Small Foot Wounds A Threat For Neuropathy Sufferers

Today's post from reuters.com (see link below) again addresses diabetics as being the target audience but as so often, this article applies to everyone with neuropathic foot problems, irrespective of the cause. It looks at a Dutch study showing how dangerous small wounds on the feet can be if neglected. This especially applies to neuropathy patients experiencing numbness on their feet. The likelihood is that wounds may go unnoticed and rapidly become ulcerated and infected. It goes on to advise people to pay special attention to footwear and daily foot care, something which may seem obvious but is easily forgotten in the daily struggle to get by.

 

Minor foot wounds a major threat for diabetics
By Krystnell Storr NEW YORK Mon Apr 14, 2014   (Reuters Health) - For people with diabetes, one foot ulcer is very likely to lead to another, according to a new study that finds even minor lesions create a major risk of more severe foot wounds.

The best defense, Dutch researchers say, is to treat even minor sores carefully and to protect feet from pressure and injury with specialized footwear.

"I hope medical specialists, and other health care practitioners will use this knowledge and implement it in clinical practice," said senior author Sicco Bus, staff scientist with the Academic Medical Center at the University of Amsterdam.

People with diabetes often lose feeling in their feet as a result of nerve damage, known as neuropathy. The lack of sensation makes diabetics prone to injure their feet without realizing it, and allows small wounds to grow into serious ulcers that can eventually lead to infection or gangrene.

In the U.S., 26 million Americans have diabetes. Every year, 65,700 of these patients have lower-limb amputations.

Past research has shown that having had a foot ulcer is a significant risk factor for having more of them.

"Ulcer recurrence is a debilitating condition for the patient, risking further complications such as infection and amputation, and influencing loss of patient mobility and quality of life," Bus told Reuters Health.

To find out what factors most strongly predict who will develop foot ulcers, Bus and his colleagues analyzed data from a large trial of specialized footwear for diabetes patients with nerve damage in their feet (see Reuters Health article of January 24, 2013 here: reut.rs/1ewrG4F).

For the new analysis, the researchers focused on 171 participants, all of whom reported having a foot ulcer at least 18 months before the study began. For a period of 18 months, each person was checked for new ulcers every three months, and interviewed about their daily habits.

The pressure on their feet while walking barefoot and in the special footwear was also measured. During one week, sensors in the shoes reported how often the participants wore their shoes and how many steps they took.

During the study period, 71 people developed ulcers on the soles of their feet, 41 of them as a result of unrecognized "trauma," Bus and his colleagues report in the journal Diabetes Care.

Among those 41, the people who had minor lesions when the study began were nine times more likely than those who didn't to develop an ulcer. Often the wounds were in the same place as a previous ulcer, suggesting there was ongoing pressure or injury happening at that spot, according to the researchers.

Patients who wore shoes customized to the pressure points of their feet, however, had a 57 percent lower risk of developing a new ulcer compared to those who didn't.

Currently, to prevent ulcers, doctors and nurses have to check the feet of diabetic patients every day for wounds or use specialized tools for determining pressure points that might be prone to blisters.

"Some diabetics wear wounds on their feet kind of in the same way that a person might wear a hole in their sock, but for a diabetic, this hole gets infected and often leads to an amputated foot," Dr. David Armstrong, a professor of surgery at the University of Arizona, told Reuters Health.

"(Neuropathy) is a massive problem, it's silent, and it doesn't hurt, even in instances of gangrene. It's no one's fault, but no one pays attention to it. This study opens up avenues for prevention," said Armstrong, who was not involved in the research.

The protective effect of customized footwear seen in the study highlights the benefits of personalized healthcare in high-risk patients, noted Dr. Lawrence Lavery, a professor of surgery at the Texas A&M Health Science Center College of Medicine and the Scott and White Memorial Hospital in Temple, Texas.

Private insurers will have to step up to pay the expense, Lavery said. "This is something that is well worth investing in."

SOURCE: bit.ly/1iBJUCL Diabetes Care, online April 4, 2014.

http://www.reuters.com/article/2014/04/14/us-foot-diabetics-idUSBREA3D0UJ20140414

Socks With Sensors To Prevent Neuropathic Foot Damage Vid

Today's long post from healthline.com (see link below) is nevertheless an easy and interesting read that will appeal to many readers with neuropathy in their feet. It's important to state right from the start that these socks (subject of the article) will do nothing to prevent or improve your neuropathy but will alert you to any physical danger (e.g. ulcers) that you may not notice due to lack of feeling and as such can be seen as a valuable tool in harm prevention. As is clearly stated: "We don't prevent neuropathy, we prevent the complications that come with neuropathy. We prevent ulcers and amputations." That said, the article does read a little like an extended advertisement for a product and this blog tries to avoid anything with potential for commercial gain. However, the story behind the development of these socks does suggest a genuine interest in improving the lot of neuropathy sufferers and more than that...it makes sense. It's also clear evidence of the potential for modern technology to improve people's health. It's long but absolutely not tedious and is well-worth a read.

Siren Socks: Revolutionizing Diabetes Foot Care with the Internet of Things
Written by Amy Tenderich | Published on February 27, 2017

Got neuropathy in your feet?

We hope not, but if you do -- or suspect that you might -- you will absolutely want to know about a new company called Siren Care. It was founded by young Chinese-American entrepreneur Ran Ma, who after completing a Biomedical Engineering degree at Johns Hopkins University, freaked out her parents by spending hours holed up in her bedroom sewing socks.

She had a brilliant idea to embed tiny sensors that would connect to an app to track temperature and localized ulceration risk. It panned out big-time!





The socks she invented recently won the coveted TechCrunch "hottest new hardware" award at CES, and the 2016 Health 2.0 "best newcomer in digital health" competition. And medical experts are now saying "what they have done with embedded IoT (Internet of Things) sensors and smart materials will totally redefine how patients can self-manage complications as a routine part of their daily life." Wow!

Please join us for this chat wth Ran to learn about Siren Socks, and possibly win a set of your own!

Q and A with Ran Ma, on Siren Socks for Diabetic Foot Care

DM) Ran, pioneering ‘smart socks’ for diabetic neuropathy is a pretty unique path... Can you share a bit about how you got here?

RM) I was born in China but I grew up in Texas and then I lived in Baltimore, Chicago, Denmark, Sweden, Germany and now back to the States in San Francisco.

My background is biomedical engineering. I studied at Johns Hopkins, and then afterwards, I actually worked in the Department of Plastic Surgery at Northwestern, under Dr. Maldonado. While I was there, I worked on a project called Biomask. We actually developed a wearable mask that would regenerate your face, using stem cells, and this was targeted for burn victims and war veterans. This was right after the Iraq war and because of the research we did, I learned a lot about wound healing, wound formation, also wound prevention. My lab also worked on diabetic foot ulcers. That's just something that really stuck in my mind.

I also come from three generations of doctors -- so my grandparents, my aunts, uncles, and my parents are doctors. My father's actually a surgeon. He cuts people every day and for me, I want to dedicate my life further up in the chain of medicine, towards the side of prevention. I really want to make great tools that are easy to use, and give people the right data at the right time, so they can take control of their own health. I always say if I do my job right, I could put my parents out of a job.

Do you have a personal connection to diabetes?

No I don’t, but my co-founder Jie Fu has lots of diabetes in his family, and some of his relatives have unfortunately suffered some of the more severe consequences.

As noted, both my parents are physicians in China – my mom does hematology so mostly leukemia, and my father works on cervical and ovarian cancers, so very late-stage cancers and they lose a lot of their patients unfortunately because it is so late-stage. That's why I want to focus on prevention.

For me, it's about knowing that diabetic foot damage is a very serious problem with very severe consequences, but it's preventable and there's strong clinical research showing that temperature monitoring can make a big difference in prevention.

So you came up with this ‘crazy idea’ to embed sensors in socks?

Here I was a biomedical engineer who was going to go to medical school, and I told my parents, ‘You know what? I'm sewing socks in my room by myself.’ My parents thought I had lost my mind. I was buying components off the Internet and just sewing it together… because it's one thing to have an idea in your head, but another to put it into physical form.

So I had this sock that was all misshapen, connected to a circuit board with all these wires coming off it (and) I went to the big annual Diabetic Foot Conference DF Con two years ago and basically said, ‘Hey, podiatrists, I'm gonna make a sock, it's going to detect injuries in real-time and then it's going to connect to a phone and your patients are going to be able to wear this and it will be soft and washable.’ And they looked at me like I was crazy, basically... because the early prototype really was just crazy-looking, but we’ve come a long way.




Fill us in on your current team, headquarters and manufacturing facilities?

The company was founded in February 2015 by myself and two co-founders: Jie Fu, whose background is electrical engineering and hardware mass production, and Henk Jan, whose background is global textiles sourcing -- he worked in the textile industry and he set up one of the world's largest manufacturing groups for textiles.

So our leadership is made up of biomedical engineering (my background), electrical engineering, and textile manufacturing. We have a team of 5 and are currently expanding.

Our headquarters are in downtown San Francisco, and we’re currently doing some manufacturing in China, with final assembly in the U.S. We plan to move more of the production to the U.S., but that's still in the works right now.

Hasn’t it been common knowledge for a long time that temperature monitoring can help with foot health? If so, what’s really so revolutionary about using this technology in socks?

You're absolutely right. Temperature monitoring has been around for at least a decade or more and it's been published in Diabetes Care and other leading journals by Dr. Lavery and Dr. Armstrong. But there's been a lack of technology.

A few years ago the technology didn't exist to make a wearable device for temperature monitoring, right?
 In recent years sensors are getting smaller and cheaper and people are putting them in bands, like Jawbone, etc. and all of this has happened because of the emergence of IoT (Internet of Things) tech. Now sensors have gotten small enough that we can actually incorporate them into fabric.

The other thing that has happened is a revolution in design thinking. As you well know at DiabetesMine, even just a few years ago the focus was, ‘This works in clinic, great!’ but (no one was) thinking about it from the patient’s side – as in:

‘If I were living with diabetes, could I use this tool?’ Even though it works in clinics, even though my doctor can use it, does it actually make sense for me to take these bulky tools home? 


There are other solutions on the market: temperature monitoring wands like the TempTouch foot thermometer, a temperature monitoring carpet and a bathroom scale, and I think those are really great and very pioneering in the field. Our team's goal is at-home prevention, empowering the user by creating something that’s easy to use and monitors continuously, so you can have a sense of security at home. So that's why we're focused on a wearable solution.

OK, so how exactly do new ‘smart’ Siren Socks work?

They monitor six spots on your foot, based on the six most common sites of injury according to clinical trials, and we actually monitor your two feet and compare the temperature difference between the same spot on each foot.

When you have a difference of more than 4 degrees Fahrenheit or 2.2 degrees Celsius, then we know that inflammation is occurring, and that means your body is fighting off injury; that's when we give you an alert on your phone. The point is, something has happened and your body is fighting that injury, reacting with inflammation and that's followed by a rise in temperature. We pick up on that and we alert you. 



And you offer the first continuous temperature monitor for feet, right?

Yes, it's very important for us to be a continuous monitor: All the other solutions mentioned are point solutions, meaning you take one measurement a day. You don’t know what happened before or afterwards -- what about the other 23 hours and 50-something minutes in the day? Since there's no reference, it’s even harder to determine why changes might occur.

Because we take so many measurements over time, we're able to filter out false positives. If it's a random spike (in foot temp), we know that's not normal. Inflammation is a sustained temperature difference averaged over time, it's a very particular signature and that's what we can pick up with our socks.

Another benefit is personalization. Maybe for you, one of your feet is just warmer because you have circulation problems or it’s just genetic. Our technology creates a baseline per user over time, so it's a lot more powerful smart tool that can learn from you over time.

Wait, if you’re targeting people already living with neuropathy or other foot conditions, how are these socks ‘preventative’?

We don't prevent neuropathy, we prevent the complications that come with neuropathy. We prevent ulcers and amputations.

What happens to people with neuropathy is they have a foot injury and don't realize it for a week, two weeks, two months even I've seen. And then you go see your doctor and the first thing they do is wheel you into the surgery room!

With our socks, if you have an injury, you might not feel it but you’ll see it with temperature and we alert you. Then you go see your doctor and he/she makes a diagnosis with the X-ray or with a physical exam and then treats you for it. Just from temperature we cannot possibly know if it's just a callous, or a blister, or Charcot foot – so you need to see your physician. But the early detection helps you avoid ulcers or even needing an amputation.


Don’t the embedded sensors, and that little anklet disc on the side, make the socks lumpy?

No, we take very tiny proprietary temperature sensors, like a grain of sand, and incorporate them into the fabric of the sock, and they send data to our companion app via Bluetooth. The anklet holds the battery and BLE chip. We've designed it to have the thinnest profile and smallest surface area possible, and we are always working to further miniaturize this component.

Back when I was hand-sewing them two years ago, you could definitely feel everything, but now… they are really good diabetic socks. The key point to making smart clothing is you have to make really good clothing first. If I gave you the socks right now, you would never know they were smart socks because you couldn't find the sensors.

Can you wash them like normal socks?

Yes, our socks are machine washable and dry-able, you don't have to charge them, and they're completely soft and flexible. They're super-absorbent and have no seams on the outside or inside, and we all know that's important because diabetic socks should be seamless so you don't have any pressure points on your feet. Right?

So we're really creating a great diabetic sock to start with and then we give it intelligence, to protect your feet.




How does the Siren app work?

The basic functions are of course that you can see the current status of your feet and it's very easy to understand, color-coded green, yellow, and red. And of course we walk you through the recommendations when an injury or potential injury is detected. The app may suggest checking your feet, reducing activity or reaching out to your healthcare professional.

You can see your foot temperature over time, and your foot health over time and that helps you know, when did this inflammation begin? This is why continuous use is important. You can see for example if inflammation was caused because every day you're wearing a certain pair of shoes that are just too small. One of the main causes of diabetic foot ulcers are shoes that are too small -- because if you can't feel pain, you don't realize you're buying shoes that are too small. So our app actually helps people start looking at their habits.




Can you share the data directly with your doctor?

Right now the Siren app basically sends you alerts on your smartphone if there are significant changes in your foot temperature – it’s alerting you to go see your doctor. The data is in the cloud and you access your account on our website or though the app, where you can easily print it or send it to your doctor in file format, but we don’t have direct data-sharing yet. That’s something for the future.

Also, at the end of the year we're going to be rolling out a solution for people living with diabetes that don't have access to a smartphone, like what we're offering but online (instead of app-based) so you can also use our smart socks without a phone.

Eventually we’d like to have a Call Center that can alert users who can’t get those alerts and alarms on a phone.

Can you add notes into the app, like about what shoes you wore or what activity you did that day?

Yes, people can add notes like, ‘Wore my new whatever-shoes,’ and then you may notice the next day after wearing this pair, you're always getting inflamed, so you can think maybe it's those shoes. It really often is the shoes you wear, and that's something you can pick up on.




In the app you can also check the battery life of your socks, track how often you wore them, which ones you're wearing, and how often you washed them. I think one of the key items is, we can tell you this week you only wore your socks 40% of the time, so maybe next week you can aim to wear them 60% of the time. The more often you the wear socks the more protected your feet are. And if you have neuropathy, you have to wear good socks anyway. That's the number one recommendation, right? We help you quantify that.

So this has big potential to help anyone with diabetes, type 2 or type 1?

Neuropathy can happen to anyone. It does happen to people with type 1 and type 2. It's usually a little bit older population, but I've also seen it in people in their 20's and 30's. It just happens, your nerves start dying, getting eaten away and it usually happens in your feet and hands first, because those are your longest nerves. Hands are not as dangerous because you see your hands every day, but you don't check your feet every day or look at them as closely, so damage can go unnoticed. That's why it's very important to take care of your feet.

Have you completed clinical studies on Siren Socks, showing effectiveness?

We did an initial small test and are now scaling. We’re actually recruiting patients right now with Dr. Reyzelman, a podiatric surgeon at UC San Francisco. This will be a published result, ongoing into March including 30 patients.

I'm also giving a talk at this year’s DF Con Diabetic Foot Conference, at the end of March. That’s the biggest diabetic foot conference in the U.S. and I’ll be presenting the background of temperature monitoring, the current form factors, and why it was important to bring up a smart sock to fill the technology gap right now. And hopefully we'll have some initial results that I will present at that conference. It's a huge deal for me to be a speaker there, because as noted, I went to this conference a few years ago with a VERY rudimentary prototype and I think I scared some of the physicians there. So now two years later, we've progressed so much.

What’s the situation with regard to FDA approval?

We are very firm in saying that we are a tool and not a diagnostic, and that doesn't currently fall under FDA scrutiny.

The studies we’re doing are more to test compliance and user experience. We have entry interviews and exit interviews. So we ask, ‘Do you enjoy the solution? Is it easy to use? Do you like the colors?’ Very basic questions like that are important because we already know that temperature monitoring works, there's no doubt about that. But we need to know: can people use this solution? It’s important to do field studies where you even go into people’s homes to see how they use it, how does it work for them?

Tell us about the prestigious TechCrunch award you received for Siren Socks...?

We just won the TechCrunch Hardware Battlefield competition at CES in January, and that was a huge deal, as they screen I think somewhere around 1,000 of the newest, hottest hardware companies and they narrowed it down to 12.




Twelve went on stage and did a live demo and then they narrowed it down to four, who did a final demo, and they picked one, and we were actually that one! It was a huge honor, we didn't think we would get that far because most of the other companies were one or two or three years older than us.

But I think one of the reasons that we made it so far is that we actually brought a patient on stage, Judy, who has been living with diabetes for seven years. She is 73 and has retinopathy and neuropathy – we had to help her on stage because the lights were so bright. She actually wore our socks on stage and we live-streamed her foot data, so it really made the story make sense, you know when you see these socks in action. You could see how much Judy enjoyed wearing them, she was modeling them in front of the judges and we think that’s great because it helps raise awareness that diabetes touches the lives of so many people.

And you won an influential Health 2.0 competition as well?

Yes, in Fall we also won Health 2.0 Launch, which is strictly digital health, encompassing software and hardware. You know, they’ve had some really great companies that have won over the years, like Basis that was purchased by Intel, Glimpse that was a runner-up and they were recently acquired by Apple, and Castlight Health also went through there. They definitely pick winners.

That one is more bragging rights than an investment prize, but TechCrunch… really brought a lot of momentum to our fundraising. We are raising our seed round right now and I must say it's going very well, especially after CES.

Wait, so you did all this pre-seed funding?

Yes exactly. We had a very small pre-seed round of about $500K last year, but most of the other companies that went on stage with us had raised $4-$5 million seed round and they were raising their A Round financing already, so they are one to two years ahead of us. We move fast.

And you got a lot of great exposure… even at home?

Funny story about my mom, who as you know is a doctor in China. I was supposed to go there to visit for Chinese New Year and she was really disappointed that I had to cancel the trip because we had all of this going and we're fundraising.




But two or three weeks ago she turned on the TV to this channel called ‘Chinese People Around the World’ she watches every day during lunch and she actually saw me there, on Chinese National TV! She was making noodles and she almost burned them all because she was running all around the room trying to find her phone so she could record it, then she was texting me all frantically, ‘Oh my God, did you know you were on TV? Can you find it online can and send me the video?’ They even translated all of our presentation to Chinese, and I had no idea.

They look for entrepreneurial Chinese people who've done cool things around the world and they report about it, so I guess they found me somehow. I have no idea where they got my Chinese name from, but it was really cool.

Kudos to proud mamas around the world! So please tell us how you are reaching out to the PWD community in particular. Have you connected with any patient advocacy orgs?


We've been doing a lot of work within the podiatrist community and diabetes HCP groups to get the word out. I am also doing a few podcasts with diabetes experts, and we're coming out with a bunch of blogs (that offer) educational background on temperature monitoring, how important it is and the history of it.

We were also included in an article published in the November ADA Diabetes Forecast magazine on what makes a great diabetic sock.

As far as reaching the patient community directly, that's very important -- getting people involved and getting their feedback. So talking to you at the ‘Mine is one of our avenues…

Glad to help if we can! We see you have an introductory pre-order pricing set up. Tell us about the offer and when the socks are expected to ship?

Our socks are priced at $180 for seven pairs of socks, but right now we’re doing a pre-sale, at a $60 discount. So it’s $120 for a pack of seven, that should last you six months. There's also an option online to purchase smaller packs, of one, three, and five pairs.

Right now it’s all online ordering directly from us, and we expect the socks to ship in Summer. We’re also in talks with distributors to bring the socks into retail stores like Wal-Mart, CVS and Walgreens. But that won’t be rolling out until later this year.

You talked about design, but these socks currently only come in plain black and white versions, correct?

We're going to make our socks as attractive as possible. We have thought about different color variations, (and) we've already come up with Christmas designs, Halloween socks, summer, fashion versions, etc. for the future.





Of course, you shouldn't be wearing high-heeled or other fancy shoes if you have diabetic neuropathy. You should wear comfortable shoes that are well padded and fit your feet properly and we help you with that.

And the life expectancy of a pair of Siren Socks is six months?

Exactly, we replace all your socks every six months because that's standard in diabetic foot care -- every three to six months you need to replace all your socks to minimize spreading infection and also if there's a thin area in the sock material, that's where a foreign object can penetrate and get to your feet. The only line of defense is your socks, so you want to make sure they’re very thick and cushioned and the fabric is in the best shape possible.

And just a reminder: you don’t have to charge these socks, even though they’re outfitted with smart technology.

Finally, what’s a Twitter-style message you might want to send to the Diabetes Patient Community from your vantage point tackling foot damage?

I would say take care of your feet, and the future is here: we’ve dreamt of a world where we can have access to the right data at the right time and that future has arrived!

I don't know if that's a good Twitter message, but I’d want your readers to know there are lots of people – lots of other teams like us – working very hard to make tools easier to use and to bring science into your home in a way that addresses a problem and helps.

Thanks so much Ran -- That’s inspiring to say the least. We thank you for your ingenuity, down to our diabetic toes!

http://www.healthline.com/diabetesmine/siren-socks-revolutionizing-diabetes-foot-care#1

I Have Sciatica Why Are You Grabbing My Foot

It is 5 am in Badwater, CA. There are approximately 100 runners toeing the chalked line. There is 135 miles, over 10,000 ft in elevation gain and 120 degree heat under the Death Valley sun between them and the finish line. I see my runner crossing the horizon towards our support car, his stride looks shortened, but smooth for mile 60. Over the next 75 miles we take turns passing off race essentials. At 4 am, as a team, we cross the finish line at Whitney Portal.

So how did this journey begin?

From the moment I met him I could hear the “thud”. It was the sound that his foot made as it he walked through the clinic.  He tells me he is a runner, but not just a runner, but he is running in the Badwater Ultramarathon in July. 135 miles of “thudding” into the ground! To bring the pressure up a notch, this is going to be his 11th consecutive finish. As I watched him move and walk, I can't stop focusing on the stiffness of his foot which is causing the "thud". But how do I explain his lack of foot mobility is contributing to what he is actually coming to see me for… SCIATICA?

What is Sciatica?

Sciatica is a general term used to describe inflammation of the sciatic nerve or nerve roots which comprise it. Sciatica can be caused by a disc injury or stenosis (narrowing of spaces of the spine), which puts pressure on the nerve roots. When our foot hits the ground force is transferred up the leg and into our lower back. Our foot is designed to pronate upon impact to allow for shock absorption.  The bony anatomy of our foot and ankle causes a biomechanical chain reaction. This generates a rotation in the leg then into the pelvis which helps to recruit the gluteals to provide the stability of the back. However, if the foot remains supinated, ground reaction force is transferred into the spine instead of being absorbed through the foot and leg. When the mobility of the foot is limited, the lower back is forced to move more to compensate for the lack of motion. The increase motion of the back decreases the amount of space the nerve has to pass through the spine.

When the foot pronates it causes a rotation up the leg which
helps to dissipate force and maintain good motion of the back.

When the foot remains supinated the foot remains rigid forcing
the back to rotate more which decreases space for the nerves.

To improve his foot mobility I begin to facilitate pronation of his foot. IT worked! His sciatic pain decreased.  I worked on it some more and his pain was gone! He was able to walk and jog in the clinic without his symptoms. 

From the moment I helped his foot become more supple and pronate, his sciatic pain got better.

So when you foot hits the ground: is it supple (pronated) or rigid (supinated)?

             

You can even see from the pictures above the difference in the position of the pelvis.

Techniques

Mobility

The technique is performed to increase mobility of the foot to reduce stress to the lumbar spine. This will help minimize your risk of sciatica. Stenosis is narrowing of the canal in which the nerves exit the spine. If you have a herniated disc, this is NOT a technique for you.

For forefoot runners, it is also important to have a mobile foot. The motion of supination and pronation occurs in the forefoot instead of the mid and rear foot.

Strengthening
After mobilizing the foot, it is important to retrain the muscles and joints in this new motion. This allows the newly acquired motion to be recognized as a movement path. If your body doesn't use this motion, the foot and ankle will become stiff again.

Here are examples of exercises which use the muscles and joints in all 3 planes of motion to retrain the body.

Please consult with a health care professional prior to performing these exercises. If it increases your pain, STOP!

HOMOEOPATHIC REMEDIES FOR HAND FOOT AND MOUTH DISEASE

Hand -foot-and-mouth disaese is a viral infection caused by  coxsackievirus A16. The coxsackievirus belongs to a group of viruses called nonpolio enteroviruses. Other types of enteroviruses sometimes cause hand-foot-and-mouth disease.

Oral ingestion is the main source of coxsackievirus infection and hand-foot-and-mouth disease. The illness spreads by person-to-person contact with an infected person's:

·         Nasal secretions or throat discharge

·         Saliva

·         Fluid from blisters

·         Stool

·         Respiratory droplets sprayed into the air after a cough or sneeze

Hand-foot-and-mouth disease is most common in children in child care settings because of frequent diaper changes and potty training, and because little children often put their hands in their mouths.

Although your child is most contagious with hand-foot-and-mouth disease during the first week of the illness, the virus can remain in his or her body for weeks after the signs and symptoms are gone. That means your child still can infect others.

Some people, particularly adults, can pass the virus without showing any signs or symptoms of the disease.

Outbreaks of the disease are more common in summer and autumn in the United States and other temperate climates. In tropical climates, outbreaks occur year-round.

Hand-foot-and-mouth disease isn't related to foot-and-mouth disease (sometimes called hoof-and-mouth disease), which is an infectious viral disease found in farm animals. You can't contract hand-foot-and-mouth disease from pets or other animals, and you can't transmit it to them.

Causes--The most common cause of hand-foot-and-mouth disease is infection with the coxsackievirus A16. The coxsackievirus belongs to a group of viruses called nonpolio enteroviruses. Other types of enteroviruses sometimes cause hand-foot-and-mouth disease.

Oral ingestion is the main source of coxsackievirus infection and hand-foot-and-mouth disease. The illness spreads by person-to-person contact with an infected person's:

·         Nasal secretions or throat discharge

·         Saliva

·         Fluid from blisters

·         Stool

·         Respiratory droplets sprayed into the air after a cough or sneeze

Symptoms--Hand-foot-and-mouth disease may cause all of the following signs and symptoms or just some of them. They include:

·         Fever

·         Sore throat

·         Feeling of being unwell (malaise)

·         Painful, red, blister-like lesions on the tongue, gums and inside of the cheeks

·         A red rash, without itching but sometimes with blistering, on the palms, soles and sometimes the buttocks

·         Irritability in infants and toddlers

·         Loss of appetite

The usual period from initial infection to the onset of signs and symptoms (incubation period) is three to six days. A fever is often the first sign of hand-foot-and-mouth disease, followed by a sore throat and sometimes a poor appetite and malaise.

One or two days after the fever begins, painful sores may develop in the mouth or throat. A rash on the hands and feet and possibly on the buttocks can follow within one or two days.

Risk factors--Hand-foot-and-mouth disease primarily affects children younger than age 10, often those under 5 years. Children in child care centers are especially susceptible to outbreaks of hand-foot-and-mouth disease because the infection spreads by person-to-person contact, and young children are the most susceptible.

Children usually develop immunity to hand-foot-and-mouth disease as they get older by building antibodies after exposure to the virus that causes the disease. However, it's possible for adolescents and adults to get the disease.

Complications--The most common complication of hand-foot-and-mouth disease is dehydration. The illness can cause sores in the mouth and throat, making swallowing painful and difficult.

Watch closely to make sure your child frequently sips fluid during the course of the illness. If dehydration is severe, intravenous (IV) fluids may be necessary.

Hand-foot-and-mouth disease is usually a minor illness causing only a few days of fever and relatively mild signs and symptoms. A rare and sometimes serious form of the coxsackievirus can involve the brain and cause other complications:

Viral meningitis. This is a rare infection and inflammation of the membranes (meninges) and cerebrospinal fluid surrounding the brain and spinal cord.

Encephalitis. This severe and potentially life-threatening disease involves brain inflammation caused by a virus. Encephalitis is rare.

HOMOEOPATHIC REMEDIES

MERCURIUS SOL 30- Merc sol is one of the leading remedies for hand foot and mouth disease . Here mouth sores can be very severe and the person is very sensitive to heat and cold. There may have a fever before getting the blisters and may alternate between getting too hot with perspiration and becoming chilled at night. Becoming too hot or too cold makes the patient worse in general. The blisters tend to be more painful at night. One of the characteristic symptoms of Mercurius is the tendency to drool or to have an excess of saliva in the mouth. The breath of the patient may be quite offensive with pus visible on the tonsils or else where in the mouth.

ANTIMONIUM TART. 30-Antimonium tart is another effective remedy for this diseases. In  the chill stage of fever--.gooseflesh and icy cold skin. Heat stage of fever.--the patient clings to those around and wants to be carried. He does not want to be touched or looked at.Thirstless despite the dry parched tongue.Sweat stage of fever-profuse , cold , clammy or sticky , dry, cracked, parched tongue with whitish discoloration in the centre. Tongue tip and sides clean, moist and red. Thrush. There is craving for apples or apple juice.

BORAX 3X—Borax is another top remedy for this disease . The patient refuses to talk during fever. Desire for cold drinks and cold food during fever.There is great heat and dryness of mouth with white ulcers. White fungus-like growth, they are tender.Ulcers bleed on touch and eating. Painful red blisters on tongue. Sore mouth prevents infants from nursing. Fear of downward motion. Startle easily. Very sensitive to sudden noises .

BELLADONNA 200-Belladonna is prescribed when there is high temperature, with flushed face and the eye is sensitive to light.There is severe headache with either restlessness or drowsiness. The  rash is red in colour with a feeling of heat and throbbing.

BRYONIA ALB. 30-Bryonia alb is prescribed when a dry cough develops if the fever persists for several days. There is thirst for large quantities of cold water with dry mouth. The child feels worse from motion. Constipation is also occurs .

APIS MELLIFICA 30-Apis mel is prescribed when the eruption is pink and puffy and very itchy, with stinging pains. The eyelids may become swollen. The child feels worse from warmth , and is irritable. There is no thirst.

RHUS TOXICODENDRON 30-Rhus tox is prescribed when severe itching occurs, which is worse from scratching and is relieved from warm bath or applying heat. The eyes may become inflamed and sticky. There is severe body pain and muscles feel very stiff, which is relieved by gentle movement or from warmth.The patient is restless both mentally and physically.

SULPHUR 200-Sulphur is prescribed when severe itching and burning occurs which is worse from scratching and washing. The symptoms worse from warmth. Both heat and chills are felt during fever. The child may feel drowsy in the afternoon and restless and hot at night.

HOMOEOPATHIC REMEDIES FOR ATHLETES FOOT

Athlete's foot (tineapedis) is a fungal infection that usually begins between the toes. It commonly occurs in people whose feet have become very sweaty while confined within tightfitting shoes.

Signs and symptoms of athlete's foot include a scaly rash that usually causes itching, stinging and burning. Athlete's foot is contagious and can be spread via contaminated floors, towels or clothing

Athlete's foot is contagious and can be spread by contact with an infected person or from contact with contaminated surfaces, such as towels, floors and shoes.

Causes-- Athlete's foot is caused by the same type of fungus that causes ringworm and jock itch. Damp socks and shoes and warm, humid conditions favor the organisms' growth.

Symptoms-- Athlete's foot usually causes a scaly red rash. The rash typically begins in between the toes. Itching is often the worst right after you take off your shoes and socks.

Some types of athlete's foot feature blisters or ulcers. The moccasin variety of athlete's foot causes chronic dryness and scaling on the soles that extends up the side of the foot. It can be mistaken for eczema or even as dry skin.

The infection can affect one or both feet and can spread to your hand — especially if you scratch or pick at the infected parts of your feet.

Risk factors-- ou are at higher risk of athlete's foot if you:

·         Are a man

·         Frequently wear damp socks or tightfitting shoes

·         Share mats, rugs, bed linens, clothes or shoes with someone who has a fungal infection

·         Walk barefoot in public areas where the infection can spread, such as locker rooms, saunas, swimming pools, communal baths and showers

Complications- Your athlete's foot infection can spread to other parts of your body, including:

·         Your hand. People who scratch or pick at the infected parts of their feet may develop a similar infection in one of their hands.

·         Your nails. The fungi associated with athlete's foot can also infect your toenails, a location that tends to be more resistant to treatment.

·         Your groin. Jock itch is often caused by the same fungus that results in athlete's foot. It's common for the infection to spread from the feet to the groin as the fungus can travel on your hands or on a towel.

HOMOEOPATHIC REMEDIES

Homoeopathic medicines are found to be very effective for Athelet’s foot. Some of the top remedies are given below.

GRAPHITES 30-Graphites is one of the top Homoeopathic medicines for athlete’s foot with cracks.It is prescribed when there is dry, rough skin along with cracks between the toes. Another leading symptom is moist and crusty eruptions which ooze out a sticky exudation. The eruptions in the folds break easily and are very slow to heal.

THUJA OCCIDENTALIS 200- Thuja is another effective Homoeopathic medicine for athlete’s foot with eruptions only on covered parts. The person has dry skin, which is very sensitive to the touch.The eruptions are accompanied by violent itching or burning.Scratching and cold bathing makes the condition worse.Athlete’s foot with needle pricking sensation will also respond well to Thuja occidentalis

SILICEA 200-Silicea is prescribed when athelet’s foot is associated with boils. Silicea acts well on boils coming out in crops along with foul pus on the feet and toes.Thereis  intense itching, especially during the daytime and evening.

highly rated Homeopathic medicines for athlete’s foot.

BARYTA CARBONICUM 30-Baryta carb.is prescribed when athelet’s foot occurs  with intolerable itching.  The person feels a peculiar burning sensation and needle-like pricks with violent itching. Excoriating and oozing athlete’s foot cases with difficulty in healing are also treated best with Homeopathic medicine BarytaCarbonica.

NITRIC ACID 30-Nitric  acidis another effective   medicine for athlete’s foot with splinter-like pains.  Nitric acid is prescribed when there are   unhealthy skin with pus formation where crusts form and fall, along with severe pain. The person may have dry skin, eroded and cracked at every angle. Another prominent symptom is violent itching, especially on undressing.

PETROLEUM 30-Petroleum is  prescribed when the skin is cracked and rough.  The person complains of deep cracks in the skin folds, especially in the toes. The skin gets hard and raw, and the cracks bleed easily. Thick greenish crusts with marked burning, itching and bleeding are usually seen .

ARSENICUM IODATUM 30-Arsenicum iodatum is best for athelets foot and is prescribed prescribed when there is scaly, flaking erythematous and dryness of the affected part.

Can Insoles Help With Neuropathic Foot Pain

Today's post from diabeteshealth.com (see link below) is a recommendation for a certain type of shoe insole designed to help people living with constant foot pain. This blog doesn't normally advertise and doesn't have personal experience of this product but it is patently obvious that anything that will help reduce the sometimes agonising pain in the soles of our feet, may be worth trying. Some of these products are so hard they can make the pain worse and although customers are warned that it may take weeks to get used to insoles, (as your foot gets used to a change in posture) that in itself can be too high a price to pay for many people. These however, come highly recommended. It's worth while remembering also though, that with neuropathy, what works for one doesn't work for another. Worth thinking about.

Airfeet Insoles Can Ease the Pain of Diabetic Neuropathy
Brenda Neugent | Apr 13, 2014

When the founder of AirFeet insoles was forced to switch jobs after years of brutalizing his body doing construction work, he needed a new path, and his aching back and feet led the way.

He decided that he wanted to do what he could to prevent others from experiencing the same aches and pains just from living their daily lives, and AirFeet insoles were born.

Most of us have some kind of foot condition that causes pain. That's especially true for those with diabetic peripheral neuropathy. The pain can range from tingling and burning to stabbing pain that feels as though hundreds of needles are being forced into the soles of the feet, but the one thing that remains the same is that it's uncomfortable for all who have it.

A problem that impacts more than 4 million people in the United States - about a quarter of the 16 million living with diabetes - neuropathy can be treated with several different drugs that have been shown to help ease the pain. Trouble is, drugs don't always work for everyone, and some may have undesirable side effects.

For those looking for an answer beyond drugs, AirFeet insoles might be the answer.

Designed to help increase circulation through the grooves and channels that cover the insole and provide constant massage to the base of the foot, the thin insoles provide cushioning with something they call Active Flow Media, a patented substance that flows back and forth with every step, providing support to the entire foot.

In addition, AirFeet insoles can be popped into the freezer for an added cooling effect that will sooth aching, sore feet, especially those with the tingling of neuropathy, which is often treated with cold packs.

Currently, the insoles are marketed at a variety of conferences and festivals - pretty much anywhere that people with sore feet much show up - and customers have posted on the company's website a wealth of testimonials about the innovative insoles.

Marie, a woman who picked her insoles up at a festival celebrating blueberries, said, "I had numbness in both legs when I walked in the AirFeet Booth. I felt like I was walking on rocks because of my neuropathy. Once I put the AF insoles in my shoes, within 10 minutes I could walk straighter, my numbness was gone, and my pain in my feet reduced! I'm so happy!"

http://diabeteshealth.com/read/2014/04/13/8207/airfeet-insoles-can-ease-the-pain-of-diabetic-neuropathy/