The early symptoms of a diabetic foot include pain, discoloration, loss of sensation, poor balance, and a “pins and needles” feeling.
As the disease advances, there is an ever-increasing risk of easy, soft-tissue wounds that frequently lead to nonhealing ulcers and infections.
At worst, chronic infections like these can lead to gangrene and amputations. Concurrent to the soft tissue vulnerability is a very high rate of appearance of notably severe foot deformities such as hallux valgus, bunions, corns and calluses, and hammer toes.
The central issue is the progressive loss of oxygenation, which is necessary for tissues to heal.
Over time, the diabetic foot follows the sequence of venous stasis, poor circulation, capillary breakdown, and, ultimately, soft tissue necrosis.
What causes a diabetic foot?
All of these issues are worsened by maladapted foot function.
Maladapted feet have poor to absent lower leg muscle function, which is essential for venous blood return. These muscles normally act as a muscular ‘pump’ for venous blood return.
Maladapted foot function also exhibits an inefficient unstable arch system. This instability results in excessive foot movement in a shoe, which creates localized points of inappropriate pressure, rubbing, and friction – creating “hot spots” that are the precursor to the formation of ulcers.
When maladapted neuromuscular function is present, especially concurrent with the metabolic vulnerabilities of diabetes, the serious consequences of deformity and soft tissue necrosis are almost inevitable.