The Diabetic Foot

Some regular massage therapy is a good thing for most diabetics. Swedish strokes tend to help lower blood sugar, and structures suffering from loss of blood – from bones to the soft tissues, enjoy a boost of circulation.

         

Most people think of diabetes as an imbalance of insulin hormones, but we massage therapists see the true disease – lack of circulation throughout the system as cells struggle with basic movement of nutrients.

         

With many clients this massage therapist works intently to improve circulation, especially in areas of the hands and feet. Such detail as massaging each toe can help prevent diabetic ulcers and other skin breakdowns. I am always on the lookout for any signs of skin compromise so it can be evaluated quickly.

         

With insulin-resistant diabetics, Type 2, I also look for ways to improve their ability to walk moderately to lessen the effects of the disease. Some diabetics, however, who have had the disease for a long time can develop a softening of the foot bones that can lead to collapse of the structures. The condition is called “Charcot foot.“

         

I had seen Charcot only in books until a recent client came in hoping to relieve some back pain. Massage for the back pain and hip muscles relieved her troubles for a few days, but as time passed her lumbar pain returned.

         

When I looked to her feet, I found bumpy surface lacking all three arches. The main medial arch was flat and had a very hard, round spot dead center – a foot bone had possibly dropped down through the arch. The lateral arch was also flat with another dropped bone. The last arch at the base of the big toe and second toes was also flattened and most of the toes had hammered down in response.

         

Her ambition to walk 30 minutes a day on the line, she checked with her doctors, and they diagnosed the Charcot foot.

         

Her doctors have advised her to wear orthotic, supportive shoes at all times – not just when out of the house. Also, she has to wear supportive arched wet shoes when doing pool exercises.

         

As massage therapists, we are often telling people with arch problems to make sure their feet are supported around the house and patio in addition to when they walk outside.

         

With this and other diabetic clients, we massage folks can help not only with suggesting people have their feet checked closely for ulcers and skin breaks, but also for structural problems worsened by the disease.