certain types of shoes.

Although certain shoes may exacerbate symptoms, bunion deformities occur over time in people with a genetic predisposition. There is a strong familial relationship and the deformity seems to be more common in women. The deformity (Hallux Valgus) involves a malalignment of the great toe joint which progressively worsens.

3. The bunion will come back even if I have surgery.

Bunion correction is approximately 90% successful. The commonly accepted recurrence rate is around 12%.

4. I will be completely incapacitated for six weeks after bunion surgery.

Most patients are beginning to regain mobility, on a limited basis, after 48 hours. Most often weight bearing is permitted with the use of a boot or post-operative shoe. Typically, activity levels begin to increase significantly after the second or third week. Only about 1/3 of patients will require crutches or a walker, depending on their procedure.

5. There is only one type of bunion operation.

In fact, there are quite a few different procedures that are commonly employed. They can vary significantly in terms of their recovery periods. The exact procedure for a given patient is based on the patient's age, activity level, severity of deformity, and x-ray findings.

Bunion deformities are a common and sometimes painful condition. Treatment options vary. Each case is unique and appropriate evaluation is necessary. In many cases, surgical correction is a common and effective treatment option.

Joseph J. Moran, DPM FACFAS