November 2nd, 2012
Written by Vanessa Raffa De Rita, C Ped (C)
Pedorthic management is vital for people living with Diabetes. Why? Canadian Certified Pedorthists are trained in foot assessments, biomechanical analysis, footwear fittings & modifications. Pedorthists are one of the few footcare professionals educated about footwear and sock choice as well as proper fit for footwear. These skills are essential in helping patients with Diabetes prevent foot issues or help manage existing foot conditions, such as ulceration.
Some patients with Diabetes experience neuropathy (reduced or lack of sensation) which can lead to reduced sensation to pain and pressure making the patient unable to tell if his/her foot develops cuts or sores which if left undetected and untreated can have serious implications. Flat feet and high arched feet are especially at risk for problems from pressure. A Pedorthist is equipped to address these risks by off-loading or creating mechanical shifts to reduce pressure – often by creating custom made foot orthotics. Based on the individual, orthotic fabrication may result in a soft full length accommodative orthotic or semi-rigid orthotic to off-load the pressure and minimize risk of pain and injury. These types of orthotics are adjustable to address changes in the diabetic foot and should be checked at least twice a year.
PEDORTHIC TIPS for healthy feet and lower limbs for patients with Diabetes:
* Wash feet daily and dry between toes
* Use a mirror after a bath/shower to check the bottoms of feet, nails and between toes for any signs of discoloration, calluses, corns, blisters
* Wear diabetic socks designed with very low to no seams and are non compressive to reduce pressure on the foot and ankle. White is preferable so that if bleeding occurs, it will be noticed
* Proper footwear fitting includes measuring & fitting for proper length, width & depth proportions of each foot. Choose seamless interiors, stretchable fabrics or soft leather to accommodate the foot shape
* Avoid going barefoot and wear closed toe shoes. Shake out any potential debris and feel around the insides for any foreign objects before putting on. When taking off shoes, remove socks and check feet with hand mirror for any redness or callusing, which indicate pressure
* Frequent follow-up care and microfilament pressure testing from a Pedorthist are recommended address changes in the foot