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April 24, 2017
Category: Foot Care
Tags: podiatrist   podiatry   Foot Care   diabetes   foot doctor  

It is common in people who have diabetes to have foot problems. If you have diabetes, you might have heard that there is a possibility to lose a leg, toe or foot. Fortunately, you can lower your chances of having foot problems related to diabetes by taking care of your feet on a daily basis. You can also keep your feet healthy by managing your blood sugar.


There are two problems caused by diabetes that can affect your feet:


Diabetic Neuropathy

This happens when uncontrolled diabetes damages your nerves. If you have damaged nerves in your feet and legs, there is a possibility that you do not feel heat, cold, or pain – this is called ‘sensory diabetic neuropathy’. If you do not feel that something is wrong with your foot, the cut or sore could get worse and become infected over time. The muscles of the foot might not function properly. This can also cause the foot to not align properly or create too much pressure in one area. Foot ulcers can also occur due to nerve damage and peripheral vascular disease.


Peripheral Vascular Disease

Diabetes affects the blood flow. Without good blood flow, a sore or a cut takes a longer time to heal. Poor blood flow in one’s arms and legs is called ‘peripheral vascular disease’. It is a circulation disorder that can affect blood vessels away from the heart. If you have an infection that does not heal because of poor blood flow, you could become at risk for developing ulcers or gangrene – death of tissue due to lack of blood.


What can you do to keep your feet healthy?

It is important to have a healthcare team at this time to make a diabetes self-care plan. This plan will include an action plan to manage your diabetes. A foot care plan is also essential and Sheldon H. Nadal, DPM can definitely help you create the best one for you.


Check Your Feet Every Day

You might be having foot problems, but there is a possibility that you are feeling no pain in your feet. Checking your feet on a daily basis can help you spot any problems early before they get worse. Each evening, when you take off your shoes, make it a point to check your feet and the areas between the toes. If you have trouble bending over to check your feet, you can use a mirror to see them, or you can also ask someone else to look at your feet.


Look for problems such as:

  • Sores, cuts, or red spots
  • Ingrown toenails
  • Swelling or fluid-filled blisters
  • Corns or calluses
  • Plantar warts
  • Warm spots
  • Athlete’s foot


For any foot problems that you want to discuss more thoroughly, set up an appointment with Sheldon H. Nadal, DPM today. 

April 21, 2017

When the tissue at the base of your big toe swells up, bunions occur, forming a large bump on the side of your foot. This foot condition can cause intense foot pain and eventually, it may lead to arthritis. There are ‘special foot exercises’ that can relieve the symptoms of bunions. Although these exercises will not get rid of the bunion, they can help increase the foot’s flexibility.


Benefits of Special Foot Exercises for Bunions

Non-surgical strategies, like physical therapy exercises, can help slow the progression of bunions. Foot exercises for bunions help keep the joint between the big toe and the rest of the foot mobile, strengthening the muscles that control the big toe and maintaining flexibility.


Here are some exercises that might benefit people with bunions:


Toe Stretches

Stretching out your toes help keep them limber and offset the pain. To do this, point your toes straight ahead for 5 seconds and curl them under for another 5 seconds. Repeat this for 10 times. This exercise can also be beneficial if you have hammertoes in addition to a bunion.


Toe Flexing and Contracting

This exercise is also recommended and to do this, you should press your toes against a hard surface such as a wall, to stretch and flex them. Hold the position for 10 seconds and repeat for three to four times. Next, flex your toes in the opposite direction, and hold that position for 10 seconds. Repeat again for three to four times.


Stretching the Big Toe

This exercise requires your fingers. Use your fingers to pull the big toe gently over into proper alignment. Hold the toe in this position for 10 seconds and repeat for three to four times.


Resistance Exercises

Resistance exercises are also great for the big toe. This can be done by wrapping a towel or belt around the big toe. Pull the big toe towards you while simultaneously pushing forward, against the towel or belt, with your big toe.


Towel Curls

You can also help strengthen your toes by spreading out a small towel on the floor. Curl your toes around it then pull it toward you – repeat this for five times. Gripping objects with your toes like this can definitely help keep your foot flexible.


Ball Roll

This can be done with the help of a golf ball. You will massage the bottom of your foot with the golf ball and this can be done sitting down. Roll the ball around under your foot for two minutes. This exercise helps relieve foot strain and cramping.


These exercises can be done ideally in the morning and at night. If you need help dealing with bunions, set up an appointment with Sheldon H. Nadal, DPM. 

Plantar fasciitis is one of the most common causes of heel pain. To be more specific, plantar fasciitis means that your plantar fascia is inflamed. 



Your plantar fascia, like a ligament, is a strong band of tissue that stretches from your heel (calcaneum) to your middle foot bones. It also supports the arch of your foot and acts as a shock-absorber in your foot.


What causes plantar fasciitis?

Repeated small injuries to the fascia that may or may not come with inflammation are thought to be the cause of plantar fasciitis. The injury is usually near the area where the plantar fascia attaches to the heel bone. There are situations wherein you are more likely to injure your plantar fascia:


  • If you have recently started exercising on a different surface – running on the road instead of a track.
  • If you are on your feet for prolonged periods of time.
  • If you do a lot of walking, running and/or standing.
  • If you are overweight – this puts extra strain on your heel.
  • If you have been wearing shoes with poor arch support or cushioning.
  • If there is sudden stretching or overuse of your sole.
  • If you have a tight Achilles tendon – this affects your ability to flex your ankle and make you prone to damaging your plantar fascia.

Plantar fasciitis might be confused with ‘Policeman’s heel’ but the two are different. Policeman’s heel is plantar calcaneal bursitis – inflammation of the sac of fluid under the heel bone. This foot condition is not as common as plantar fasciitis.


How common is plantar fasciitis?

This foot condition is common. Around 1 in 10 people will develop this foot problem at some point in their life. It is most common in people aged 40 to 60 years. However, it can still occur at any age. It is also twice as common in women as it is in men as well as in athletes.


What are the symptoms of plantar fasciitis?

The main symptom of this foot problem is pain that can be anywhere on the underside of your heel. However, one spot is found as the main source of pain commonly. It is often about 4cm forward from your heel, and it might be tender to touch.


The pain is often worst upon getting up in the morning when you take your first steps or when you take long periods of rest where no weight is placed on your foot. Gentle exercises might ease things a little as the day goes by. However, being on your feet for a long time or a long walk often makes the pain worse. Resting your foot, on the other hand, usually, eases the pain. 

April 14, 2017

Some people are born with a type of foot that predisposes them to claw and hammer toes. Those who have flat feet, high-arched feet or flexible feet are more prone to develop these foot problems. Other causes include tendon imbalance, excessively long toes, rheumatoid arthritis, injury, and neuromuscular diseases. Overtime, the mechanics of their foot and shoes increase deformities. Women tend to be affected more due to the types of shoes they wear.


What is Hammertoe?

Hammertoe is a foot condition that results in the toe being bent upwards in the middle portion of the joint, making it somewhat look like a hammer. It can be either flexible or stiff, and it can result in significant pain. In some cases, it can even have a substantial effect on one’s quality of life.


What are the Signs I Need Hammertoe Surgery?

Many people want to avoid hammertoe surgery at all costs. Some try changing or stretching their shoes in order to find relief, while some wear padding around the affected area. However, if you try these quick-fixes and other treatments and still have pain or cannot wear footwear without significant discomfort, then you just might be the perfect candidate for hammertoe surgery.


What are Instances I Should Avoid Surgery?

If you have multiple foot problems, then you may want to hold off on hammertoe surgery until the other foot issues are rectified. You should also avoid having a procedure performed if you have poor circulation, a serious illness, or any sort of infection. Before any kind of surgery, you will need to have a detailed discussion with your podiatrist about all treatment options available to you.


What Happens After Surgery?

Following a hammertoe surgery, most people are required to wear special shoes for a little while in order for them to be able to walk. The length of time it will take to recover from this surgery will depend on the extent of the surgery. For the first weeks, you will most likely be required to rest for quite a bit. The affected foot must be kept elevated above your heart to reduce pain and swelling. The stitches usually come out 2-3 weeks following the surgery. The pins, on the other hand, are typically removed a short while later.


If you have more questions on hammertoe surgery, it is best to confer with Sheldon H. Nadal, DPM. He will not only discuss hammertoe surgery thoroughly, but he will also explain all available treatment options that are best for your case. 

April 08, 2017
Tags: bunions   podiatrist   podiatry   Foot Care   foot problems  

When the tissue at the base of your big toe swells, forming a large bump on the side of your foot, this is called a bunion. This foot condition is a bone and soft tissue deformity that can cause relapsing or constant inflammation and pain. The number one complaint a person suffering from bunion has is pain and irritation. The pain is caused by the inflammation occurring in the tissues of the toe joint being progressively stretched as the bones shift out of their position.


A bunion might also rub against a tight-fitting shoe, creating more irritation. As with any foot problem, it is best to seek professional care. In addition, here are several tips that can help reduce bunion pain:


Do a soak. A cool foot soak is an easy way to soothe sore and irritated foot. If you do not have a foot spa at home, a clean basin will do. Pour a few tablespoons of your favourite bath salt or Epsom salt into the basin and fill it with lukewarm water, just enough to cover the ankles. Soak for 5 to 15 minutes.


Stretch toes. Stretching exercises are also a great way to address your sore joints and this includes your toes, too. While seated comfortably, use a strap or your hands to grasp your toe. Pull the toe through a comfortable range of motion gently. Hold that position for 30 seconds and repeat a few times. Then, gently stretch the toe away from the next toe, also holding for 30 seconds and repeat.  If you have a bunion on the big toe side, grasp your big toe and stretch away from the second toe. If the pain worsens, discontinue any stretching.


Wear new shoes. Having your feet sized is not just for children. Our feet can change in size throughout our lives and it is always a great idea to measure your feet. Make sure you also measure for the width and not just the length. A bunion usually leads to a gradual widening of the forefoot, requiring a wider size shoe for comfort. When you think of dress shoes for feet with bunions, you might envision old-style orthopaedic shoes. However, there are more fashionable styles to choose from today. There are also a variety of athletic shoes that are ideal for feet with bunions. If your favourite pair of shoes is too tight over your bunion, you can have that area stretched at a shoe repair or a leather repair store.


For a more permanent relief from bunion pain, see Sheldon H. Nadal, DPM today. 

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