"Women tell me all the time their high heels are killing them. Yes. They are.": High heels, neuropathy, and the diabetic foot

Tuesday, June 24, 2014

I really do not think much about my feet.  Maybe after a long day walking around.  Or when I'm staring at my toes during yoga.  Otherwise, I lace up my running shoes, kick on my heels for court.  And I take my feet for granted.

As a diabetic, I've been to the podiatrist.  He told me to ditch high heels.  I didn't listen.  "I'll listen when I'm starting to get old," I've always thought.  I am apparently coming of age faster than I realized.  Tonight our speaker at our monthly t1-diabetes group was an orthopedic surgeon, Dr. Mark Sanders, who has an acute interest in the diabetic foot.  But, also other feet.  

He spent a lot of time talking about the stakes for diabetics.  Most diabetic hospitalizations are for a foot problem.  Most of those hospitalizations result in an amputation.  Most diabetics who have a foot amputation cannot handle the cardiac load of a prosthetic body part given how weak diabetes makes your heart and they die within five years.  Okay, so, yikes.  But, what can you do?

The surgeon explained that diabetes creates two major problems in feet.  First, glucose causes neuropathy.  Second, as part of its terror hardening arteries everywhere, glucose can affect the dorsiflexion in your ankles.  A normal individual can flex his ankle back towards his knee to 20 degrees.  The 20 degree flexion is necessary to walk properly.  Without that flexion, the ankle becomes frozen, and you walk in a way that tends to lead to problems.  I've linked his youtube demonstrating the simple diagnostic test below.

At the meeting he screened some of us, including me, since I've had some issues with my feet going numb while running.  It turned out that I do have neuropathy.  I can't feel nearly what a normal individual can.  But, my neuropathy isn't yet so bad that I wouldn't be able to feel a nail go through my foot or something like that.  Some neuropathy is just expected.  I've been diabetic 18 years.  But, what my dorsiflexion test revealed I had only at 8 degree ankle bend.  

I was shocked.  "But I'm so flexible!" I kept thinking.  Even more shocking, though, he looked at me, picked my work pump off of his makeshift examining table and held it in front of my face.  "Honestly, I can't tell you whether or not the dorsiflexion issue is caused by your diabetes or these shoes," he proclaimed to the group.  High heels are terrible.  "Women tell me all the time their high heels are killing them.  Yes!"  Apparently high heels freeze your foot in the same way that hardening arteries do.

Although he had previously explained that he normally recommends a procedure in the case of someone with an 8-degree ankle bend, in my case, the case of a high-heel wearer, he suggested some physical therapy type exercises to work on the flexion before attempting a surgical release to restore the ankle bend.  

So, what are my takeaways?  
  • My next suits will be pants suits instead of skirt suits so that I'll be able to get away with wearing flats more of the time.  At this point, I own only one pants suit.  
  • Time to start researching all of the exercises, stretches that I need to do to restore my dorsiflexion.  
  • I was not expecting to discover I had any type of foot issue.  I only went to the group to socialize.  I guess it's good to devour as much medical information as possible, even at a young age.  I'm older than I think.

P.S. Here's the link to the example of the dorsiflexion test: https://www.youtube.com/watch?v=iNTrdoomjyc&list=UUg8xHRHrajiuhRCSIqm2iRw.

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