
Diabetic Foot Conditions
Diabetes is the condition in which the body does not properly process food for use as energy. People with Type 1 diabetes cannot produce insulin, which is required for glucose to feed your body’s cells. It is typically caused by the immune system mistaking healthy cells for foreign invaders and destroying the insulin-producing cells in the pancreas. On the other hand, people with Type 2 diabetes cannot respond to insulin properly, and eventually cannot produce enough. The Centers for Disease Control and Prevention reports that over 30 million people in the United States have diabetes, with 1 in 4 having no idea they have it. Surprisingly, diabetes is the seventh leading cause of death in the US. The symptoms of diabetes include frequent urination, fatigue, hunger, and even blurry vision.
Diabetes can also affect the feet as well. Over time, diabetes can cause nerve damage to your feet, which could then lead to symptoms such as tingling, pain and numbness in the feet. Neuropathy can be very dangerous to a person with diabetes, since it prevents them from feeling injuries such as cuts or blisters in the feet, and if not detected early enough, may lead to infection. Neuropathy can also lead changes in the shape of your feet and toes. The best way for people with diabetes to prevent or delay neuropathy is keeping their blood glucose levels in their target range. This consists of eating right, having the correct amount of exercise, and taking medications.
Diabetes can also create calluses and foot ulcers as well. Calluses build up faster and occur more frequently with those affected by diabetes. If there are too many calluses, therapeutic shoes and inserts may be required. It is important to have calluses trimmed by a health professional, as doing it yourself may lead to infections. If these calluses continue to develop and thicken, they can lead to foot ulcers. Foot ulcers are open sores, that appear on the ball of the foot or on the bottom of the big toe. These ulcers can lead to future infections if not treated and may possibly result in losing a limb. It is important to report any ulcers to your podiatrist right away. Your doctor may take x-rays to examine the foot and clean out any dead and infected tissue.
Lastly, diabetes can also lead to poor circulation and peripheral arterial disease (PAD). The poor circulation in the feet and leg area is a result of diabetes narrowing and hardening, eventually slowing down the blood flow in that area. The best way to prevent this is to keep away from smoking and follow your doctor’s advice for maintaining blood pressure and cholesterol. PAD is similar to this complication. PAD is when blood vessels narrow or are blocked by fatty deposits. PAD also increases your risk of heart attacks and strokes and is a common condition to those affected by diabetes. The combination of both PAD and neuropathy may lead to infections and can result in amputation of certain limbs. PAD can be prevented with wearing the proper foot wear and regularly taking care of your feet.
If you want to take care of your feet, you should wash and dry them carefully and perform daily inspections to check for cuts, blisters, or swelling. Any physical activity you partake in should be approved by your health care provider. You should also be sure to wear special shoes if advised to do so by your doctor.
Comparing Pronation and Supination of the Feet

Pronation and supination describe how the feet move during walking or running. Pronation occurs when the foot rolls inward, placing more weight on the inside edge, often flattening the arch. Supination is the opposite, with the foot rolling outward and weight shifting to the outer edge. Both are natural motions, but when either is excessive, it can lead to imbalance and discomfort. Overpronation may result in pain in the arch, heel, or ankle, while too much supination can strain the outer foot and cause heel pain or calluses. The uneven wear on shoe soles can often reveal if a person’s gait leans inward or outward. Factors such as high arches, leg length differences, past injuries, or prolonged standing on hard surfaces can contribute to these gait patterns. A podiatrist can assess the alignment of your foot and ankle, examine the extent of pronation or supination, and recommend orthotics or footwear changes to reduce strain and prevent further injury. If you have gait issues that are causing foot pain, it is suggested that you schedule an appointment with a podiatrist for an exam, possible gait analysis, and treatment options.
If you have any concerns about your feet, contact Joseph D. Ruffo, DPM, PC from New York. Our doctor can provide the care you need to keep you pain-free and on your feet.
Biomechanics in Podiatry
Podiatric biomechanics is a particular sector of specialty podiatry with licensed practitioners who are trained to diagnose and treat conditions affecting the foot, ankle and lower leg. Biomechanics deals with the forces that act against the body, causing an interference with the biological structures. It focuses on the movement of the ankle, the foot and the forces that interact with them.
A History of Biomechanics
- Biomechanics dates back to the BC era in Egypt where evidence of professional foot care has been recorded.
- In 1974, biomechanics gained a higher profile from the studies of Merton Root, who claimed that by changing or controlling the forces between the ankle and the foot, corrections or conditions could be implemented to gain strength and coordination in the area.
Modern technological improvements are based on past theories and therapeutic processes that provide a better understanding of podiatric concepts for biomechanics. Computers can provide accurate information about the forces and patterns of the feet and lower legs.
Understanding biomechanics of the feet can help improve and eliminate pain, stopping further stress to the foot.
If you have any questions please feel free to contact one of our offices located in Sea Cliff and Babylon, NY . We offer the newest diagnostic and treatment technologies for all your foot and ankle needs.
Biomechanics in Podiatry
Podiatry is a branch of medicine that deals with the study, diagnosis, and treatment of foot and ankle conditions. There are various subdivisions in podiatry; biomechanics is one of them. Biomechanics is the way in which the bones, muscles, and joints of the feet and lower limb interact with each other.
Our feet play crucial roles in the way we move, and it is rare to have feet that are completely symmetrical. Common biomechanical issues include high or low arches or uneven leg heights. Excessive pronation often leads to fallen arches, or flat feet, and is a common cause of running injuries. People whose feet are over-pronated tend to have flexible and unstable feet. Pain is usually experienced during walking and running.
At times, people may be able to adapt to these abnormalities without any difficulties, but in other cases, these issues can cause a great deal of pain. This pain occurs because the joints, muscles, ligaments, and tendons are put under an excess amount of stress during movement. Common symptoms of biomechanical problems stemming from the feet include hip pain, knee pain, leg cramps, ankle pain, lower back pain, weak ankles, tripping, heel pain, Achilles pain, and shin splints.
Many biomechanical issues can be treated with orthotics. Orthotics are shoe insoles that are used to help control the way the foot operates. They can provide relief from foot pain, heel pain, and knee pain. Depending on your specific case, you may need to purchase over-the-counter orthotics or custom orthotics to fit your feet. Your podiatrist will be able to prescribe the perfect orthotic for your feet to help you walk around with ease.
Gait is defined as the way we move our bodies from one point to another. This is usually done by either walking or running. Gait analysis is a method used to assess the way we walk or run to highlight biomechanical abnormalities. Gait analyses are a great way to take a detailed look at how you walk and how your foot moves while you walk. An examination of the feet will help your podiatrist understand why you are suffering pain in other parts of your body.
Bunions and Surgical Treatment Options

A bunion is a bony bump that forms at the base of the big toe due to misalignment of the foot’s bones. This condition causes the tip of the big toe to shift toward the smaller toes, leading to discomfort, swelling, and difficulty walking. When conservative treatments are not effective, bunion surgery may be necessary to relieve pain and correct the deformity. An osteotomy involves cutting and realigning the bone to restore proper positioning. An exostectomy focuses on removing the bony prominence without realigning the joint. An arthrodesis fuses the affected joint to eliminate movement and pain, while a resection arthroplasty removes a portion of the bone to create more space within the joint. Each procedure is chosen based on the severity of the bunion and the patient’s individual needs to improve function and comfort. If you have a bunion that is painful, it is strongly suggested that you consult a podiatrist who can determine if surgery is right for you, and which type you would most benefit from.
Foot surgery is sometimes necessary to treat a foot ailment. To learn more, contact Joseph D. Ruffo, DPM, PC of New York. Our doctor will assist you with all of your foot and ankle needs.
When Is Surgery Necessary?
Foot and ankle surgery is generally reserved for cases in which less invasive, conservative procedures have failed to alleviate the problem. Some of the cases in which surgery may be necessary include:
- Removing foot deformities like bunions and bone spurs
- Severe arthritis that has caused bone issues
- Cosmetic reconstruction
What Types of Surgery Are There?
The type of surgery you receive will depend on the nature of the problem you have. Some of the possible surgeries include:
- Bunionectomy for painful bunions
- Surgical fusion for realignment of bones
- Neuropathy decompression surgery to treat nerve damage
Benefits of Surgery
Although surgery is usually a last resort, it can provide more complete pain relief compared to non-surgical methods and may allow you to finally resume full activity.
Surgical techniques have also become increasingly sophisticated. Techniques like endoscopic surgery allow for smaller incisions and faster recovery times.
If you have any questions please feel free to contact one of our offices located in Sea Cliff and Babylon, NY . We offer the newest diagnostic and treatment technologies for all your foot and ankle needs.
Foot Surgery
In most cases, foot surgery is often chosen as the last available option for conditions that have otherwise been unsuccessfully treated. Surgery may be necessary for several reasons, including the removal of foot deformities (e.g. bone spurs or bunions), arthritis problems, reconstruction due to injury, and congenital malformations (e.g. club foot or flat feet). Regardless of one’s age, foot surgery may be the only successful option for treatment for certain conditions.
The type of surgery one undergoes depends on the type of foot condition the patient has. For the removal of a bunion growth, a bunionectomy is necessary. If the bones in the feet need to be realigned or fused together, a surgical fusion of the foot is needed. For pain or nerve issues, a patient may require surgery in which the tissues surrounding the painful nerve are removed. Initially, less invasive treatments are generally attempted; surgery is often the last measure taken if other treatments are unsuccessful.
While in many cases surgery is often deemed as the final resort, choosing surgery comes with certain benefits. The associated pain experienced in relation to the particular condition is often relieved with surgery, allowing patients to quickly resume daily activities. The greatest benefit, however, is that surgery generally eliminates the problem immediately.
Podiatry history has shown that foot treatments continue to evolve over time. In the field of foot surgery, endoscopic surgery is just one of the many advanced forms of surgery. As technology vastly improves so too will the various techniques in foot surgery, which already require smaller and smaller incisions with the use of better and more efficient tools. Thanks to such innovations, surgery is no longer as invasive as it was in the past, allowing for faster and easier recoveries.
Achilles Tendon Injury in Dancers

Dancers place significant strain on the Achilles tendon due to repetitive movements, jumps, and intense footwork. This can lead to inflammation, microtears, or even more severe injuries if not properly managed. Overuse, inadequate warm-ups, and wearing improper footwear increase the risk of injury. Strengthening the calf muscles and improving flexibility through targeted exercises can help reduce strain on the tendon. Proper technique, gradual intensity progression, and sufficient rest between training sessions are essential for injury prevention. Supportive footwear and using appropriate dance surfaces can also minimize stress on the Achilles tendon. Paying attention to early signs of discomfort, such as stiffness or pain, allows for timely intervention. If you have sustained an Achilles tendon injury from dancing, it is suggested that you promptly contact a podiatrist who can offer effective treatment solutions and prevention tips.
Achilles tendon injuries need immediate attention to avoid future complications. If you have any concerns, contact Joseph D. Ruffo, DPM, PC of New York. Our doctor can provide the care you need to keep you pain-free and on your feet.
What Is the Achilles Tendon?
The Achilles tendon is a tendon that connects the lower leg muscles and calf to the heel of the foot. It is the strongest tendon in the human body and is essential for making movement possible. Because this tendon is such an integral part of the body, any injuries to it can create immense difficulties and should immediately be presented to a doctor.
What Are the Symptoms of an Achilles Tendon Injury?
There are various types of injuries that can affect the Achilles tendon. The two most common injuries are Achilles tendinitis and ruptures of the tendon.
Achilles Tendinitis Symptoms
- Inflammation
- Dull to severe pain
- Increased blood flow to the tendon
- Thickening of the tendon
Rupture Symptoms
- Extreme pain and swelling in the foot
- Total immobility
Treatment and Prevention
Achilles tendon injuries are diagnosed by a thorough physical evaluation, which can include an MRI. Treatment involves rest, physical therapy, and in some cases, surgery. However, various preventative measures can be taken to avoid these injuries, such as:
- Thorough stretching of the tendon before and after exercise
- Strengthening exercises like calf raises, squats, leg curls, leg extensions, leg raises, lunges, and leg presses
If you have any questions please feel free to contact one of our offices located in Sea Cliff and Babylon, NY . We offer the newest diagnostic tools and technology to treat your foot and ankle needs.
Achilles Tendon Injuries
The Achilles tendon is the largest tendon in the body; it is a tough band of fibrous tissue that stretches from the bones of the heel to the calf muscles. This tendon is what allows us to stand on our toes while running, walking, or jumping, it is common for this tendon to become injured. In severe cases, the Achilles tendon may become partially torn or completely ruptured. However, this tendon is susceptible to injury because of its limited blood supply and the high level of tension it endures.
The people who are more likely to suffer from Achilles tendon injuries are athletes who partake in activities that require them to speed up, slow down, or pivot. Consequently, athletes who engage in running, gymnastics, dance, football, baseball, basketball, or tennis are more likely to suffer from Achilles tendon injuries. Additionally, there are other factors that may make you more prone to this injury. People who wear high heels, have flat feet, tight leg muscles or tendons, or take medicines called glucocorticoids are more likely to have Achilles tendon injuries.
A common symptom of an Achilles tendon injury is pain above the heel that is felt when you stand on your toes. However, if the tendon is ruptured, the pain will be severe, and the area may become swollen and stiff. Other symptoms may be reduced strength in the lower ankle or leg area, and reduced range of motion in the ankle. When the Achilles tendon tears, there is usually a popping sound that occurs along with it. People who have acute tears or ruptures may find walking and standing to be difficult.
If you suspect you have injured your Achilles tendon, you should see your podiatrist to have a physical examination. Your podiatrist will likely conduct a series of tests to diagnose your injury including a “calf-squeeze” test. Calf squeeze tests are performed by first squeezing the calf muscle on the healthy leg. This will pull on the tendon and consequently cause the foot to move. Afterward, the same test will be performed on the injured leg. If the tendon is torn, the foot won’t move because the calf muscle won’t be connected to the foot.
What Your Feet Can Reveal About Your Health

The condition of your feet can provide important clues about your overall health. Cold feet may indicate poor circulation, which can be a sign of conditions like peripheral artery disease or diabetes. Persistent foot pain that does not improve with rest may suggest arthritis, nerve damage, or an underlying structural issue. Changes in the nails, including discoloration, thickening, or brittleness, can be linked to fungal infections, nutritional deficiencies, or even thyroid disorders. Additionally, burning foot pain may be a symptom of nerve damage, often associated with diabetes or vitamin B deficiency. Paying attention to these signs and seeking medical advice when necessary can help detect health issues early. If you have any type of foot pain, it is suggested that you consult a podiatrist who can treat various foot conditions, and determine if it is an indicator of additional health issues.
When dealing with systemic disease of the feet, it is extremely important to check the affected areas routinely so that any additional problems are caught quickly. If you have any concerns about your feet and ankles contact Joseph D. Ruffo, DPM, PC from New York. Our doctor will assist you with all of your podiatric needs.
Systemic Diseases of the Feet
Systemic diseases affect the whole body, and symptoms usually are displayed in the feet. This condition can make a patient’s ability to walk unbearable. Systemic diseases include gout, diabetes mellitus, neurological disorders, and arthritis.
Gout – is caused by an excess of uric acid in the body. Common symptoms include pain, inflammation, and redness at the metatarsal/phalangeal joint of the base big toe. Gout can be treated by NSAIDs to relieve pain and inflammation, and other drugs that lower the acid levels in the body.
Diabetes mellitus – is an increase in the level of blood sugar that the body cannot counteract with its own insulin. Failure to produce enough insulin is a factor in Diabetes.
Diabetes of the Feet
Diabetic Neuropathy – may lead to damaged nerves and affect the feet through numbness and loss of sensation.
Peripheral Vascular Disease – can restrict the blood flow to the feet, and often times lead to amputation of the feet.
If you have any questions please feel free to contact one of our offices located in Sea Cliff and Babylon, NY . We offer the newest diagnostic and treatment technologies for all your foot and ankle needs.
Systemic Diseases of the Foot
There are several systemic diseases, or diseases that affect the whole body, that either display symptoms in the feet or affect the health of the feet. Common systemic diseases that affect the overall health of the feet, and the patient’s ability to walk comfortably, include gout, diabetes mellitus, neurological disorders, and arthritis, among others.
In gout, which is caused by an excessive buildup of uric acid in the body, the most common symptoms of pain, inflammation, and redness occur at the metatarsal/phalangeal joint at the base of the big toe. Any excess levels of uric acid crystallize and are deposited in tendons, joints, and surrounding bone and muscle tissue. Gout is commonly treated with NSAIDs to relieve pain and inflammation and other drugs to lower uric acid levels in the body. Gout most commonly affects those who are overweight, have low protein diets and lead a more sedentary lifestyle.
Diabetes mellitus is an increase in the level of blood sugar in which the body cannot counteract with naturally occurring insulin in the body. The three types of diabetes, Type I, Type II and Gestational Diabetes, are all signs the body is either not producing enough insulin or is not efficiently using the insulin that is produced. Gestational diabetes only affects women who are pregnant and have never, prior to pregnancy, exhibited symptoms of the disease.
There are two main issues that affect the feet that are commonly caused by diabetes. They include diabetic neuropathy and peripheral vascular disease. Diabetic neuropathy can lead to damaged nerves and affect the feet through numbness and loss of sensation. Peripheral vascular disease restricts the flow of blood to the foot and can, in extreme cases, lead to the necessity of amputating the foot. Peripheral issues that are caused by diabetes and can affect the foot include athlete’s foot, nail infections, corns, blisters, bunions, severe dry skin, plantar warts and ingrown toenails. These can all be attributed to the decrease of blood flow to the foot.
Neurological disorders and rheumatoid arthritis can also have severe impact on the health of the feet. Neurological disorders can affect the nerves in the main structure of the foot and cause loss of sensation and possible decreased muscle response. Rheumatoid arthritis can affect the bones and joint structures of the foot, making it impossible to walk normally without serious pain.
All systemic diseases that affect the foot can effectively be treated to minimize joint and muscle damage if they are diagnosed early and treated with medication and lifestyle therapy. Diabetes patients must monitor their blood sugar levels and work with their physician to keep their levels as close to normal as possible. Rheumatoid arthritis patients should work with their physician to ensure the proper medications are being taken to reduce the amount of damage to the joints of the body.