Dr. Berg's Foot Facts

Posts for tag: foot care

By Rion A. Berg DPM
August 23, 2011
Category: foot care
Tags: diabetes   foot care   ulcers  

I saw a popular show on cable TV called, “Pawn Stars”. This show is about a three-generation family business in Las Vegas, NV, a pawn shop that sees some very interesting and bizarre items. As you may know, none of these gentlemen, (grandfather, son and grandson) seem to be starving, as evidenced by the bigger sized black work shirts they wear on the show. One of the sons, Corey Harrison, recently took his weight problem seriously and decided to do something about it. Corey was diagnosed by his doctor as “pre-diabetic” and he weighed 365 pounds.

Corey opted for the increasingly popular lap-band surgery to aid in his weight reduction. Lap-band surgery has proven successful for Corey, who embraced a new diet and exercise program as well. It’s the exercise and dietary changes -made for the rest of his life after the procedure- that will improve Corey’s long term health. 

Now, of course you don’t need any procedure done by a doctor in order to start your own lifestyle changes, but these small, daily adjustments are just as likely to save your life in the long run as any procedure ever could.

Let’s talk today about diabetes mellitus: what it is, what causes it, what life-changing damage it can cause to your feet and other body parts, and the one simple way to treat it and possibly prevent it altogether.

Diabetes Mellitus (DM) is split into Type 1 and Type 2, but both are characterized by high levels of glucose (“sugar”) in the blood. In Type 1 DM (usually onset at a younger age), genetics and other factors cause your body to make antibodies to certain cells in the pancreas that normally make insulin. These antibodies start to destroy the pancreatic cells, and therefore less insulin is able to be made. One of insulin’s normal functions is to push glucose from your blood into your muscle and other tissue to be used as a source of energy. Therefore without insulin from the pancreas, the glucose just stays in the blood, causing high blood sugar.

Type 2 DM (adult onset) is typically related to obesity, lack of exercise, and a diet high in fats and sugars. The increased body fat causes the muscles and other tissue to be resistant to insulin, therefore keeping the glucose in your blood and causing high blood sugar. Increased body weight also leads to pancreatic dysfunction, therefore decreasing the amount of insulin secreted and also leading to high blood sugar. Type 2 DM is also associated with other factors such hypertension, (high blood pressure), high cholesterol/triglycerides and increased abdominal fat.

When the blood sugar reaches high enough levels, glucose starts spilling over into the urine (most glucose is usually reabsorbed by your body and not excreted), which causes more water to be pulled out of the body and into the urine, leading to an increase in the frequency of urination and increased thirst. Pre-diabetes is when your fasting blood sugar (as measured by blood from a finger stick) is above normal (normal is <100 mg/dl and pre-diabetes is 100-125 mg/dl) but not high enough to be technically diagnosed as diabetes. Without a significant weight loss with diet and exercise, someone diagnosed as pre-diabetic is very likely to progress to Type 2 DM within 10 years, with the early beginning of damage caused by Diabetes Mellitus.

Tune in next week to find out exactly what parts of your body (hint: you’ve been walking on one of the most at-risk body parts since you were about 1 year old) are at risk to be damaged and the best thing you can do to ensure your own health!
 

Rion A. Berg, DPM
Podiatrist and Board Certified Foot Surgeon

Foot and Ankle Center of Lake City
2611 NE 125th, Ste 130
Seattle, WA 98125

Centrally Located in Northeast Seattle
Our office is located in Lake City within 10 minutes of Shoreline, Kenmore, Juanita, Sandpoint, Meadowbrook, Wedgewood, Maple Leaf, Broadview, Greenwood, Northgate, and Pinehurst. Parking is free.

Click here to request an appointment or call 206.368.7000.

 

By Rion A. Berg, DPM
June 30, 2011
Category: foot care

On June 21, 2011, the Seattle Mariners suffered an unfortunate 6-5 loss in the bottom of the 9th inning while they were visiting the Washington Nationals. Perhaps more important than losing the game is the injury suffered by Seattle’s shut-down closer, Brandon League, who is currently tied for 4th in Major League Baseball with 21 saves. While pitching in the bottom of the 9th inning, he was struck by the baseball in the back and side of his right leg in the area of the calf muscle (gastrocnemius muscle) after the Washington batter hit a low line drive. Though he was able to run after the ball to try to throw the runner out at first base, Brandon had to leave the game after that play due to the injury. He is currently listed as day-to-day with a calf muscle contusion.

A contusion can be considered a large bruise on a much more severe scale and in sports is usually due to a direct traumatic blow or repeated blows from a blunt object. In Brandon’s case, force or energy was transferred from the baseball into the tissue of his leg, crushing the underlying muscle fibers, blood vessels and connective tissue without breaking the skin. The injured tissue was then likely flooded with a collection of blood and inflammatory products as a result of a) the tissue damage from the blow, and b) the body’s natural inflammatory response to injury. This would be seen by the naked eye as swelling in the area, multiple blue-purple-yellow colors associated with bruises, and increased warmth as part of the inflammatory process.

The reason Brandon had to leave the game is that he was unable to pitch with the same effectiveness because he could not push off of the mound with his right (now injured) leg due to pain in the area, temporary weakness and stiffness of the calf muscle, and perhaps decreased range of motion in his right knee due to swelling and pain. Also, if he tried to continue playing, there is a very good chance he would have caused further damage to the muscle tissue and perhaps made his recovery that much longer.

Any injury caused by a direct blow from a blunt object could lead to a contusion. This could be sports-related, including (but not limited to) being hit by a baseball, being kicked or having your foot stepped on by another player in basketball, or by running in shoes that are too large or too small causing repeated traumatic contact between your foot and the shoe. Foot and ankle contusions can also come from regular daily activities, such as improperly fitting shoe gear, stubbing your toe or foot on a bed frame, someone stepping on your foot, or dropping a heavy object on your foot.

In most cases of a contusion, you would want to see your doctor as soon as possible to rule out extensive damage and be educated on the quickest way to regain normal function. In some cases, this may include an xray, CT scan or MRI depending on the situation and location of the contusion. The team doctor decided Brandon did not need xrays because the ball struck him in the meat of the calf muscle tissue rather than directly on any bone, but anytime you suffer this type of injury, you should see your doctor to rule out any fractures or other damage, especially in the foot where there is more bone than muscle tissue.

The treatment for a contusion (after you see the doctor as necessary) is usually going to be RICE, (rest, ice, compression and elevation.) doctor-recommended NSAIDs (non-steroidal anti-inflammatory drugs) and after a couple of days some light stretching of the muscle to prevent any scar tissue formation within the muscle tissue. Recovery time can vary depending on the severity and location of the contusion, from no limitations on activity to keeping weight off of the area for several days.

Injuries to the foot or ankle may take a week or two to feel "normal" because obviously every step we take puts force and motion throughout the foot. You would definitely want to limit activity until at least all the pain and swelling are gone. With any contusion, whether to bone or muscle or other soft tissue, you should consult your doctor’s advice regarding the next step in treatment and recovery, especially if the swelling and pain has not decreased after 2 days of RICE.

If you or someone in your family - particularly a child - sustains a foot or ankle injury while having some summer fun, please do not hesitate to call our office at 206-368-7000 or request an appointment online. Childhood injuries that do not heal correctly can cause long-term foot problems. The Foot and Ankle Center of Lake City is here to help "kids" of all ages keep their feet happy and healthy!

 

 

By Rion A. Berg, DPM
March 22, 2011
Category: Uncategorized

Spring often brings hope and sometimes the motivation towards improved health through exercise. For those who enjoy exercising in a group, (and who enjoy dancing), aerobic dancing can be a great choice to help you get in shape. Aerobic classes have been around for over 30 years and are offered in many locations in and around Seattle.

Aerobic dancing is a workout set to music, usually for about an hour, following a specific routine to warm up, peak heart rate and cool down. The benefits of aerobics are multiple – strengthening heart and lungs, lowering cholesterol levels and decreasing stress. Unless they are designed as “low impact,” most aerobic programs are quite strenuous.

If you have never taken an aerobics class or have been away a long time, it's a good idea to have an exam to assess the risk of injury to your feet.

Take Care Of Your Feet!

Impact forces from aerobics can reach up to six times the force of gravity, which is transmitted to each of the 26 bones in the foot. 

Proper shoes are crucial to successful, injury-free aerobics. Shoes should provide sufficient cushioning and shock absorption to compensate for pressure on the foot many times greater than found in walking. They must also have good medial-lateral (side-to-side) stability.

If your ankles turn inward or outward too much (e.g., excess pronation or supination) you may want to call the Foot and Ankle Center of Lake City about custom orthotics, custom because they will be designed for your feet and correct problems that could contribute to an injury.

Don’t be tempted to wear your running shoes for aerobic exercise. Running shoes lack the necessary lateral stability and lift the heel too high to be considered acceptable for aerobics.

Prevention of Injuries

Injuries from aerobics usually result from improper shoes, surfaces, or routines, and overuse of muscles through too vigorous a regimen. Take classes from a certified instructor and give yourself time to learn the program correctly. If you can, start at a low-impact level and work your way up as you become fit and more confident of the routine.

If you exercise at home with a video, be very careful. Read the label to determine whether the video is produced by certified aerobics instructors and whether you can handle the degree of impact. While it's safe to do low-to-moderate impact aerobics on the living room carpet, that's not a proper surface for high-impact routines.

Don't under estimate the importance of the cool-off period. It burns off lactic acid (which makes muscles feel tired) and adrenalin, while keeping blood from pooling in the extremities.

The Pain Factor

If you feel pain in your feet, stop. Don't attempt to exercise through pain, or you may aggravate an acute injury into a chronic or even permanent one. If you continue to be bothered by pain in your feet or ankles for more than 24 hours after exercising, contact our office for an appointment.

Common Aerobics Injuries

Plantar fasciitis (arch pain) -- Arch pain is often caused by frequent stress on the plantar aspect, or bottom of the foot, in an aerobics routine.

Heel spurs -- Heel spur syndrome, related to plantar fasciitis, occurs after calcium deposits build up on the underside of the heel bone.   

 

Sesamoiditis --. Incredible forces are exerted on the sesamoid bones during aerobics, and inflammation and fractures can occur. Proper shoe selection and custom orthotic devices can help avoid sesamoiditis.

Stress fractures -- Probably the most common injuries to aerobics instructors, stress fractures are caused by poor shoe selection, hard surfaces, and overuse. When swelling and pain surface, call for an appointment. X-ray evaluation and early treatment can prevent a disabling injury.

The Bottom Line

Remember, foot pain is not normal, so don't ignore it. Chances are, a successful aerobics regimen will bring out the body you've always dreamed of, and a better feeling about yourself both physically and mentally!

By Rion Berg, DPM

Please visit our on-line library for more information on keeping your feet happy and healthy!