Posts for: July, 2011
The numbers concerning diabetes are staggering. Almost 8% of the US population has diabetes. Of the 24 million Americans with this disease, about 6 million do not know it. Men and women are equally affected by the disease and a little over half of those with the disease are 60 years of age or older. Breaking down the 6 million that do not know they have diabetes, 4 million men and 2 million women over the age of 20 are unaware. On average non-Hispanic blacks are 1.8 times more likely to have diabetes than non-Hispanic whites of the same age. Mexican-Americans are almost two times as likely to have diabetes as non-Hispanic whites. Diabetes affects non-Hispanic black and Hispanic/Latino American women 2-4 times more often than non-Hispanic white women.
Realizing that diabetes is a disease and taking, the steps to control the disease can save your life. 60-70% of people with diabetes have mild to severe forms of diabetic nerve damage. Severe forms of diabetic nerve damage can lead to foot and leg amputations. The rate of amputation for people with diabetes is 10 times higher than that for people without the disease. After an amputation, the chance of another amputation with 3-5 years is almost 50%.
A podiatrist plays a crucial role in a diabetes management team. They are uniquely qualified to treat the foot and ankle, which is where diabetic nerve and blood flow problems first occur. If you have diabetes or are at risk, it is important to have a podiatrist check your feet at least once a year for symptoms, such as loss of sensation, burning, or tingling. Since diabetes affects your entire body it is important to have other doctors involved in your treatment team. A primary care physician or internist plays the important role of coordinator. They can make referrals to other specialists and conduct general care. Endocrinologist is a specialist used for people having difficulty controlling the disease. People with diabetes are at an increased risk for gum disease and infections in the mouth due to the elevated blood sugar. This makes it important to maintain regular dentist appointments. An ophthalmologist should be a part of the diabetes management team as well. They are specially trained to detect blood flow problems to the eye along with vision difficulties. Diabetics should include a trip to the eye doctor for exam once a year as part of their treatment.
*All statistics and numbers are from the American Podiatric Medical Association*
So now I have a 2nd running injury. Very frustrating and very common when starting barefoot running. It takes the body time to adapt. (A middle age 56 year old body even longer) This time it's my right calf muscle. 3 weeks ago it was the left calf muscle. The calf muscle and achilles tendons are very vulnerable to injury because of the midfoot strike in the barefoot running. It will take them time to adjust. In the meantime all I can do is listen to my body and back off until these annoying little aches and pains subside. What's interesting is that the muscles in front of the leg get sore when running with shoes due to the heel strikes these shoes encourage. Luckily I've got cycling to fall back on and I'll continue to walk with short (100 yard) running spurts to test the healing of the calf muscles. Next week I'll give you tips to avoid the mistakes I've made.
Running is an excellent form of exercise. However, without proper precaution, foot and ankle injuries can limit the ability to run or walk. The following is a list of the most common running injuries, tips for treatment, and ways to prevent them from occurring. The treatment tips are just a starting point and if pain continues consult a podiatrist for an evaluation.
Plantar Fasciitis This is an inflammation of the fibrous band of tissue in the bottom of the foot. This band extends from the heel to the toes, helping to form the arch in the foot by supporting the bones and muscles. The tissue can become irritated for many reasons; most commonly from placing too much stress on the bottom of the foot. Plantar fasciitis can be prevented by stretching before and after every run. Wearing supportive running shoes equipped with shoe inserts can also provide relief. It is important not to over-train and gradually increase running distance and time. The recommendation to reduce plantar fasciitis pain is icing, ibuprofin, and rest.
Achilles Tendonitis Achilles tendonitis is an inflammation of the Achilles tendon. This tendon connects the calf muscles to the back of the heel. Lack of flexibility and too much movement of the foot’s bones often cause this condition. Regular stretching and shoe inserts prevent Achilles tendonitis. Ice, ibuprofin, and rest are important methods to reduce pain.
Shin Splints Also known as tibial stress syndrome, shin splints are experienced as a shooting pain felt near the front or sides of the shin. Toe raises and shin stretches are excellent prevention exercises. Replacing worn running footwear is also a key for preventing shin splints. It can be treated with ice and ibuprofin. A podiatrist may also recommend a physical therapy program.
Stress Fracture Stress fractures are caused by repetitive force to a bone. This starts as a localized pain and swelling that grows worse over time. Stress fractures are prevented by modifying running equipment or training regimens with emphasis placed on replacing running shoes on a regular basis. A stress fracture is a break in the bone and requires 8-10 weeks to heal completely. Treatments consist of rest, icing and if needed immobilization casts.
Morton’s Neuroma Morton’s neuroma is felt as a burning, stinging pain between the third and fourth toe. It may also be felt as a pain in the ball of the foot or a feeling of pins and needles or numbness in the toes. Wearing proper fitting shoes with adequate cushioning is a great way to prevent a neuroma. Shoes should also have a roomy toe box and not laced too tightly. Treatment for a neuroma is a cortisone injection and shoe inserts.
For those who run as their passion or primary method of excercise you may find my weekly blogs on barefoot running interesting and informative. I have become interested in barefoot running after reading Chris McDougalli's popular book "Born to Run". I recommend this book to anyone who would like to learn more about running barefoot. Most of the concepts of unshod running made sense to me both as a running athlete and as a healthcare professional. In order to determine whether running barefoot is all it's hyped up to be, I have decided to start a barefoot running program, this goal of which is to run the half marathon in Myrtle Beach, SC next February barefoot. In my weekly blog updates I will keep you all posted on my experience. I will also share my professional insight on the differences of running shod vs. unshod. Next week 's blog will introuduce my initial experience into running barefoot including my first (and hopefully last) barefoot running injury.