Simcoe Foot Clinic
September 27, 2017
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Preventing Diabetic Foot Complications

Without proper diabetes management, complications from diabetes can be severe and sometimes life threatening. With a variety of potential complications like cardiovascular disease, kidney disease and vision impairments, foot care is not always at the top of everyone’s mind but it should be viewed with equal importance. Of the 1.5 million people with diabetes in Ontario up to 27,600 are expected to have a diabetic foot ulcer in one year alone. Diabetic wounds and ulcers are often debilitating, preventing patients from performing daily activities - even walking.

A long term complication from diabetes is poor circulation and immunity associated with nerve damage in the feet. With loss of feeling in the feet, diabetics may not feel a foot injury, blister or cut. Left untreated, sores, ulcers and wounds may become infected leading to serious complications like amputation.


Every four hours, there is one amputation in Ontario as a result of a diabetic foot ulcer.
That’s over 2000 amputations a year in Ontario alone, amputations that are associated with 800 deaths.

The good news is that with early detection and effective wound care, most of these amputations can be prevented. Diabetic foot assessments should be performed as a part of proper diabetes management at least annually and more frequently for those at high risk for complications. Your Chiropodist will perform neurological (nerves), vascular (blood), dermatological (skin) and musculoskeletal (muscle, ligaments, joints and bone) examinations in order to detect and prevent serious foot related complications.

Taking care of your feet at home is essential to maintaining proper diabetes management and preventing foot related issues from occurring.

Check your feet daily

Remember that you may not feel the pain of an injury so it is important to examine your bare feet every day for any cuts, sores, swelling, bruises, redness or any changes in colour. Check the tops, bottoms, in between the toes as well as the nails.

Wash your feet every day

With mild soap, wash feet daily with warm (not hot) water for no longer than 15 minutes. It is important to dry them thoroughly, especially between the toes.

Keep your skin soft and smooth

To prevent cracking which can lead to infection, apply lotion to the tops and bottoms of your feet but never between your toes. We recommend using products containing Urea when possible.

Change your socks daily

Wear diabetic or seamless socks, or wear regular socks inside out. If your feet get cold at night, wear socks to bed.  White socks are recommended incase of injury so that any blood will be visible.

Smooth corns and callouses gently

If your feet are at low risk for problems, use a pumice stone to smooth out callouses. If your feet are at medium or high risk then see your chiropodist for professional treatment. Do not use any products that are sharp or have a blade to treat your feet. Additionally, Do not apply over the counter corn or wart treatments.

Cutting your nails

If you can see and reach your toenails, trim them each week or as needed. Trim your toenail straight across and file the edges and corners with an emery board or nail file. If you cannot see or reach your feet or have neuropathy, see your chiropodist.

Wear shoes and socks at all times

Never go barefoot. Wear well fitting shoes, sandals or slippers at all times with a sole protective enough that a thumbtack could not pierce through.
Before putting on your shoes, feel inside to make sure the lining is smooth and there are no foreign objects.

Keep the blood flowing to your feet

Wiggle your toes and move your ankles up and down for five minutes 2-3 times a day to increase circulation. Put your feet up when sitting and don’t cross your legs for long periods of time. Smoking constricts blood vessels and can worsen symptoms so talk to your physician about smoking cessation.

Want to learn more? Visit Wounds Canada for additional resources. 

August 14, 2017
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5 Reasons not to go barefoot this summer
1. Infections and warts and fungus...oh my!
Spending a hot summer day lounging by the pool sounds just about perfect, right? Unfortunately bacteria and virus' love it just as much as we do and thrive in the warm, moist environments found in and around pools and change rooms. 
Athletes foot, plantar warts and fungal nail infections, some of the most common conditions contracted, are highly contagious and therefore are easily passed between family members.
2. You won't get a kick our of this
Going barefoot outside leaves your fee
t vulnerable to a large number of injuries including cuts, scrapes, bruises, stubbed toes, insect bites and punctures, which may require medical attention or a tetanus shot. 

Mowing the grass barefoot, a very unsafe practise, is unfortunately more common than you may think - with 16% of lawn mower injuries resulting in amputations.

3. A green thumb can be a pain in the foot
Gardening is a relaxing hobby for many and a great way to unwind and get some exercise. But for anyone with dry, cracked heels, going barefoot in soil can lead to infection.
Tips to remember: use a cream as a barrier to protect the feet and to aid in after-garden clean-up; wash your feet carefully being sure to dry thoroughly between your toes and cover any abrasions or cuts with a bandage and antiseptic.

4. Anything is possible if you have the right support
Shoes provide essential support for our feet. They also provide shock absorption that our feet lack while walking or running barefoot. The loss of stability going barefoot causes added stress of the feet and can lead to slips and falls, especially for seniors. 

5. A shoe-in for sunburn
The feet are often overlooked when it comes to sunscreen but melanoma and other skin cancers occur anywhere on the feet - on the top, on the soles, between your toes and even under your nails.
If you are barefoot outdoors make sure to apply sunscreen to the tops and bottoms of your feet and check regularly for any abnormal moles or freckles. 

It's important to note that diabetics should NEVER go barefoot. The lack of sensation in the feet can mean that an injury can go completely unnoticed leading to infection, amputation and other serious health complications. 
May 16, 2017
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Don't overlook your feet!
Top tips to keep your feet healthy during pregnancy.

Ahhh,  the joys of pregnancy - nausea, fatigue, stretch marks – oh, and don’t forget the often overlooked changes to your feet. Due to the natural weight gain during pregnancy, a woman's center of gravity is completely altered. This causes a new weight-bearing stance and added pressure to the knees and feet. Two of the most common foot problems experienced by pregnant woman are over- pronation and edema.


Over-pronation, also referred to as flat feet, is caused when a person's arch flattens out upon weight bearing and their feet roll inward when walking. This can lead to pain at the heel, arch, or the ball-of-foot and to inflammation on the plantar fascia, the fibrous band of tissue that runs from the heel to the forefoot.
The reason many pregnant women suffer from over-pronation is the added pressure on the body as a result of weight gain. Over-pronation can be treated with proper fitting footwear and the appropriate orthotics.
It is important to treat over-pronation for pain relief but also to prevent other foot conditions from developing such as Plantar Fasciitis, Heel Spurs, Metatarsalgia, Post-Tib Tendonitis and/or Bunions.

Swelling and Edema

Raised hormone levels cause you to retain fluid during pregnancy. Typically, fluid retention is particularly pronounced in your feet, ankles, and calves because your growing uterus puts pressure on the veins that carry blood back from your lower body. This partially blocks blood flow, keeping fluid in your legs and feet and leaving you feeling swollen and bloated.
The amount of swelling varies from person to person and even fluctuates throughout the day, often becoming more prominent in the evening as well as in warmer months or climates.
All that swelling may mean a trip to the shoe store as it’s not unusual to go up a full shoe size during pregnancy.  Investing in footwear with extra support, shock absorption and comfort will benefit you throughout your pregnancy as your center of gravity continuously changes as you gain weight.
Keep in mind that while mild swelling is normal, if you hands or face become puffy , swelling lasts more than a day or experience rapid weight gain, call your doctor as these can be signs of preeclampsia, a potentially life-threatening condition.  
Many women may also experience leg cramping and varicose veins as another side effect of pregnancy.

Leg Cramps

Leg cramping in the calf can be a sign of a calcium or potassium deficiency. Eating more dairy products or snacking on potassium-rich foods like bananas can help eliminate these painful muscle contractions. If you experience leg cramps, check with your doctor before taking any supplements.
Cramps are most common at night when your feet and legs are resting. You can relieve the pain by resting your calf on a hot water bottle and flexing your foot to stretch your calf. Of course the best way to relieve the pain is to walk it off. Walking each night 15-20 minutes will help to keep your circulation moving.

Vericose Veins

Pregnant women have up to 40% more blood in the circulatory systems, increasing the amount of pressure on vein walls.  The veins can stretch so much that the valves become faulty, allowing blood to pool in the veins and allowing them to become varicose.
Increasing circulation with walking and mild exercise can relieve discomfort and even prevent varicose veins from occurring. Gaining too much weight and/or standing for long periods at a time can increase your risks, as can your genetics (they’re hereditary).

10 Tips for healthy feet during pregnancy

  • Sleep on your side, not your back. This relieves pressure on the vena cava, the largest vein leading to the heart. Otherwise, the pressure slows the blood returning from your lower body.
  • Consume a lot of fluids. Dehydration worsens swelling.
  • Elevate your feet as often as you can. Try to raise your legs 6 to 12 inches above your heart for 15 to 20 minutes to help the blood flow back to your heart and lungs.
  • Monitor your weight. Women of normal weight should gain 25 to 35 pounds during pregnancy. Excessive weight gain exacerbates swelling and can lead to other problems.
  • Improve the circulation in your ankles with rotation exercises. Try sitting, with one leg raised. Rotate your ankle 10 times to the right, then to the left. Switch legs. Repeat 10 times.
  • Ice your ankles. With your feet up, apply ice to the inside of your ankles for 15 to 20 minutes every half hour to an hour.
  • Take regular breaks from sitting or standing. A short walk every so often will help keep your blood from pooling in your lower extremities.
  • Don't wear socks or stockings that have tight bands around the ankles or calves.
  • Eat well, and avoid junk food and excess salt
  • Exercise regularly, especially by walking, swimming, or riding an exercise bike. Or try a water aerobics class – immersion in water may temporarily help reduce swelling.
May 16, 2017
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Do you really know what your nail polish is doing to your nails?
It’s nothing new to learn that nail polishes contain chemicals. Over the last couple of years, most big brands have gone “3-free” – meaning they are free of Dibutyl Phthalate (DBT), toluene and formaldehyde, 3 of the most toxic ingredients often found in nail polish.

But chemicals aside, what happens to our nails when we’re constantly rotating through a rainbow of our favourite polishes? Our nails may appear solid but they are actually relatively permeable and soak up substances that are applied to them.  Applying a base coat beforehand can prevent polish from soaking into your nails and help keep nails from yellowing, staining or drying up.

What may actually be worse than the nail polish itself, is the acetone used in nail polish remover. Acetone is very dehydrating to the nail plate, causing flaking and weakness. Picking off chipped polish might seem like a safer alternative but by doing this you’re also removing the top layer of your nail, weakening them further. So when it comes time to remove your polish, be sure you’re using a non-acetone remover or a natural alternative.

Though it may seem like good value when a pedicure lasts all summer, it’s important to take a break from nail polish every few weeks and let our nails breathe for at least a week.  With our nails constantly covered, not only are they more susceptible to cracking and breakage, but we can’t see any problems that may have arisen. With any nail damage, bacteria and fungus can develop under the nail plate, conditions that can be treated successfully when recognised early.

Toenails can take 9 months to grow so it can take a long time to recover from any significant damage. Try using polishes and basecoats with natural oils and vitamins and moisturize daily to keep nails hydrated.

If you notice anything unusual with your toenails, always check with your Chiropodist to assess and treat any issues as soon as possible.
March 20, 2017
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Get active while putting your best foot forward!
With summer (hopefully) just around the corner, many of us are thinking about how to get our exercise routines back on track or maybe thinking about starting a new workout program. While it may seem like a good idea now to jump in feet first, don’t go sign up for your first half-marathon just yet. When starting any rigorous exercise, there are a few things to keep in mind before you begin:

Slow and steady wins the race
Whether it’s been a couple months or 20 years since you were last on a serious exercise program, it’s important to increase intensity gradually in order to progress from one week to the next without the risk of injury. Pushing yourself too fast or training too hard can lead to injuries that may take weeks to recover come, leaving you frustrated and discouraged.
Quality over Quantity 
In order to get the most out of your workouts, learning the proper technique is more important than how much you can bench or how many squats you can do. Using improper technique means you’re not putting enough stress on the intended muscles and inadvertently straining other areas.  
An Ounce of Prevention…
Plantar fasciitis and Achilles tendinitis are two of the most common exercise related injuries, particularly for runners. To prevent foot, toe and heel pain, be sure to stretch and strengthen your feet often (daily if possible).

Calf Drops
  • Stand on a step with forefeet on the edge, holding on to a railing if necessary. Push up with both feet into a calf raise. Lift one leg off the step and lower your other leg so that your heel drops below the step. Take up to 10 seconds to lower it. Return to start; repeat 10 times on each foot. Do three times a week.
Toe Spread
  • While seated, place a thick rubber band (or a towel) around your toes and spread them apart. Double the band if it's not tight enough to provide resistance. Hold for five seconds. Do 10 times on both feet. Do three times a week.
Arch Massager
  • Stand with a tennis ball directly under second toe of right foot. Slowly roll ball around sole of foot for 1 to 3 minutes; repeat with left foot. 
“A shoe is not only a design, but it's a part of your body language, the way you walk. The way you're going to move is quite dictated by your shoes”. – Christian Louboutin
While Christian Louboutin may not have been talking about athletic shoes, the message still stands. Choosing the proper style and fit of shoes can dictate how you perform and prevent injuries. Because of the specific needs for individual sports, purchasing shoes from specialty stores from experienced staff will assure you that you are getting the shoe that works best for you and your feet. A few key points to keep in mind are
  • Try on shoes at the end of the day when your feet are the largest
  • Wear the same type of sock that you wear for that sport
  • Shoes should never need to be “broken in”. They should be comfortable as soon as you put them on
As always, it’s recommended that you check with your doctor before starting any new exercise program and remember to listen to your body - it is your best indicator of what works for you, what doesn’t and when you’re able to step it up a notch or need to take a break. Foot pain is never normal and if you’re experiencing any discomfort, call your chiropodist to assess any concerns and keep your feet at their best.

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