Posts for: December, 2013

By Nrupa Shah
December 27, 2013
Category: Diabetes

Ever wonder how your body stays warm? Well, your body stays warm by burning fuel for energy.  The same way a fire burns wood and oxygen for heat and light.  Your body is just much more efficient and well controlled.  The most fuel is used by your heart as it is constantly pumping like the ultimate endurance athlete.  That's why the warmest part of your body is your heart.  Your heart pumps warm red oxygen filled blood to your hands and feet to keep them warm and healthy.  That blood then finds its way back to the heart and lungs to get warmed up and refueled with oxygen.  When your body is exposed to cold weather it conserves heat by limiting blood flow to your hands and feet to keep your head and core warm (the important stuff).  That's right; your body is willing to sacrifice your limbs to keep you alive.

If you have diabetes, like actor Tom Hanks who recently made his diagnosis public, or you're pre diabetic then one of the most problematic side effects is damage to your circulation (blood flow). Diabetes causes your vessels to shrink and harden.  This happens to a higher degree in your feet because they are so far away from your body.  It's the damage to your circulation that leads to neuropathy and poor ability to heal.  Unfortunately, this is why so many diabetics are prone to ulceration on their feet.  They can't feel the irritation and develop a wound that is difficult to heal.

In the cold weather, diabetics need to be especially careful because their already poorly vascularized feet are subject to further limits in blood flow as the body conserves heat.  When someone who can't feel their feet very well tries to warm them up, they run into further issues as they don't know how hot is too hot.    You may be able to stick your feet in the fire and not realize your feet are burning (DON'T TRY IT!).  Here are a few winter tips for diabetics.

  1. Keep your feet warm with breathable socks.  You want to keep your feet warm and dry so that if your feet sweat they won't freeze.  I like thick merino wool socks that absorb moisture and regulate temperature well. 
  2. Always dry your feet.  When your feet are wet they are prone to infection.  Always dry your feet after you get out of the shower or finish a workout.  Pay special attention between your toes as this area can harbor moisture and makes a nice home for nasty invaders.
  3. Wear proper footwear.  If you're diabetic you probably already wear shoes with proper support and cushioning but if you don't, now is the time.  I like to wear boots in the winter as they provide support, warmth, and lots of style. 
  4. Be cautious with heated massagers or warming devices.  Diabetics with neuropathy should always use thermometers or have a non-neuropathic loved one check to make sure that heating devices can't burn the feet.
  5. Keep your nails clipped and filed regularly by professionals.  Clip your nails straight across and keep them clean and dry to avoid infection. 
  6. Apply moisturizer to your feet once or twice a day to make sure the cold dry weather isn't drying out your feet.  Dry feet are prone to fissures which can split open causing wounds that can become infected.  If you keep your nails clean and pretty you may be able to get a loved one to rub lotion on your feet.
  7. Last tip is inspection.  A cornerstone of diabetic foot care is to inspect the feet daily to quickly spot wound formation and stop it in its tracks.

Stay warm out there and remember to take care of your feet if you want them to take you where you want to go.  If you have any questions about your shoe gear or your feet, make an appointment with your local podiatrist at Affiliated Foot and Ankle Care located in Edison and Monroe NJ today.

By Nrupa Shah


With Thanksgiving past us and the promise of snow to come, it's time to break out the winter boots.  Those who work outside are no strangers to wearing boots to work, but boots offer advantages to men in all walks of life.  Boots are often constructed with a stiff sole and a sturdy arch support.  Quality boots can be worn in the snow and protect your feet from the moisture and the cold.  Many boots are lightweight, comfortable, and great for walking.  Boots are also a stylish choice for many men looking for new dress shoes. A good pair of boots will likely cost you more than $100, but with proper care your boots withstand many years of abuse.

Those with foot and ankle instability will benefit from the stability and comfort of a well constructed boot.  The stiffness of the sole is great for those who suffer from hallux rigidus or hallux limitus, a painful arthritis of the big toe joint.   The height of the boot allows for greater ankle stability as the laces and upper part of the boot extend well past the ankle.  Podiatrists love working with boots because of their size and stability.  The large size of most boots is accommodating for even the largest of orthotic inserts and we know that the shoe will support the foot well.

This holiday, resist the minimalist movement and treat yourself to a classic pair of boots made out of real American materials. Nothing is more manly and stylish than a real pair of leather boots.

If you have any questions about your shoe gear or your feet, make an appointment with your local podiatrist at Affiliated Foot and Ankle Care located in Edison and Monroe NJ today.

by Varun Gujral


Everyone (well almost everyone), has two arches in their feet: a transverse and a longitudinal.  The longitudinal arch is the largest and most obvious arch which stretches from your heel to the ball of your foot.  The height of this arch is sometimes referred to as the instep.

This arch has to support a lot of weight throughout the day so it has to have some support.  It’s supported by muscles in the foot as well as tendons from the muscles in your leg.  The biggest support however, is by ligaments and connective tissue.  Your arches have a very thick and resilient piece of connective tissue that runs from the heel to the digits called the plantar fascia.  The plantar fascia holds the arch up and keeps your foot from collapsing when your feet are bearing weight (If you have flat feet your arch is low or collapsed).

You can think of the plantar fascia as sort of a spring that is stretched when your feet hit the ground to absorb force and conserve energy.  If you aren't wearing shoes I want you to reach down and pull up on your big toe while grabbing your arch with the other hand.  You should be able to feel your plantar fascia tighten up, just like it does while you're walking.  It's easy to see how this can undergo a little wear and tear.

Plantar fasciitis is a painful inflammation of your plantar fascia that many feel in their arches or at their heel (where the plantar fascia attaches).  This is usually due to an increase in weight, activity, or overuse.  The pain arises with tiny micro tears that can cause the fascia to tighten up.  The tighter it gets the more prone it becomes to injury.  It can be a vicious cycle of progressing tightness and pain if not properly addressed. 

Often there are simple things you can do at home to keep plantar fasciitis at bay. 

  • Massage your arches a few times a day with your fingers.  Or, place a small ball (a golf ball works well) under your foot and roll it around on your arches.  This will work out the scar tissue and allow the tissue to expand. 
  • Tight calves can cause tight plantar fascia.  Do calve stretches and work on your flexibility.
  • Wear shoes with supportive arches that decrease the strain on your plantar fascia.
  • If you are still having trouble then try buying a device that will stretch out your fascia.  The Strassburg sock is a device that pulls up on your toes to stretch your plantar fascia while you sleep.  Many patients have had a lot of success with devices like this.
  • Severe plantar fasciitis can result in heel spurs and may require surgery, but surgery is always a last case scenario

If you want to learn more about your feet or you can't get rid of the pain in your archesmake an appointment with your local podiatrist at Affiliated Foot and Ankle Care located in Edison and Monroe NJ.

by Nrupa Shah