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arrowAmerican Academy of Orthopedic Surgeons

Diabetic Feet

Diabetes causes blood vessel and nerve damage. Blood vessel damage decreases circulation to the foot and nerve damage decreases the protective sensation in the foot. Less sensitive feet are put through more stress because they do not feel the pain that usually stops the stress. Obesity, calf stiffness, and bony deformities are more common in diabetics, causing further increase in pressure on smaller areas of the sole of the foot. This can lead to skin breakdown and ulcer formation. Non-healing ulcers lead to infections and foot amputations.

How does calf stiffness increase the pressure on the sole?

In normal feet, the heel bears more weight than the front (ball) of the foot. With calf tightness, the heel is unable to touch the floor adequately. This increases the force on the ball of the foot. Increased weight and stress along with decreased sensation causes ulcers in the ball of the foot. Calf stiffness can also cause increased stress on the arch of the foot. The arch can flatten and go on to develop a rocker bottom foot, a condition that stretches out the foot arch and rounds the foot up. A stiff flat foot allows weight bearing on the delicate arch skin causing ulcer formation.

Can calf stiffness cause Charcot arthropathy?

Calf muscle tightness increases the stress in the foot. Increased stress on the arch, normal blood supply, and decreased sensation in the foot lead to bone and joint destruction called Charcot arthropathy. Charcot arthropathy leads to severe rocker bottom deformity of the foot.

What can you do to prevent foot ulcers?

Along with good foot hygiene and proper footwear, supple calf muscles are a must. Calf stretching with older methods is not effective and may increase the stress on the foot. Using ArchSafe™ wedges will protect the arch while stretching the calf muscles better.