The foot is the lower part of the lower limb. One side of it, the one in contact with the floor surface, is called the sole, and the opposite, upper side is called the back. The foot has a movable, flexible and elastic arched structure with an upward convexity. The anatomy and this shape makes it capable of distributing weights, reducing shocks when walking, adapting to unevenness, achieving a smooth gait and elastic standing.
It performs a supporting function, bears the entire weight of a person and, together with other parts of the leg, moves the body in space.
Interestingly, a person’s feet contain a quarter of all the bones in their body. So, there are twenty-six bones in one foot. Sometimes it happens that a newborn has several more bones. They are called accessory and usually do not cause trouble to their owner.
If any bone is damaged, the entire mechanism of the foot will suffer. The anatomy of the bones of the human foot is represented by three sections: tarsus, metatarsus and toes.
The first section includes seven bones, which are arranged in two rows: the posterior one consists of the calcaneus and the talus, and the anterior one consists of the navicular, three cuneiforms and the cuboid.
Each of them has joints that connect them to each other.
The anatomy of the sole of the foot includes the metatarsus, which contains five short tubular bones. Each of them has a base, a head and a body.
All fingers, except the thumb, have three phalanges (the thumb has two). All of them are significantly shortened, and on the little finger, the middle phalanx of many people merges with the nail.
The anatomy of a joint consists of two or more bones connected to each other. If they get sick, severe pain is felt. Without them, the body would not be able to move, because it is thanks to the joints that the bones can change position relative to each other.
In relation to our topic, the anatomy of the lower leg of the foot is of interest, namely the joint that connects the lower part of the leg to the foot. It has a block shape. If damaged, walking, and even more so running, will cause great pain. Therefore, the person begins to limp, transferring the main weight to the injured leg. This leads to the fact that the mechanics of both limbs are disrupted.
Another area in question is the subtalar joint, formed from the connection of the posterior calcaneal surface to the posterior talar surface. If the foot rotates too much in different directions, it will not work correctly.
But the wedge-navicular joint can to some extent compensate for this problem, especially if it is temporary. However, pathology may eventually occur.
Severe pain, which can be long-lasting, occurs in the metatarsophalangeal joints. The greatest pressure is on the proximal phalanx of the thumb. Therefore, it is the most susceptible to possible pathologies - arthritis, gout and others.
There are other joints in the foot. However, it is the four named that can suffer the most, since they have the maximum impact when walking.
The anatomy of this part is represented by nineteen different muscles, thanks to the interaction of which the leg can move. Overstrain or, on the contrary, underdevelopment will affect them due to the ability to change both the position of bones and tendons and affect the joints. On the other hand, if there is something wrong with the bones, then this will certainly affect the muscles of the foot.
The anatomy of this part of the limb consists of the plantar and calf muscles.
Thanks to the first, the toes move. Muscles located in different directions help maintain the longitudinal and transverse arches.
The muscles of the lower leg, which are attached by tendons to the bones of the foot, also serve this purpose. These are the anterior and posterior tibial muscles, peroneus longus. Those that extend and bend the toes originate from the bones of the lower leg. It is important that the muscles of the lower leg and foot are tense. The anatomy of the latter will then be better expressed than in a constantly relaxed state, since otherwise the foot may flatten, which will lead to flat feet.
Muscles are attached to bones by tendons, which are their continuation. They are durable, elastic and light. When a muscle is stretched to its limit, the force is transferred to the tendon, which can become inflamed if it is overstretched.
Ligaments are flexible but inelastic tissues. They are found around the joint, supporting it and connecting the bones. If you hit your finger, for example, swelling will be caused by a torn or sprained ligament.
Cartilage covers the ends of bones where joints are located. You can clearly see this white substance at the ends of the chicken leg bone - this is cartilage.
Thanks to it, the surfaces of the bones have a smooth appearance. Without cartilage, the body would not be able to move smoothly and the bones would have to knock against each other. In addition, terrible pain would be felt due to their constant inflammation.
The foot contains the dorsal artery and the posterior tibial artery. These are the main arteries that represent the foot. The anatomy of the circulatory system is also represented by smaller arteries, through which they transmit blood and further to all tissues. If there is insufficient oxygen supply, serious problems arise. These arteries are furthest away from the heart. Therefore, circulatory disorders occur primarily in these places. This can be expressed in atherosclerosis and atherosclerosis.
Everyone knows that veins deliver blood to the heart. The longest of them runs from the big toe along the entire inner surface of the leg. It is called the great saphenous vein. The small subcutaneous tissue runs along the outer side. The anterior and posterior tibiae are located deep. Small veins are busy collecting blood from the legs and transferring it to large ones. Small arteries supply tissues with blood. And capillaries connect arteries and veins.
The image shows the anatomy of the foot. The photo also shows the location of the blood vessels.
Those who have circulatory problems often complain of swelling in the afternoon, especially if they spent a lot of time on their feet or after flying. A common condition is varicose veins.
If there is a change in skin color and temperature on the legs, as well as swelling, then these are clear signs that the person has problems with blood circulation. However, the diagnosis must in any case be made by a specialist, who should be contacted if the above symptoms are detected.
Nerves everywhere transmit sensations to the brain and control muscles. The foot has the same functions. The anatomy of these formations is presented in four types: posterior tibial, deep peroneal, superficial peroneal and sural nerves.
Diseases in this part of the limb can be caused by too much mechanical pressure. For example, tight shoes can compress the nerve, resulting in swelling. This, in turn, will lead to tightness, numbness, pain, or a strange feeling of discomfort.
After the anatomy of the foot and the structure of its individual organs have been studied, you can move directly to its functions.
Thanks to its mobility, a person easily adapts to different surfaces on which he walks. Otherwise, it would be impossible to do this, and he would simply fall.
The body can move in different directions: forward, sideways and backward.
Most of the loads are absorbed by this part of the leg. Otherwise, excessive pressure would be created in other parts of it and the body as a whole.
With a sedentary lifestyle, a disease such as flat feet can develop. It can be transverse and longitudinal.
In the first case, the transverse arch is flattened and the forefoot rests on the heads of all metatarsal bones (in the normal state it should rest only on the first and fifth). In the second case, the longitudinal arch is flattened, causing the entire sole to come into contact with the surface. With this disease, the legs get tired very quickly and pain is felt in the foot.
Another common disease is arthrosis of the ankle joint. In this case, there is pain, swelling and crunching in the indicated area. The development of the disease involves damage to the cartilage tissue, which can lead to joint deformation.
Arthrosis of the toes is no less common. In this case, there is a disruption of blood circulation and metabolic processes in the metatarsophalangeal joints. Symptoms of the disease include pain when moving, crunching, swelling of the toes, and the anatomy of the toes may even be disrupted (deformity).
Many people know firsthand what a lump at the base of the big toe is. In official medicine, the disease is called hallux valgus, when the head of the phalangeal bone is displaced. In this case, the muscles gradually weaken and the big toe begins to lean towards the others, and the foot becomes deformed.
The anatomy of this part of the lower limb shows its uniqueness and functional importance. Studying the structure of the foot helps to treat it more carefully in order to avoid various diseases.
The foot is a part of the lower limb that bears the weight of the body and, together with other parts of the leg, serves to move a person in space.
The foot is a part of the lower limb that performs a supporting function when standing and walking. It bears the entire weight of the human body and, together with other parts of the leg, serves to move the body in space. Thanks to the arched structure, the foot has spring properties. The bones of the foot, connecting with each other, form an arch, convex upward. At the back, the foot rests on the heel tubercle, and at the front - on the heads of the metatarsal bones (they protrude at the base of the toes). The toes are used to push off the supporting surface when walking, running and jumping.
This design of the foot allows you to distribute the weight falling on it, reduces shocks and jolts when walking, adapts the foot to uneven ground, imparts a smooth gait and elasticity to standing. In a newborn, the arch of the foot is not pronounced; it develops as the child begins to walk.
The skeleton of the foot is divided into 3 sections: tarsus, metatarsus and toes.
The tarsus consists of 7 strong bones arranged in 2 rows. The posterior row includes the relatively large calcaneus and talus, the anterior row consists of the scaphoid, cuboid and 3 sphenoid bones. Each of these bones has articular surfaces for connection with adjacent bones. The talus articulates above with the bones of the tibia, below with the calcaneus, and in front with the scaphoid. The largest calcaneal bone at the back is elongated and thickened, forming the calcaneal tubercle, which serves as a support when standing and as the attachment point for the tendon of a powerful muscle (the Achilles tendon of the triceps surae muscle). The navicular bone, occupying a central position in the tarsus, articulates with all its bones, with the exception of the calcaneus. The sphenoid bones are located in a row in front of the scaphoid bone. The cuboid bone is located at the outer edge of the foot and articulates behind the heel bone, and in front with the IV and V metatarsal bones.
The metatarsus is formed by 5 short tubular bones, of which I is the thickest, and II is the longest. Each metatarsal bone has a base resting on the tarsus, a head articulated with the main phalanx of the corresponding toe, and a tubular body. At the base of the fifth metatarsal bone (on the little toe side) there is a tuberosity that can be easily felt through the skin.
The toes have 3 phalanges, except for the first (big) toe, which has two phalanges. All phalanges, especially the middle ones, are significantly shortened, and on the fifth finger the middle phalanx often merges with the nail.
The foot has many similar structural features to the hand, since they originated from homologous fore and hind limbs of lower vertebrates. However, during the course of evolution, the hand was freed up to perform labor movements, and the leg remained an organ of support and movement in space. Functional differences led to structural features. The massive tarsal bones and short toes make the foot strikingly different from a hand with long fingers and a narrow wrist. Among the joints of the hand there are many movable joints that are absent in the foot. The joints of the thumb are particularly mobile, allowing them to grasp objects. In apes, the foot, like the hand, has grasping ability. But only in humans this ability is lost and the foot acquires a arched structure.
The foot is connected to the bones of the lower leg using a movable ankle joint. The bones of the lower leg (tibia - on the inside - and fibula - on the outside), thanks to the protruding ankles, form a kind of fork that covers the block of the talus bone. Movements in the ankle joint occur around the transverse axis: flexion, when the toe of the foot moves down, and extension, when the toe moves up and approaches the lower leg. These movements are sometimes called plantarflexion and dorsiflexion.
The ligaments that strengthen the ankle joint are located on the sides of the joint. Their fibers fan out from the ankles to the navicular, talus and calcaneus bones. Sprains in the joint are common. This happens when plantar flexion occurs simultaneously with the lowering of the outer edge of the foot. In this case, the narrower rear part of the talus block appears in the fork between the ankles, which is weakly wedged and leads to lateral movement - the leg is tucked in. The lateral collateral ligament may be sprained, and sometimes even part of the ankle may be torn off where the ligament attaches to it.
The connections between the bones of the foot form a complex system of numerous joints, reinforced by many short, strong ligaments. From a practical point of view, the transverse tarsal joint, or Chopart joint, and the tarsometatarsal joints, collectively called the Lisfranc joint, are of greatest importance. If necessary, the forefoot is amputated along the line of these joints.
Most joints of the foot are classified as stiff because the shape of the bones and strong ligaments limit movement in them. The greatest mobility is possessed by the metatarsophalangeal joints, in which flexion, extension, abduction and adduction of the fingers are possible, as well as the block-shaped interphalangeal joints of the foot, allowing slight flexion and extension of individual phalanges.
The most amazing thing about the structure of the human foot is its arches. Only in humans the foot is built on the principle of a strong and elastic arch with short toes. The bones of the foot form 2 arches - longitudinal and transverse, which were formed in connection with the vertical position of the human body. The foot rests on the floor area not with its entire plantar surface, but only with the heel tubercle at the back and the heads of the first and fifth metatarsal bones in front, which ensures its spring properties.
The longitudinal arch of the foot can be thought of as a system of five arches, each of which starts from the calcaneal tubercle and extends forward to the head of the corresponding metatarsal bone. On the inside of the foot, its longitudinal arch is higher, on the outside it is lower. This is easy to see even when looking at the plantar surface of the foot. The outer part of the foot serves as support when standing and walking, the inner part springs when moving. Therefore, the outer part of the longitudinal arch of the foot (formed by the arches going to the 4th and 5th toes) is usually called the supporting arch, and the inner part (I–III arches) is called the spring arch.
The transverse arch of the foot is well defined in the area of the metatarsal heads. Normally, the foot rests in the anterior section only on the heads of the outermost (I and V) metatarsal bones; the heads of the II, III and IV metatarsal bones form a convex arch.
The arched structure of the foot is maintained by the shape of the bones and the strength of the ligaments, especially the long plantar ligament and the plantar aponeurosis—the so-called passive ligaments of the foot.
An equally important role in strengthening the arches is played by muscles - active tightening, which are located both longitudinally and transversely. There are 3 muscle groups on the sole: some carry out the movements of the thumb; others - the little finger; the third, lying in the middle, acts on all toes. Bundles of fibers of these muscles, running in different directions, help maintain the longitudinal and transverse arches of the foot.
The arches of the foot are strengthened not only by the muscles lying directly on its plantar surface, but also by the muscles of the lower leg, which are attached to the bones of the foot with their tendons. First of all, these are the anterior and posterior tibial muscles and the peroneus longus muscle, located on the lower leg. Long muscles that flex and extend the toes also begin from the bones of the lower leg. Therefore, when standing and moving, when many leg muscles are tense, the arches of the feet are often better expressed. When the muscular system is weakened, the arches of the feet are smoothed, the ligaments are stretched, and the foot is flattened. This phenomenon is called flat feet.
There are transverse and longitudinal flat feet. With transverse flatfoot, the transverse arch of the foot is flattened and its forefoot rests on the heads of all five metatarsals, and not just on I and V. With longitudinal flatfoot, the longitudinal arch is flattened and the foot comes into contact with the floor with the entire plantar surface. The main cause of flat feet is weakness of muscles and ligaments, resulting from injuries or as an occupational disease (in people whose work involves prolonged standing or walking). Flat feet are more common in obese people than in people of average weight. For many people, by the evening the foot also becomes somewhat flattened and lengthened (due to muscle fatigue).
Flat feet manifest themselves as pain in the foot area and rapid fatigue of the legs. Pain may also be felt in the lower leg and thigh area and may be accompanied by deformation of the fingers. In children, flat feet can develop due to frequent physical overload: carrying heavy objects, the habit of picking up younger brothers and sisters, etc.
Prevention of flat feet consists of strengthening the muscles of the foot and lower leg with special exercises (for example, walking on toes and the outer edge of the foot), creating conditions that prevent prolonged standing on the feet, and using special insoles-arch supports that raise the arches of the feet.
Professional stress on the foot causes clearly noticeable changes in it.
An example is the foot of ballerinas. When standing and walking on your toes
the entire weight of the body falls on the first three fingers, so the metatarsals and phalanges of these
ballerinas' fingers are relatively more massive than those of people of other professions. Despite
that the human foot is highly specialized as an organ of support and movement,
among some peoples it is used as an auxiliary organ of labor. That's why
movements in the joints of the foot achieve great mobility, and the muscles
differ in dexterity. If necessary, mobility of the foot joints
can be increased by appropriate exercises.
Attention should be paid to the fact that the support area of a vertically standing human body is limited precisely by the outer edge of the feet. The wider the feet are spread, the larger the area of support and, in accordance with the laws of physics, the more stable the balance of the human body. Any movement in space (walking, running) begins with a loss of balance (translational movement of the body forward - falling) and the subsequent creation of a new area of support (repositioning the legs). In this case, the foot is both a support and an engine, since it pushes the body away from the ground.
Authors: Olga Gurova, Candidate of Biological Sciences, senior researcher, associate professor of the Department of Human Anatomy of the RUDN University; Igor Ponomarev
The foot is the distal section of the human lower limb and is a complex articulation of small bones that form a unique and strong arch and serve as support during movement or standing. The bottom of the foot that is in direct contact with the ground is called the sole (or foot), the opposite side is called the dorsum of the foot. According to the structure of the foot skeleton, it can be divided into 3 parts:
Thanks to its multiple joints and arched design, the foot is remarkably strong, yet flexible and resilient. The main function of the foot is to hold the human body in an upright position and ensure its movement in space.
To understand the structure of the joints of the foot, you need to have an idea of the anatomy of its bones. Each foot is made up of 26 individual bones, which are divided into 3 parts.
Metatarsus, which consists of 5 short tubular bones located between the tarsus and the proximal phalanges of the toes.
The phalanges are short tubular bones that form the segments of the toes (proximal, intermediate and distal phalanges). All fingers, except the first, consist of 3 phalanges. The thumb has only 2 phalanges, just like on the hands.
Structure of the foot skeleton
The metatarsal bones form a whole group of joints among themselves. Let's take a closer look at them.
The calcaneus and talus bones take part in its formation. The joint has a cylindrical shape. The joint capsule is poorly stretched. The surfaces of the bones that form the joint are covered with smooth hyaline cartilage, along the edge of which the joint capsule is attached. Outside, the joint is additionally strengthened by several ligaments: interosseous, lateral and medial, talocalcaneal.
As the name implies, the articulation is formed by the articular surfaces of the talus, calcaneus and navicular bones. Located in front of the subtalar. The talus forms the head of the joint, and the other two form the glenoid cavity for it. The joint is spherical in shape, but movements in it are possible only around one sagittal axis. The articular capsule is attached to the edges of the hyaline cartilage that covers the articular surfaces. The joint is strengthened by the following ligaments: talonavicular, calcaneonavicular plantar.
Located between the articular surfaces of the calcaneus and cuboid bones. The joint is saddle-shaped in shape, but movements are possible only around one axis. The capsule is stretched tightly and attached to the edges of the articular cartilages. The joint participates in the movements of the two previous joints, increasing the range of motion. It is strengthened by the following ligaments: long plantar ligament, calcaneocuboid plantar ligament.
This joint, together with the talocaleonavicular joint, is usually divided into one joint, which is called the transverse tarsal joint. The articulation line is S-shaped. Both joints are separated from each other, but have one common ligament - a bifurcated one.
This is a complex articulation, in the construction of which the scaphoid, cuboid and three wedge-shaped bones of the tarsus take part. All individual joints are enclosed in one joint capsule, which is attached to the edges of the articular cartilages. The joint is strengthened by such ligaments and is inactive:
This group of joints connects the bones of the tarsus and metatarsus. There are three such joints:
The first joint is saddle-shaped, the rest are flat. The line of these joints is uneven. Each joint has a separate capsule, which is attached to the edges of the articular hyaline cartilages. The joints are strengthened by the following ligaments: dorsal and plantar tarsometatarsal, interosseous metatarsal and cuneiformatatarsal.
Joints and bones of the foot
These are small joints that connect the bases of the individual metatarsal bones. Each such joint is strengthened by ligaments: interosseous metatarsal, dorsal and plantar metatarsal. The space between the long bones of the metatarsus is called the interosseous metatarsal space.
The heads of the 5 metatarsal bones and the bases of the proximal phalanges of the fingers take part in the construction of these joints. Each joint has its own capsule, which is attached to the edges of the joint cartilage; it is poorly stretched. All these joints are spherical in shape.
On the dorsal side the capsule is not strengthened by anything, there are collateral ligaments on the sides, and plantar ligaments on the plantar side. In addition, a deep transverse metatarsal ligament runs between the heads of all metatarsal bones.
This group of joints connects the proximal phalanges of the fingers with the intermediate ones, and the intermediate ones with the distal ones. They are block-shaped in shape. The articular capsule is thin, reinforced below by plantar ligaments, and on the sides by collateral ligaments.
Joints and ligaments of the metatarsus and phalanges of the toes
Every day, the joints of the foot are exposed to enormous loads, supporting the weight of the entire body. This leads to frequent trauma to individual components of the joints, which may be accompanied by inflammation and deformation. As a rule, the main symptom of diseases of the foot joints is pain, but it is difficult to immediately determine its cause, since there are many pathologies that affect these joints. Let's take a closer look at the most common of them.
Deforming osteoarthritis of the joints of the feet is a fairly common pathology, especially among women. As a rule, the disease begins at the age of 40-50 years, although earlier cases of pathology are also found. The metatarsophalangeal joint of the big toe is most often affected.
This disease is often mistakenly called gout due to the similarity in the localization of the pathological process, although there is nothing in common between these ailments. Also, many associate the disease with mythical salt deposits and unhealthy diet, which also does not correspond to reality.
In fact, the formation of a lump on the big toe joint and deformation of other structural components of the foot is associated with the negative influence of the following factors and, as a rule, develops in people genetically prone to this:
The disease is characterized by 3 stages and slow but steady progression:
Three stages of deforming osteoarthritis of the foot
Treatment of the disease must begin at the initial stages. Only in this case can its progression be slowed down. The main treatment measures are the elimination of all risk factors and possible causes of arthrosis. In addition, medicinal therapy methods, various folk remedies, physiotherapy and physical therapy can be used. In cases where the pathological process has gone far, only surgery will help. Surgical intervention can be gentle (arthrodesis, resection of exostoses, arthroplasty) or radical (endoprosthetics).
Absolutely all joints of the foot can become inflamed. Depending on the causes, primary and secondary arthritis are distinguished. In the first case, the joint itself is damaged; in the second, its inflammation is a consequence of the underlying disease.
The most common causes of foot arthritis:
Foot deformity in a patient with rheumatoid arthritis
Regardless of the cause, the symptoms of arthritis are more or less similar. Patients complain about:
Gouty arthritis of the metatarsophalangeal joint of the big toe
Treatment for arthritis should first be aimed at eliminating its underlying cause. Therefore, only a specialist should engage in therapy after making a correct diagnosis. Incorrect treatment is a direct path to the development of chronic inflammation and deformation of the foot joints.
Foot deformities can be either congenital or acquired. They are caused by changes in the shape or length of bones, shortening of tendons, pathology of the muscles, articular and ligamentous apparatus of the foot.
With the development of this pathology, all the arches of the foot become flattened, as a result of which its shock-absorbing abilities are impaired. Flat feet can be congenital, or can arise during a person’s life as a result of excessive loads on the lower limbs, rickets, the development of osteoporosis, various injuries, obesity, wearing inappropriate shoes, and damage to the nerve endings of the legs.
This is what flat feet look like
This is a fairly common type of foot deformity and, as a rule, is congenital. It is characterized by shortening of the foot and its supination-type position, which is caused by subluxation of the ankle. The acquired form of deformity develops due to paresis or paralysis, traumatic injuries to the soft tissues or skeleton of the lower extremities.
It is very easy to identify congenital clubfoot in a child - a routine examination is sufficient.
Other types of foot deformities (less common) include cauda equina, calcaneal, and cavus.
Cauda and calcaneal foot
There are many other diseases that can affect the joints of the feet, such as traumatic injuries or tumors. But, as a rule, they all manifest themselves with fairly similar symptoms. Therefore, if you develop pain, fatigue, swelling, or deformation of the foot structures, be sure to seek specialized help, since not only your health and activity, but also your life may depend on this.
There is another terrible complication that can lead to amputation of the fingers of the lower extremities, feet, legs... All these are disastrous consequences of the developed diabetic foot syndrome, which, according to statistics, occurs in 80% of patients with diabetes.
This syndrome as a separate problem began to be considered by scientists only from the middle of the last century. In those years, another branch of medicine appeared that began to closely study foot diseases, called podiatry. Endocrinologists, vascular surgeons, and orthopedists began to jointly offer possible options for helping those suffering from diabetes. It has been noted that foot diseases occur ten times more often in patients with type II diabetes. With prolonged elevated levels of glucose in the bloodstream, damage occurs to the nerves and blood vessels located in the lower extremities. The full blood supply to the legs is disrupted (angiopathy), neuropathy is recorded, that is, there is a disruption in communication and interaction of organs and tissues with the CNS (central nervous system). When blood circulation in the vessels is impaired, little oxygen reaches the skin, muscles, joints, and bones; this is indicated by swelling of the feet and legs, pain in the calf muscles, and periodically recurring cramps in the lower extremities. The sensitivity of the skin with neuropathy is noticeably reduced, and there is even a feeling of numbness in some areas of the leg. A diabetic does not notice that the shoes are uncomfortable, that small foreign objects (sand, pebbles, twigs) have gotten into them, so abrasions and wounds appear. The danger also lies in the fact that with diabetes, all wounds heal very poorly and difficultly. Even minor injuries (crack, callus, scratch, bruise, abrasion, cut when trimming nails) are fraught with serious consequences. For example, purulent non-healing wounds, phlegmon, trophic ulcers, osteomyelitis of bone tissue, gangrene. And if the patient does not seek help from doctors for a long time, then surgeons have to amputate part of the limb in order to save the suffering person’s life. For many years, those suffering from diabetes gradually deteriorate the structure of the bones and joints of the foot, causing them to become crushed, sagging, deformed, flat feet, and loss of spring function. These are phenomena of osteoarthropathy. When the bones sag, areas of increased stress appear in certain areas of the foot. Most often, ulcerative defects form on the heel area and plantar surface of the fingers. There is even a medical term - Charcot's foot.
The percentage of foot complications is higher in those who:
The following symptoms indicate the possible development of diabetic foot syndrome and poor circulation in the extremities:
Malfunctions in the peripheral nervous system are said to be:
Doctors believe that limb amputations can be prevented in people with diabetes, provided that such patients, at the first signs of developing diabetic foot, seek help from specialists dealing with this problem, and then follow all their treatment recommendations. Treatment methods for diabetic foot, of course, depend on the stage and form of the disease. As a rule, an integrated approach includes the following areas:
In severe cases, surgical treatment is indicated.
In recent years, modern effective methods of vascular surgery have been actively introduced, the purpose of which is to restore blood flow in damaged lower extremities, for example, stenting, balloon angioplasty. Thanks to the constant improvement of methods, doctors are able to restore the functioning of not only the popliteal and femoral arteries, but also smaller arteries located in the lower leg and foot. This operation is carried out in a gentle way: punctures are made on the affected leg, then catheters are inserted into the artery, with the help of which, using special balloons, surgeons try to expand the closed vessels, thereby restoring their patency. After all, it is the complete closure or narrowing of blood vessels that leads to tissue necrosis, that is, their death. When the lumen of the vessel is restored, so-called stents (metal frames) are inserted into it so that in the future these vessels cannot close again.
All people who have been diagnosed with diabetes need to know and follow rules that are very important for their lives, which can delay and prevent serious complications.
What should you do every evening?
What should people with diabetes not do?
Do not try to take measures for treatment and relief on your own in the following cases:
Initial care for patients with diabetic foot syndrome should always be provided by endocrinologists and surgeons of the clinic to which he is attached and registered. But effective and qualified assistance can only be obtained in specialized clinics, centers (or departments) dealing with diabetic foot problems. In case of complications, try to get a referral there as soon as possible. Keep your diabetes under control to slow down the development of vascular complications.
Diabetic foot: find out everything you need to know. Below we describe in detail the causes, symptoms, stages, and most importantly, the effective treatment of this complication. Read how to keep blood sugar at 3.9-5.5 mmol/l stable 24 hours a day at the level of healthy people. The system of Dr. Bernstein, who has been living with diabetes for more than 70 years, helps protect against leg problems and other dangerous complications.
Diabetics often have wounds and ulcers on their feet that take a long time to heal and have a high risk of infection. Pathogenic microbes can cause gangrene, which cannot be avoided without amputation. This problem is called diabetic foot syndrome. Not only an endocrinologist, but several doctors of different specialties should work with the patient at the same time. Read about antibiotics and other medications, surgical treatment of wounds, dressings, creams, ointments, and herbal folk remedies.
Diabetic foot: detailed article
Learn and apply unique foot care tips from Dr. Bernstein. Find out how to choose orthopedic shoes and socks, what to do with calluses, how to restore sensitivity in the skin of your feet, get rid of numbness, and achieve healing of ulcers. The classification of diabetic foot according to Wagner is given. Understand how an accurate diagnosis affects your treatment plan. It is also explained what ischemic form and polyneuropathy are.
The main cause of diabetic foot syndrome is neuropathy, damage to nerve fibers caused by elevated blood glucose levels. Sensory neuropathy causes the skin to lose sensitivity to touch, vibration, pressure, temperature changes and other factors. Motor neuropathy causes muscle atrophy and foot deformity. Due to autonomic neuropathy, the skin loses its ability to sweat, becomes dry and cracks easily. All of these types of neuropathy are almost always combined with each other.
When walking, certain areas of the foot are exposed to excess pressure. Because of this, soft tissues are gradually destroyed and an ulcerative defect is formed. Sometimes a violation of the integrity of the skin can occur quickly under the influence of mechanical trauma with a sharp object or a thermal burn, which the patient does not feel due to neuropathy. Diabetes also accelerates the development of atherosclerosis, which impairs blood circulation in the legs.
Diabetes that is not properly treated damages nerve fibers throughout the body. This complication is called neuropathy. It has dozens of different unpleasant manifestations. In particular, the skin's sensitivity to touch, pressure and temperature changes is impaired. After this, the diabetic gets injuries to his legs while walking, but does not notice them and does not take action on time.
Blood circulation in the legs can be impaired due to atherosclerosis. Because of this, skin damage on the feet hardly heals. If proper treatment is not carried out, pathogenic bacteria multiply in them. Diabetic foot syndrome gradually progresses to more and more severe stages. It may lead to gangrene and the need for amputation.
Treatment of diabetic foot: patient review
Additionally, diabetic neuropathy can cause the skin on your feet to lose its ability to sweat. In this case, it becomes dry and cracks easily. Damage and cracks are inhabited by pathogenic bacteria. The body's ability to fight them and restore the integrity of the skin is usually weakened due to the effects of diabetes. This situation also threatens gangrene and amputation.
The main symptom of diabetic foot is leg ulcers that take a long time to heal. If harmful bacteria multiply in them, then these ulcers look truly scary to an unfamiliar person. If left untreated, the infection can cause gangrene. Amputation of a finger, foot, or entire leg will be required. Otherwise, the patient may die from intoxication. In addition to ulcers, signs of diabetic foot may include:
Sometimes there is pain due to the fact that the shoes are not chosen correctly and are not designed for swelling of the feet.
What do leg ulcers look like in diabetes?
Impaired blood circulation due to atherosclerosis can cause attacks of pain called intermittent claudication. If you are worried about leg pain, read about pain medications here. However, in most cases, the patient has lost pain sensitivity due to diabetic neuropathy. Redness and swelling are signs of infection or skin rubbing from unsuitable shoes. It even happens that the temperature of the infected area of the foot to the touch is 2 or more degrees higher than that of the surrounding tissues. Blood poisoning can cause fever or chills.
There are several options for classifying the injuries that form diabetic foot syndrome. However, none of these approaches are generally accepted. For example, you can classify ulcers based on their depth. The deeper the wound, the more advanced the stage of the disease and the higher the likelihood that amputation will be necessary. An aggravating factor that worsens the prognosis is impaired circulation in the legs due to atherosclerosis, which is called ischemia.
The root cause of your foot problems is diabetic neuropathy. Watch Dr. Bernstein's video to learn how to recover from this complication. It is curable, unlike blindness and severe kidney problems. If you try, you can restore the health of the nerves and blood vessels in your legs. How to do this is described in the video. There are success stories of patients who managed to avoid amputation, and at the same time other troubles.
The Wagner classification of diabetic foot is popular. She identifies 5 (actually 6) stages of this disease:
The diagnosis may also contain additional information. In particular, polyneuropathy is a diabetic lesion of nerve fibers. Due to the loss of nerve sensitivity, a diabetic does not notice the injuries and damage to the legs that he receives while walking. If the wounds are not treated, then microbes multiply in them and soon it comes to gangrene.
Ischemic form of diabetic foot - this diagnosis means that blood circulation in the legs is impaired due to blockage of blood vessels with atherosclerotic plaques. In such cases, the damage heals very slowly. The legs may have a bluish color. Slow nail growth is common. The problem of ischemia can be combined with polyneuropathy.
The most unpleasant consequence is gangrene, requiring amputation of a finger, foot or leg. The patient may also die from intoxication caused by pathogenic bacteria. Treatment for diabetic foot is aimed at avoiding death, amputation and disability. Keep in mind that having a leg amputated is not the end of the world. After it, you can wear a prosthesis and lead a full life. Diabetes can cause more severe, truly catastrophic complications. Namely, blindness or kidney failure requiring dialysis.
Treatment of diabetic foot is carried out in several areas:
Some of the necessary steps can only be performed in specialized medical centers, but the main treatment is at home. Obviously, you need to try to bring your glucose levels as close to normal as possible. Read the article “How to lower blood sugar” for more information. If there is an infected wound, surgical debridement is usually required. You cannot limit yourself to taking antibiotics without the participation of a surgeon. He must remove all non-viable tissue. Patients are taught daily inspection and care of the wound until it is completely healed. This is done by specialists who work in diabetic foot clinics.
Cure from diabetic foot is possible if you are not lazy
Many different types of bacteria can cause infected foot wounds and ulcers. First, tests are used to determine which microbes are causing problems, and then antibiotics are prescribed that are effective against them. Universal broad-spectrum drugs help in no more than 50-60% of cases. This page does not contain detailed information about antibiotics to discourage patients from self-medicating with them. The worst thing is if a diabetic is attacked by bacteria that have developed resistance to modern drugs.
Wet gangrene, phlegmon, deep abscesses are serious complications that threaten the life or safety of the patient’s limb. To treat them, antibiotics usually have to be administered through injections in a hospital setting. Success depends on how conscientiously the surgical treatment of the wound is carried out. In milder cases, antibiotic tablets are taken at home to treat diabetic foot. The doctor must carefully adjust their doses, taking into account the fact that a diabetic may have kidney complications.
It is very important to relieve the affected area of the foot. You need to try to distribute the pressure that occurs when walking more evenly. A healthy person with a foot injury limps, trying not to step on the wound to avoid pain. However, many diabetics do not feel this pain due to neuropathy. They step on wounds when walking. This causes additional injury and blocks healing. It can drag on for many months or even years.
Unloading of the affected leg can be achieved with the help of a professional bandage made of polymer materials. This bandage is called an immobilizing bandage. Do not confuse this with an antibacterial dressing that is applied to a wound. For details, contact specialized centers that treat diabetic feet. Orthopedic shoes are good for prevention, but they are no longer enough to treat advanced cases. Ask if it is possible to provide the patient with a special unloading bandage.
Treatment at home consists of following foot care rules, recommendations for unloading the affected foot, and achieving and maintaining normal blood sugar. Due to a depressed mental state, many patients do not want to conscientiously follow the regimen and neglect to perform the necessary procedures. Relatives of a diabetic and the patient himself should think about solving this problem.
A specialist in foot problems is called a podiatrist. He should not be confused with a pediatrician. The main thing you must learn is: don't let him remove calluses! Because after their removal, wounds remain that become a haven for harmful bacteria. Removing calluses often leads to gangrene. It should not be done under any circumstances. In addition to the podiatrist, the participation of a surgeon and an orthopedist may be necessary. The main role in treatment should be played by an endocrinologist who helps the patient maintain normal blood sugar. In practice, diabetics need to independently control their glucose metabolism, without relying on the help of doctors.
If gangrene has not yet developed and there has been no amputation, then diabetic foot can, in principle, be completely cured. However, it is not easy. It is necessary to lower blood sugar to normal and keep it stable within the range of 3.9-5.5 mmol/l, as in healthy people. To do this, you should switch to a low-carb diet and take the time to inject insulin in precisely calculated doses in addition to a healthy diet. Read more about the step-by-step treatment plan for type 2 diabetes or the type 1 diabetes control program.
You need to learn to accurately calculate insulin dosages and follow the regimen every day, making no exceptions on weekends and holidays. However, the time and effort put in will pay off. Because normal blood glucose levels protect not only from diabetic foot, but also from all other complications.
No diet other than a low-carbohydrate diet allows diabetics to maintain stable, normal sugar levels without spikes. There are no miracle pills, bandages or physical therapy treatments that can cure a diabetic's foot problems without adopting a healthy lifestyle.
The main cause of diabetic foot is neuropathy, a loss of sensitivity in nerve fibers. This complication is completely reversible. After several months of maintaining stable, normal blood sugar, the nerves gradually recover. Atherosclerotic plaques that have managed to form in the vessels will no longer disappear. However, you can slow down their growth and improve blood circulation in the legs. Sensitivity is restored and skin lesions that have been bothering you for a long time are healed.
Diabetics who are not lazy to keep their sugar consistently normal live to a ripe old age, like healthy people. However, patients who try folk remedies to treat infected wounds on their legs, instead of urgently consulting a doctor, quickly die.
The prognosis depends on the length of diabetes, the severity of complications that have already developed, and most importantly, on the patient’s motivation. As they say, if a person truly wants to live, then medicine is powerless. Dr. Bernstein's methods, as promoted by Endocrin-Patient.Com, work wonders. Except in advanced cases, when diabetic kidney damage has already passed the point of no return.
Choose soft and comfortable orthopedic shoes, regardless of their non-standard appearance. Under no circumstances should shoes rub, squeeze the foot, or interfere with blood flow. You should buy or order it not in the morning, but in the afternoon, late in the evening, when the leg size is at its maximum during the day. Shoes should be comfortable from the first try on. It shouldn't require breaking in. Sandals that have a strap between the toes should not be worn.
Shoes to prevent foot damage
Inspect your shoes daily to see if there are any pebbles or other foreign objects, protruding nails, or any abrasions or compactions. If necessary, contact your shoemaker immediately to correct the problem. Don't wait until your foot gets damaged and you have to deal with it to heal. You need to have at least two pairs of comfortable, suitable shoes and alternate them every other day, rather than wearing the same pair every day.
Socks also need to be given attention. Not ordinary socks will suit you, but special ones that do not compress the blood vessels with elastic bands. They should be the right size, not too big. You should not wear socks with holes to avoid damaging your feet. For diabetics who have poor circulation in their legs, socks are an important means of protection against freezing during the cold season. Thus, you need to carefully select socks, not using the first ones you come across or the cheapest ones.
If the skin on your leg is dry, it needs to be lubricated to prevent it from cracking. Olive or any other vegetable oil is suitable for this, as well as animal fats and lanolin. It’s not bad if the ointment or cream contains vitamin E. It is better not to use mineral oil, petroleum jelly and other petroleum products. Because they are not absorbed.
It is important to lubricate the skin after prolonged water procedures. Because at this time she is especially vulnerable to damage. In general, it is better to avoid long-term water procedures. This is discussed in more detail below in the list of foot care rules. Don't expect that lubricating a wound or ulcer will protect you from infection or cure diabetic foot syndrome. Such a magical miraculous ointment or cream does not yet exist in nature.
No herbal folk remedies for diabetic foot help, nor do animal products. On the Internet you can find recommendations for making baths and poultices for affected feet from mustard seeds, clove oil, bird cherry decoction, and other common and exotic plants. Stay away from these quack drugs. Traditional recipes for diabetes and its complications are a trap.
While the patient is losing precious time, he may develop gangrene. It will lead to amputation or death. Many patients are looking for some miracle Cuban drug that will quickly and easily cure diabetic foot. Such a magical medicine does not exist in nature. You need to urgently consult a qualified doctor. If you're lucky, you'll be able to avoid amputation.
Some diabetics make foot baths with baking soda at home. However, baking soda is not a suitable means to disinfect and soften the skin. Instead of taking baths, you need to protect your feet from excessive contact with water. Because after prolonged exposure to water, the skin is most vulnerable to damage.
Sodium thiosulfate and shock wave therapy definitely do not help with diabetic foot. At the expense of diabetics who are fond of folk remedies, surgeons carry out their plan for amputations. Specialists who treat kidney and vision complications of diabetes are also not idle. Don't do anything stupid. Learn and use a step-by-step treatment plan for type 2 diabetes or a type 1 diabetes management program. Keep your blood sugar normal with a low-carb diet.
Diabetic foot syndrome is highly preventable. Long-lasting ulcers, gangrene, and amputation can generally be prevented. However, the patient or his relatives must be highly motivated to engage in daily prevention. In a specialized medical center you can learn skills, but the main work is still done at home, in everyday life.
The first step is to read and follow the step-by-step type 2 diabetes treatment plan or type 1 diabetes management program. Achieve consistently normal blood sugar, like healthy people. This is an achievable goal if you try hard enough. Don't be lazy and don't be afraid to inject insulin if following a diet and taking pills isn't enough.
A patient with diabetic neuropathy of the lower extremities needs to wear orthopedic shoes and special socks, which are described in detail above. You should have several pairs of suitable shoes and alternate them, rather than wearing the same ones all the time. You should also study the foot care rules listed below.
Above we describe in detail how to choose orthopedic shoes and socks and how to lubricate your feet. And here is important additional information about foot care that was not included in the previous sections.
The main rule: do not remove calluses under any circumstances! Do not allow your podiatrist, pedicurist, or anyone else to do this. Calluses are a natural and effective defense against excess pressure on areas of the feet. Their appearance signals that you need orthopedic shoes. After removing calluses, wounds remain, from which trophic ulcers often form.
Quit smoking if you haven't already. Avoid secondhand smoke. People with diabetic neuropathy should not walk barefoot to reduce the risk of ulcers and other foot injuries. When you recover from neuropathy, restore sensitivity in your feet, and then you will walk barefoot. Until then, it’s impossible.
Foot care for diabetes
You need to carefully examine your feet every day, paying attention to any changes, and even more so, damage. You should be concerned about blisters, cracks, calluses, traces of minor subcutaneous hemorrhages, and even more so, ulcers and wounds. Don't forget to check the skin between your toes. If necessary, use a mirror to look at everything carefully. Don't hesitate to see a doctor quickly if the condition of your feet worsens.
Do not immerse your feet in water for more than 3-4 minutes, even if your doctor recommends it. Don't take any baths. Avoid prolonged skin contact with water to avoid unnecessary risk of damage. Turn on the water, check its temperature with an alcohol thermometer, get in, quickly wash and get out. Don't lie in the bathroom. If you like to swim in the pool, it is advisable to lubricate your feet with Vaseline before diving into the water.
Avoid open flames and objects that can cause burns. Keep your feet and hands away from radiators and radiators. You need an alcohol thermometer. Use it to check the temperature of the bathroom before you get into it. Moreover, this temperature should not be higher than 34?. Because any higher temperature can cause burns in people who have poor circulation. Do not check the temperature with your foot or hand. Use an alcohol thermometer for this.
Hypothermia of the feet is almost as serious a danger as a burn. Don't stay out in the cold for more than 20 minutes at a time. Choose warm and comfortable socks carefully. Every few years, it is advisable to undergo a medical examination to determine how severely the blood circulation in the legs is impaired. If you keep your blood sugar consistently normal using Dr. Bernstein's methods, it will gradually return to normal.
Do not apply adhesive tape, tape, or any other type of adhesive tape to your skin. Because there may be damage left after you remove them. Do not apply hydrogen peroxide, iodine in alcohol, salicylic acid, or callus preparations to your skin. Do not use the listed disinfectants. Because they cause burns and inhibit the healing of damage.