Bronx, NY Podiatrist
NYNJ Foot and Ankle Associates
2425 Eastchester Rd
Bronx, NY 10469

(718) 881-7990
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According to the American Diabetes Association, about 15.7 million people (5.9 percent of the United States population) have diabetes. Nervous system damage (also called neuropathy) affects about 60 to 70 percent of people with diabetes and is a major complication that may cause diabetics to lose feeling in their feet or hands.

Foot problems are a big risk in diabetics. Diabetics must constantly monitor their feet tp prevent complications including amputation.

With a diabetic foot, a wound as small as a blister from wearing a shoe that's too tight can cause a lot of damage. Diabetes decreases blood flow, so injuries are slow to heal. When your wound is not healing, it's at risk for infection. As a diabetic, your infections spread quickly. If you have diabetes, you should inspect your feet every day. Look for puncture wounds, bruises, pressure areas, redness, warmth, blisters, ulcers, scratches, cuts and nail problems. Get someone to help you, or use a mirror.

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456According to the American Diabetes Association, about 15.7 million people (5.9 percent of the United States population) have diabetes. Nervous system damage (also called neuropathy) affects about 60 to 70 percent of people with diabetes and is a major complication that may cause diabetics to lose feeling in their feet or hands.

Foot problems are a big risk in diabetics. Diabetics must constantly monitor their feet or face severe consequences, including amputation.

With a diabetic foot, a wound as small as a blister from wearing a shoe that's too tight can cause a lot of damage. Diabetes decreases blood flow, so injuries are slow to heal. When your wound is not healing, it's at risk for infection. As a diabetic, your infections spread quickly. If you have diabetes, you should inspect your feet every day. Look for puncture wounds, bruises, pressure areas, redness, warmth, blisters, ulcers, scratches, cuts and nail problems. Get someone to help you, or use a mirror.

Here's some basic advice for taking care of your feet:

  • Always keep your feet warm.
  • Don't get your feet wet in snow or rain.
  • Don't put your feet on radiators or in front of the fireplace.
  • Don't smoke or sit cross-legged. Both decrease blood supply to your feet.
  • Don't soak your feet.
  • Don't use antiseptic solutions, drugstore medications, heating pads or sharp instruments on your feet.
  • Trim your toenails straight across. Avoid cutting the corners. Use a nail file or emery board. If you find an ingrown toenail, contact our office.
  • Use quality lotion to keep the skin of your feet soft and moist, but don't put any lotion between your toes.
  • Wash your feet every day with mild soap and warm water.
  • Wear loose socks to bed.
  • Wear warm socks and shoes in winter.
  • When drying your feet, pat each foot with a towel and be careful between your toes.
  • Buy shoes that are comfortable without a "breaking in" period. Check how your shoe fits in width, length, back, bottom of heel, and sole. Avoid pointed-toe styles and high heels. Try to get shoes made with leather upper material and deep toe boxes. Wear new shoes for only two hours or less at a time. Don't wear the same pair everyday. Inspect the inside of each shoe before putting it on. Don't lace your shoes too tightly or loosely.
  • Choose socks and stockings carefully. Wear clean, dry socks every day. Avoid socks with holes or wrinkles. Thin cotton socks are more absorbent for summer wear. Square-toes socks will not squeeze your toes. Avoid stockings with elastic tops.

When your feet become numb, they are at risk for becoming deformed. One way this happens is through ulcers. Open sores may become infected. Another way is the bone condition Charcot (pronounced "sharko") foot. This is one of the most serious foot problems you can face. It warps the shape of your foot when your bones fracture and disintegrate, and yet you continue to walk on it because it doesn't hurt. Diabetic foot ulcers and early phases of Charcot fractures can be treated with a total contact cast.

The shape of your foot molds the cast. It lets your ulcer heal by distributing weight and relieving pressure. If you have Charcot foot, the cast controls your foot's movement and supports its contours if you don't put any weight on it. To use a total contact cast, you need good blood flow in your foot. The cast is changed every week or two until your foot heals. A custom-walking boot is another way to treat your Charcot foot. It supports the foot until all the swelling goes down, which can take as long as a year. You should keep from putting your weight on the Charcot foot. Surgery is considered if your deformity is too severe for a brace or shoe.
3Here's some basic advice for taking care of your feet and preventing wounds and infections:

  • Always keep your feet warm.
  • Don't get your feet wet in snow or rain.
  • Don't put your feet on radiators or in front of the fireplace.
  • Don't smoke or sit cross-legged. Both decrease blood supply to your feet.
  • Don't soak your feet.
  • Don't use antiseptic solutions, drugstore medications, heating pads or sharp instruments on your feet.
  • Do not use sharp instruments (such as nail clippers) to cut your toenails. Use a nail file or emery board. If you find an ingrown toenail, contact our office.
  • Use quality lotion to keep the skin of your feet soft and moist, but don't put any lotion between your toes.
  • Wash your feet every day with mild soap and warm water.
  • Wear loose socks to bed.
  • Wear warm socks and shoes in winter.
  • When drying your feet, pat each foot with a towel and be careful between your toes.
  • Buy shoes that are comfortable without a "breaking in" period. Check how your shoe fits in width, length, back, bottom of heel, and sole. Avoid pointed-toe styles and high heels. Try to get shoes made with leather upper material and deep toe boxes. Wear new shoes for only two hours or less at a time. Don't wear the same pair everyday. Inspect the inside of each shoe before putting it on. Don't lace your shoes too tightly or loosely.
  • Choose socks and stockings carefully. Wear clean, dry socks every day. Avoid socks with holes or wrinkles. Thin cotton socks are more absorbent for summer wear. Square-toes socks will not squeeze your toes. Avoid stockings with elastic tops.

When your feet become numb, they are at risk for becoming deformed. One way this happens is through ulcers. Open sores may become infected. Another way is the bone condition Charcot (pronounced "sharko") foot. This is one of the most serious foot problems you can face. It warps the shape of your foot when your bones fracture and disintegrate, and yet you continue to walk on it because it doesn't hurt. Diabetic foot ulcers and early phases of Charcot fractures can be treated with a total contact cast.

The shape of your foot molds the cast. It lets your ulcer heal by distributing weight and relieving pressure. If you have Charcot foot, the cast controls your foot's movement and supports its contours if you don't put any weight on it. To use a total contact cast, you need good blood flow in your foot. The cast is changed every week or two until your foot heals. A custom-walking boot is another way to treat your Charcot foot. It supports the foot until all the swelling goes down, which can take as long as a year. You should keep from putting your weight on the Charcot foot. Surgery is considered if your deformity is too severe for a brace or shoe.

Diabetes and Your Feet |

Diabetic Foot Care

A callus, also known as hyperkeratosis, is an area of hard, thickened skin that can occur across the ball of the foot, on the heel, or on the outer side of the big toe. Although many consider them a skin problem, they are indicative of a problem with the bone.

Calluses form from repeated friction and pressure, as the shoe (or ground) rubs against a bony prominence (bone spur) on the toe or foot. The skin thickens in response to this pressure. Small amounts of friction or pressure over long periods of time cause a corn or callus. A great deal of friction or pressure over shorter periods of time can cause blisters or open sores. Calluses typically develop under a metatarsal head (the long bone that forms the ball of the foot). Calluses have painful nerves and bursal sacs (fluid-filled balloons that act as shock absorbers) beneath them, causing symptoms ranging from sharp, shooting pain to dull, aching soreness.

Calluses can be treated with over-the-counter callus removers, which use strong acids to peel this excess skin away after repeated application. Be careful using these products as they can cause chemical burns when misapplied or used in excess. Alternatively, treat calluses as follows: Begin by soaking the foot or feet in warm soapy water and gently rubbing away any dead skin that loosens. Next, use a pumice stone or emery board to file away the thickened skin. Apply a good moisturizer to the hardened areas to keep them softer and relieve pain. Nonmedicated corn pads or moleskin (a thin fuzzy sheet of fabric with an adhesive back) are available in stores and can relieve pain caused by calluses. However, use caution removing pads or moleskins to avoid tearing the skin.

If you need assistance relieving calluses, please contact our office. We can trim and apply comfortable padding to the painful areas. In more severe cases, we may prescribe medication to relieve inflammation, or inject cortisone into the underlying bursal sac to rapidly reduce pain and swelling.

A plantar callus forms on the bottom of the heel over time where one metatarsal bone is longer or lower than the others. This structure causes the one metatarsal to hit the ground first and with more force than it is equipped to handle. As a result, the skin under this bone thickens. In most cases, plantar calluses can be treated without surgery. In some recurring cases, however, a surgical procedure, called an osteotomy, is performed to relieve the pressure on the bone.

A condition called Intractable Plantar Keratosis (IPK) is a deep callus directly under the ball of the foot. IPK is caused by a "dropped metatarsal," which happens when the metatarsal head drops to a lower level than the surrounding metatarsals and protrudes from the bottom of the foot. This results in more pressure being applied in this area and causes a thick callus to form. A dropped metatarsal can either be a congenital abnormality, a result of a metatarsal fracture, or a structural change that may have occurred over time.

You can prevent calluses by:

  • Switching to better-fitting shoes or using an orthotic device to correct an underlying cause.
  • Buying socks with double-thick toes and heels or nylon hose with woven cotton soles on the bottom of the foot.