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Lower Limb Issues

Peripheral Neuropathy in Diabetics

Overuse Injuries

Achilles Tendinitis

Vascular Conditions in Diabetic Patients

Peripheral Neuropathy in Diabetics


Diabetes can affect several systems in the body, including the nervous system. The most common type of peripheral neuropathy affects the leg and foot. Diabetic Peripheral neuropathy results in the loss of sensation of the foot. Symptoms may include tingling, numbness, and in some cases, pain.

This loss of protective sensation may result in the patient being unaware of an injury by ill-fitting shoes, objects that have fallen in their shoes, stepping on an object while walking barefooted, or a burn. The loss of sensation may also result in the development of painless ulcers. These painless ulcers may become infected and may result in amputation. 


Proper treatment includes management of diabetes by your physician and daily inspection of the feet by the patient or a family member. Your podiatrist can evaluate your sensation for signs of peripheral neuropathy and other signs of diabetic foot complications and provide advice on proper foot care. Annual visits to a podiatrist for a foot examination are recommended for all diabetic patients.

Overuse Injuries


Overuse injuries due to lifestyle problems, unbalanced walking or sporting activities commonly lead to ankle and foot abnormalities. The tendons, bones and muscles are specifically prone to degeneration. The various disorders may be classified by a grading system that includes peritendinous inflammation, degenerative tendon disease, and ruptures. Bone marrow edema is another typical manifestation of overuse. An anatomic distribution is an urgent need to provide immediate positive effects on walking.

Overuse injuries provide a challenge to the diagnostic acumen and rehabilitative and preventive skills of the medical community. The challenge is intensified when the primary lesion is located in the foot, whose levers, arches, and pulleys are responsible for absorbing shock, as well as converting a mobile adapter into a rigid lever for propulsion.

Podiatrists permit people and sportspeople to benefit from accurate diagnosis, technique correction where necessary, manual therapies to joint and soft tissue, appropriate strengthening programme. They perform gait control using shoe-insoles and sensor technologies such as ankle joint support for falls prevention, shock absorption, preserving dynamic balance via foot and may contribute to prevent overuse injuries. Expertise rehabilitation and clinical competencies are important as well. Reduction of predisposing factors is of utmost importance in the successful management of overuse injuries.

Most overuse injuries are avoidable: the risk of traumatic injuries and, in particular, of sustaining a fracture, contusion, or concussion is higher during sports. They are also more likely to occur as you get older — especially if you don't recognise the impact ageing can have on your body and modify your routine accordingly. If you suspect that you have an overuse injury, get in touch.


Achilles Tendinitis


Achilles tendinitis is an overuse injury of the Achilles tendon, the band of

tissue that connects calf muscles at the back of the lower leg to your heel bone.

Achilles tendinitis most commonly occurs in runners who have suddenly increased the intensity or duration of their runs. It's also common in middle-aged people who play sports, such as tennis or basketball, only on the weekends. Most cases of Achilles tendinitis can be treated with relatively simple, at- home care under your doctor's supervision. Self-care strategies are

usually necessary to prevent recurring episodes. More-serious cases of Achilles tendinitis can lead to tendon tears (ruptures) that may require surgical repair.

The pain associated with Achilles tendinitis typically begins as a mild ache in the back of the leg or above the heel after running or other sports activity. Episodes of more-severe pain may occur after prolonged running, stair climbing or sprinting.

You might also experience tenderness or stiffness, especially in the morning, which usually improves with mild activity.

Podiatrists can help by assessing the underlying cause (such as your gait or running style) and implementing a treatment plan specific to you which may incorporate shockwave therapy, orthotics therapy, taping techniques, mobilisation, stretching, strengthening and more.


Vascular Conditions in Diabetic Patients


Diabetic patients have a higher incidence of lower extremity peripheral vascular disease (PAD) than non-diabetic patients. Patient complaints may include pain with walking relieved by a short rest period (intermittent claudication), rest pain at night, and a slow healing or non healing wound.
Annual visits to a podiatrist for a foot examination are recommended for all diabetic patients.

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