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Chronic wounds remain in a chronic inflammatory state and therefore fail to follow normal patterns of the healing process. Three principle types of chronic wounds are diabetic foot ulcers, venous leg ulcers, and pressure ulcers, although other wounds, such as surgical wounds, can also become chronic.
Diabetics are prone to foot ulcers due to peripheral neuropathy: decreased sensation caused by this condition can result in a cut and trauma to the foot going unnoticed or can result in unusual pressures being placed on the foot.
Diabetes and, therefore, diabetic foot ulcer complications are growing at double digit rates and have the potential of becoming even a more devastating epidemic.
Venous leg ulcers are caused by a failure of valves in the veins of the legs, resulting in congestion and slowing of blood flow.
In 1989 the estimated cost for managing venous leg ulcers was $200 million in the United Kingdom. Pressure ulcers, also termed decubitis ulcers or bed sores, result from pressure on skin, soft tissue, muscle, and bone that exceeds capillary-filling pressure for an extended period of time. In the most extensive study of acute care facilities, Meehan surveyed 148 hospitals and found the prevalence of pressure ulcers was 9.2%. Diabetic patients frequently develop an intermittent or permanent loss of sensation (neuropathy) in their feet.
Flat Feet:  Congenital (at birth) or developed with age, weight gain, and long hours of use, a flat arch allows the ankle to tip inward.
Short First Toe:  12% to 28% of the population is born with this condition called Morton’s Syndrome. High Arch:  Pes Cavus (high arched feet) are subject to excessive pressures due to their shape. The Semi-Rigid (soft) Orthotic:  Following the evaluation of your foot and ankle, the mould taken of your foot by the Pedorthist will reflect the amount of support, correction and pressure accommodations to be built into your custom made orthotic.
Rocker Soles:  A large number of ulcerations occur under the metatarsal joints of the forefoot.
Footwear: Stable extra deep footwear is needed to accommodate the orthotic and give support to the patient. The BioPed Pedorthist is specialized in the casting, manufacturing, fitting and modification of many types of custom-made orthotics. If you're looking for high quality, comfortable, and stylish footwear, or other foot care products and accessories, visit our online site and shop from the comfort of your own home! Throughout more than 75 full-service and satellite clinics across Canada, our Foot Specialists (Canadian Certified Pedorthists and Registered Chiropodists) specialize in non-surgical and surgical treatment for conditions related to the functions of the feet and lower limbs.
Visit any one of our clinics to speak to a Foot Specialist about our quality products including custom orthotics, orthotic-friendly footwear, lower limb braces and compression stockings.
BioPed’s Clinical Foot Specialists work closely with their patients and their family doctor or other health care providers, to choose the best treatment option for each individual.

Read More Articles:Foot Injuries In Runners From OveruseFoot injuries in runners seem to go hand-in-hand (or should we say foot-in-foot). Foot Pain Stretching – Relieve Your Foot PainYou wake from bed in the morning and as soon as you stand, you experience a terrible heel pain.
With more than 30 years of experience, BioPed has become the standard of excellence in alleviating lower limb and foot-related discomfort. Find A Clinic:We are privileged to service clients through more than 75 full service & satellite clinics across Canada. Diabetic foot ulcers are the most significant wound care problem in the United States and the world. Although the cost of venous leg ulcers in the United States has not been formally calculated, the costs of treatment have been projected at $1 billion per year in 1992, and the scope of the problem has continued to increase yearly.
These wounds occur in individuals that are unable to sense the pressure or are unable to change their body position to relieve the pressure.
The prevalence of pressure ulcers in subjects cared for in skilled care facilities and nursing homes has been reported to range from 2.4% to 23%. The weight of the body moves from the centre of the foot to the inside edge, increasing pressure under the inside heel and large ball joint of the first toe. Normally the large toe is the primary stabilizer of body weight as we push up and off our feet when walking.
When removing your shoes and socks check for redness and callousing which are indicators of pressure.
The actual fit of a specific shoe size can change from one style to another style even when made by the same manufacturer.
Walk for 15-20 minutes in the store, then take shoes off and examine the top, bottom, sides and toe tips of your feet. This may be true for normal feet, however people with bunions, hammer toes or swollen ankles don’t have a plethora of footwear choices, if any. Mild changes are often best initially, and more support can be progressively added as the foot acclimates to the orthotic. This is due to the pressure these joints endure when we push up and off them, flexing, twisting and turning.
After all, the foot strikes the ground with enormous force as it supports the weight of the body. There are now over 60 million diabetic patients in the United States, with an incidence of foot ulcers of approximately 20-25 percent over the patient’s lifetime. Pressure ulcers are a common and expensive problem in acute care, nursing home, and home care populations. Such open wounds can allow direct entry of bacteria into the tissues resulting in infection and possible gangrene.

The toe may angle and stiffen at the joint (Bunion) creating pressure at the tip of the toe. In Morton’s Syndrome, the pressure shifts from the shorter 1st ball joint onto the longer 2nd metatarsal ball joint.
Pedorthists are trained to take off-the-shelf footwear and modify them to fit an irregular foot shape. A rocker sole, applied to most stability footwear can eliminate flexion and significantly reduce the pressure under the joints at toe off. The footwear industry has met the needs of the diabetic patient by manufacturing a selection of walking shoes, sandals and hiking boots – all available at BioPed centres.
A selection of fashionable footwear that are orthotic friendly, blended with on-site labs that can mould and shape footwear to fit, offers the patient relief from foot problems. Currently, there are approximately 100,000 limb amputations performed in diabetic patients each year in the United States. A survey by Nelzen established a prevalence of venous leg ulcers of 0.16 percent in Sweden (Nelzen et. The total cost of pressure ulcer treatment in the United States is estimated to exceed $1.3 billion.
This post is designed to educate the diabetic patient on the high risks associated with the diabetic foot and to give insight into Pedorthic treatments related to diabetic complications.
Rocker soles have been shown in numerous medical studies as the most effective means to treat foot ulcers.
The exact cost of care for diabetic foot ulcers is difficult to determine, but is likely to be measured in billions of dollars. This survey also demonstrated that as the population ages, venous leg ulcers are more common. In 1985 the estimated annual cost of treatment in Scandinavia for venous leg ulcers was $25 million.
Activities, such as running, cause the force on our feet to increase by up to 7 times our body weight!
A 150lb adult can expect over 1000lbs of force to be absorbed by their feet with each running leap.

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