1. 1 FOOTCARE : What You Should Know!

2. 2 Feet: Most efficient form of transportation Stable base Composed of many small parts Fully integrated and adapted Every foot is different Unique bony structure allows man to stand erect and walk on two feet

3. 3 Natural Physical Attributes That Contribute to Feet’s Vulnerability : The feet are the most distant from the heart BP of the foot is 1/3 less than normal BP

4. 4 Normal Changes That Occur With Age: Bones and Joints Loss of bone mass Low rate of repair of articular surfaces Reduction of synovial fluid Result: Prone to stress fractures Prone to osteoarthritis Prone to develop bursitis

5. 5 Ligaments: Loss of pliability Loss of elastic fibre Result: Reduced tensile strength causing: a. Permanent stretching of the ligaments b. Increased rigidity of foot

6. 6 Muscles: Arches: Loss of muscle fibre Result: Loss of agility Loss of muscle volume (thin feet) Loss of integrity of the arches Result: Higher arches-rigid Lower arches lose spring Foot becomes wider and longer

7. 7 Circulation: Nerves: Reduced blood supply Reduced return to heart Result: Decreased O2 and nutrients Increased healing time Edema Nerve supply decreased Result: Reduced sensation Reduction in deep tendon reflex Reduction in active sweat glands

8. 8 Skin: Loss of fatty pad Reduction in active sweat glands Reduction in active sebaceous glands Lower rate of cell replacement Diminished hair growth Result: Prone to injury Skin becomes dry Skin becomes thin,flaky and scaly

9. 9 Nails : Reduced rate of growth Thickening of nail plate Result: Nails lose lustre, become brittle, thickened and striated Prone to infection (fungal)

10. 10 The “High Risk Foot” Feet are totally dependent on the major systems of the body for nutrition and innervation Presence of chronic disease in any of the major body systems will cause deprivation and could result in development of pathology…………. ”Foot at risk”

11. 11 Individuals Considered High Risk Need Special Care Presence of chronic disease i.e.. Diabetes, heart disease, circulation problems, arthritis Stressful over loading i.e..Plant workers, obesity, pregnancy, sports activities Certain medications i.e.. Steroids, vaso- active agents Neglect and/or ill-fitting footwear

12. 12 Risk Factors - If You Have: Loss of feeling in your feet Pain in legs while walking Changes in the shape of your feet Previous foot ulcers You are at risk for development of foot ulcers and possible amputations

13. 13 What We Know! 50 to 60% of all individuals with Diabetes have peripheral vessel disease 50 to 70% of non-traumatic amputations are due to Diabetes Over 50% will require a second amputation in 5 years Lower limb amputation is done 13 times more often on individuals with Diabetes Foot problems account for 47% of all Diabetes related hospital beds

14. 14 What Can We Do? Check feet twice per day. Look for sores, cuts, bruises,injuries Do you suffer from neuropathy? Decrease in sensation is the single most important reason for foot injury Footwear is vitally important Check shoe wear before buying and putting on foot Avoid anything which restricts circulation

15. 15 What Can We Do? Avoid exposing your feet to extreme temperatures Do not soak feet Do wash feet daily

16. 16 What Can We Do? Trim nails carefully Exercise promotes circulation If you fall into a high risk category, you should be seen by a foot specialist Make sure your doctor/nurse examines your feet at each visit