What Classifies A Foot As High Risk?

Posted 12 Jun

Our podiatrists treat a lot of high-risk feet. We’re trusted by thousands of high-risk Brisbane residents every month to care for their foot health - and for very important reasons. Your foot health is one thing you shouldn’t take for granted, yet it’s often easy to forget about the importance of being able to stay active and happy on our feet without being held back by pain or other problems. When foot pain and problems arise, you feel them with every step. They interfere with every part of your life - from playing with your kids, to meeting your health and fitness goals, to just walking comfortably up and down your stairs. 

So, how exactly does a foot get classified as high risk? Here are the most common reasons we see for a high-risk foot classification, in line with the Queensland Health referral framework.

You’re High Risk If You Have Conditions That Limit Your Ability To Feel (Neuropathy)

Our nerves are responsible for our ability to feel, detecting even the lightest sensations, like a feather being moved across our toes. When our nerves are damaged, our ability to feel can become reduced, the feelings we feel may get all mixed up, and ultimately, the ability to detect what’s happening to and around our feet may eventually be lost altogether. This is called neuropathy. 

When you can’t feel what’s happening to and around your feet, you start entering some pretty serious danger zones - such as standing on a pin, or a sharp bit of glass outside, and not being able to feel it. With full feeling, we’d say ‘ouch’ and promptly remove the foreign object from our foot, taking care to use antiseptic to clean the foot. Without the ability to feel, instead we’d keep going about our day, driving the foreign object further into the foot, and creating a big risk of infection, ulceration and other damage.

The biggest cause of neuropathy we see is diabetes (more on this below), but neuropathy can be caused by various other factors like inflammatory diseases or infections, alcohol, autoimmune disorders, kidney failure, poor nutrition, hereditary disorders and more.

You’re High Risk If You Have Circulation Problems To Your Feet

When your circulation is impaired, your tissues aren’t able to receive the regular, healthy amount of blood (with the oxygen, nutrients and immune cells) they need to thrive and effectively carry out essential cellular processes. This means that when you sustain a wound, it will take longer for the body to heal, leaving it open and vulnerable to picking up an infection for longer, especially when you consider how the location of the feet close to the ground make them closer to dirt and bacteria. If an infection takes hold, having circulation issues also makes it more difficult for your body to overcome it creating a myriad of potential problems. This is why your feet are also considered high risk if you have impaired circulation.

Common causes and risks factors for circulation problems include atherosclerosis (a build-up of fat in the artery walls), diabetes, smoking, hypertension (high blood pressure), high cholesterol, being overweight, living a sedentary lifestyle, inflammatory diseases like rheumatoid arthritis or lupus, and more.

You’re High Risk If You Are Deemed Likely To Develop Foot Ulcers

Foot ulcers are a very big concern for us as podiatrists - especially given that most (85%) foot ulcers are preventable, and they can have severe consequences to your foot health. Foot ulcers are the leading cause of lower limb amputation in Australia aside from traumatic injuries. Specifically, there are 10,000 hospital admissions and 4,400 amputations every year in Australia as a result of foot ulcers - the second-highest rate in the developed world. This immediately puts you in the high-risk category if you have a history of foot ulcers or have qualities that significantly increase your risk of getting them. Other factors that increase your risk include having certain autoimmune disorders, foot deformities that mean you have significant areas of high pressure on the foot, limited mobility or prolonged pressure on the feet, and wearing shoes that are too tight or narrow (that rub against your feet), or have high heels that then overload your forefoot.

Diabetes

Having diabetes puts you in the high-risk category because the effects of diabetes on your feet can lead to all of the problems we’ve mentioned above. In diabetes, having excess blood sugar for prolonged periods can be seriously damaging for the nerves and blood vessels. This makes peripheral neuropathy, where the feeling is lost from the feet, and circulation issues, very common side effects that progressively worsen over time.

If you have diabetes, recommendations by Diabetes Australia are that you book in a diabetic foot health assessment at least once per year. If you need foot care, such as helping to manage ingrown toenails, corns and calluses, cracked heels or other issues, this should be done by a podiatrist to reduce your risk of any cuts, abrasions or damage to the feet and toes.

Learn more about what happens during a diabetic foot assessment here. Also, if you have diabetes, here are 7 things that your podiatrist wants you to know.

We Provide Specialised Podiatry Care To High Risk Feet

If your feet are at risk, we’re here to help. Our podiatrists provide a comprehensive high-risk foot assessment so you understand exactly what your risks are at this moment in time (given that symptoms like sensation loss and impaired circulation progressively worsen) and what you can be doing to provide the best care to your feet and keep them healthy and safe, reducing your risk of complications.

You can also care for your feet at home by:

• Checking your feet daily for any possible problems, specifically looking out for redness, swelling, cuts, splinters, blisters or pus.
  
• Washing and thoroughly drying your feet daily, especially between your toes. 
  
• Moisturising your feet daily to avoid dry skin (but not between the toes)
  
• Avoiding walking barefoot
  
• Avoiding using over-the-counter corn pads or razors — it may cause marked maceration to the skin.
  
• Cutting your toenails straight across, with good quality nail clippers, and file the corners and edges. 
  
• Wearing comfortable and well fitted shoes. 
  
• Wearing diabetic or bamboo socks 
  
• Avoiding having your feet in close contact with direct heat including: heaters, hot water bottles & electric blankets
  

Book your appointment online or call us on (07) 3356 3579.