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Posts for: March, 2013


An estimated 23.6 million Americans have diabetes and some 750,000 new cases are diagnosed every year, according to the American Diabetes Association (ADA). The most common form of the disease, Type 2 diabetes, accounts for 90 to 95 percent of the cases and is caused by the body’s resistance to insulin at the cellular level and a relative insulin deficiency. Also known as adult-onset diabetes, the disease is nearing epidemic proportions due to an increased number of older Americans and a greater prevalence of obesity and sedentary lifestyles.


A number of systemic disorders occur from diabetes, including sensory neuropathy, a common complication of the disease in which patients lose nerve sensation. Numbness and Tingling  As a result, they lose feeling at the bottom of the feet and are unable to react to pain, pressure and heat. Another complication of diabetes affecting the foot is compromised circulation.Peripheral Arterial Disease (PAD) and Amputation Poor circulation to the feet can cause foot ulcers and prevent timely healing of wounds and injuries in the patient with diabetes.


According to published studies, 15 percent of Americans afflicted with diabetes, will develop a serious foot ulcer during their lifetime. Repetitive trauma or pressure that goes unnoticed due to sensory neuropathy can produce calluses that, without proper attention, eventually progress to ulcers. Chronic ulcers can become seriously infected if they are unnoticed or untreated. As a result, some 80,000 foot amputations are performed every year in the U.S. on patients with diabetes.Diabetic Foot Amputation Prevention


Early detection of risk factors associated with ulcer formation, therefore, is essential in the overall management of diabetic patients and can significantly reduce the incidence of ulcers and eventual amputation. Prompt and aggressive treatment of foot ulcers can prevent worsening and help accelerate healing. Diligent self care also is a key component for early detection. Diabetic patients should inspect their feet every day, wear shoes that fit properly and minimize pressure, and maintain their blood glucose levels within the desired range. Regular visits to a foot and ankle surgeon for removal of calluses and ingrown toenails provide an opportunity to reinforce self-care behavior and detect new or impending foot problems. Diabetic patients should not try to remove calluses by themselves.Diabetic Foot Care 


Patients with a long patient history of diabetes may experience change to their foot such as limited joint mobility, muscle atrophy and diminished fat padding that contribute to foot deformities and foot ulcers. For example, diabetes-induced atrophy of the muscles in the foot increases pressure at the tips of the toes and can cause a hammertoe deformity. The resulting constant pressure on the toes makes them susceptible to ulcers.


Off-loading techniques using orthotics and special shoes can help minimize pressure and prevent calluses. The pressure reduction approach also can prevent or minimize the risk of the foot ulcers that result from the abnormal, repetitive pressures caused by the foot deformities that are a complication of diabetes.


Optimal care of chronic foot ulcers also requires supportive home and work environments that allow patients to be compliant with an off-loading treatment regimen. This must be combined with appropriate glucose control through diet and medication, aggressive wound care, adequate treatment of infection, and use of custom-fitted shoe gear and orthotics to prevent reoccurrence of these ulcers.


If you or someone you know has diabetes, please contact 1 of our offices, for a consultation: Our Offices


Middleburg Heights Office: Phone (440) 243-1473

Lyndhurst Office: Phone (216) 382-8070

Beachwood Office: Phone (216) 591-1905



What is a Diabetic Foot Ulcer?

A diabetic foot ulcer is an open sore or wound that occurs on the foot, most commonly on the bottom or plantar surface.  Approximately 15 percent of patients with diabetes, will develop an ulcer during there lifetime, of which 6 percent will be hospitalized due to an infection or other ulcer-related complication and 14 to 24 percent will have some form of amputation.

Diabetes Diabetes By The Numbers is the leading cause of non-traumatic lower extremity amputations in the United States, however, research has shown that the development of a foot ulcer is preventable.

Who Can Develop a Diabetic Foot Ulcer?

Anyone who has diabetes can develop a foot ulcer. Native Americans, African Americans, Hispanics and older men are at an increased risk in developing ulcerations. People who use insulin are also at a higher risk of developing a foot ulcer, as are patients with diabetes-related kidney, eye, and heart disease. Being overweight and using alcohol and tobacco also play a role in the development of ulcerations.

How do Diabetic Foot Ulcers Form?

Ulcers form due to a combination of factors, such as lack of feeling in the foot, poor circulation, foot deformities, irritation (such as friction or pressure), trauma and duration of diabetes. Patients who have diabetes for many years can develop neuropathy, a reduced or complete lack of feeling in the feet due to nerve damage caused by elevated blood glucose levels over time. The nerve damage often occurs without pain and one may not even be aware of the problem. Your podiatric physician can test your feet for neuropathy with a simple and painless tool called a monofilament. Numbness and Tingling

Vascular disease Peripheral Arterial Disease (PAD) and Amputation can also complicate a foot ulcer, reducing the body’s ability to heal and increasing the risk for an infection.

Elevations in blood glucose can reduce the body’s ability to fight off a potential infection and also retard or halt healing.

What Can You Do if You Develop a Diabetic Foot Ulcer?

Once an ulcer or wound is noticed, seek podiatric medical care immediately at one of our offices listed below, to reduce the risk of infection and amputation.

We can be reached at one of the offices listed below: Our Offices

Middleburg Heights Office:Phone (440) 243-1473

Lyndhurst Office: Phone (216) 382-8070

Beachwood Office: Phone (216) 591-1905




Parents can help prevent a common and painful foot problem in children by following a few simple tips.

Ingrown toenails is one of the most common podiatric conditions treated in children. Ingrown Toenails Tight shoes, tight socks and/or incorrect nail trimming are the main culprits. In other cases, inheritance of nails to curve in is another less common culprit.

Most kids hide their ingrown toenails from their parents, even though the condition may cause significant pain due to fear of doctors or other underlying reasons. However, over time, the nail may break the skin and lead to dangerous infections. In order to prevent this from occurring, please follow the tips provided below:

1.) Teach children how to trim their toenails properly. Trim toenails in a fairly straight line, and don't cut them too short.

2.) Ensure your child's shoes fit. Shoe width is more important than length. Make sure that the widest part of the shoe matches the widest part of your child's foot. Children's Shoes

3.) If your child develops a painful ingrown toenail, reduce the inflammation by soaking the child's foot in room-temperature water and gently massaging the side of the nail fold.

The only proper way to treat a child's ingrown toenail is with a minor surgical procedure at a doctor's office. Never try to dig the nail out or cut it off. These dangerous "bathroom surgeries" carry a high risk for infection. If your child is suffering from this condition, please contact one of our offices immediately for a consultation.Our Offices

Middleburg Heights Office: Phone (440) 243-1473

Lyndhurst Office: Phone (216) 382-8070

Beachwood Office: Phone (216) 591-1905 

March is Women's Health Month, therefore, are practice would like to help those ladies who have fallen victim to fashion with frequent wear of high heel shoes.

The human foot was once described by Leonardo Da Vinci as “a masterpiece of engineering and a work of art”, and this is evidenced by our ability to walk, run, jump, and play. Foot Anatomy  However, it doesn’t take much to upset the fine balance between precision function and disaster. High heels, by their nature shift the body’s anatomy into foreign territory, causing marked postural and alignment strain.

By elevating the heel bone (calcaneus) there is an immediate change in the distribution of weight under the feet from the heel to the forefoot – the percentage of which is directly proportional to the height of the heel. With regular use, the calf muscles in the lower leg can permanently shorten, leaving you unable to comfortably wear flat shoes and further increasing pressure under the ball of the foot.

Habitual high heel wearers will invariably, at some point, suffer pain and disability because of this alteration in the way our body adapts to the ground and distributes weight. Common complaints can include calluses, corns and blisters to more permanent deformities including bunions, hammer toes and acquired flat feet. It additionally can contribute to increased incidences of fractures of the ankle and metatarsals (forefoot), arthritis, pinched nerves, tendonitis and other soft tissue injuries and inflammation.

Before you lose faith and trust in all things fashionable, here’s some tips on how to minimise risk while wearing your heels:

Moderation is the key: Avoid wearing heels when walking to and from work. Also, kick off the pumps in the office and replace with flats.

Pick shoes that suit the activity for the day: Flats or shoes with only a slight heel are best for standing and walking, whereas heels may be suitable during a seated meeting or dinner date.

Keep the heel height sensible: Anything over 5cm is hazardous and should be for only special occasions.

Stilettos: A dangerous shoe for ankle sprains and fractures. Try broader heels with more stability and tread on the ground.

Stretch your calf muscles regularly to improve fl exibility and reduce the likelihood of muscle contraction. Stretching

Seek immediate assistance from one of our offices, should you experience pain, swelling or a change in shape of any part of your foot. Our office locations and assocaited numbers are listed below: Our Offices

Middleburg Heights Office: Phone (440) 243-1473

Lyndhurst Office: Phone (216) 382-8070

Beachwood Office: Phone (216) 591-1905