The Facts About Foot Ulcers and Orthotics

Are you tired of painful wounds on your feet? Well, maybe it’s time to learn the facts about foot ulcers and orthotics.

The Facts about Foot Ulcers and Orthotics (

The Facts about Foot Ulcers and Orthotics (

A foot ulcer is an open sore on the foot that can potentially develop into a more serious wound if left untreated.

These ulcers typically take the form of a shallow red crater that involves only the surface skin. In some cases, however, a deep foot ulcer may lead to the formation of a crater that extends through the full thickness of the skin that may involve tendons, bones and other deep structures.

If you suffer from poor circulation due to chronic condition such as diabetes, then you are more likely to develop foot ulcers. In people with these conditions, even a small foot ulcer can become infected if it does not heal quickly.

About 15 percent of all people with diabetes will develop a foot ulcer at some point in their lives. Additionally, approximately 40 percent of diabetic foot ulcers are located on the plantar surface related to metatarsal heads.

The Facts about Foot Ulcers and Orthotics

Who is at risk for foot ulcers?

Although foot ulcers can affect anyone, they are especially common in people who have one or more of the following health problems:

  • Peripheral neuropathy: This is a condition that affects the normal activity of the nerves that connect the central nervous system — the brain and spinal cord — to the rest of the body. Diabetes – both Type 1 and Type 2 — is the most common cause of peripheral neuropathy. When nerves in the feet are damaged, they can no longer warn about pain or discomfort, which allows normal wounds to develop into painful ulcers.
  •  Circulatory problems: Any illness that decreases circulation to the feet can cause foot ulcers. Less blood reaches the feet, which deprives cells of oxygen, thus making the skin more vulnerable to injury and slowing the foot’s ability to heal.
  •  Foot Abnormalities: Any condition that distorts the normal anatomy of the foot can lead to foot ulcers. This is particularly true if the foot is forced into shoes that don’t fit the foot’s altered shape, such as high heels.

Can custom-made orthotics help?

While it certainly isn’t the only method used for treating ulcers, custom-made orthotics can be used to lessen the chance that they come back to haunt you.

In a recent article published in Diabetes Care, a 15-month randomized study of 150 patients with recently healed submetatarsal-head plantar ulcers found that those who wore custom-made orthoics saw a 3-fold reduction in ulcer recurrence compared to those who wore standard orthotics.

At Delray Beach Podiatry, Dr. Ian S. Goldbaum, a podiatric physician and surgeon with over 30 years of experience, notes that orthotics play a pivotal role in his overall treatment plan for patients suffering from ulcers.

Dr. Goldbaum, however, is also quick to point out that not all shoe inserts are created equal and the best way for patients to safeguard themselves from reoccurring ulcers is by using custom-made orthotics.

“People often confused inserts with orthotics,” said Dr. Goldbaum. “An insert usually comes with the shoe or is bought off the shelf while an orthoic is actually made specifically for a patient.

“In our office, we use a three-dimensional scanner that tells us how they’re walking and also take weight bearing x-rays so we can see when the bones are loaded. Between those two things and actual casting of the foot, we are able to get an imprint so that I can make a determination as to how I should change a patient’s foot in order to get it into a better position.”

As Dr. Goldbaum alluded to, the position of the foot is the key factor for offloading the pressure that can lead to ulcer reoccurrences. If left untreated, reoccurring ulcers can result in significant morbidity and cost even when they do not lead to an amputation.

After an initial foot ulcer, the risk for reulceration is extraordinarily high. By utilizing custom-made orthotics in conjunction with other treatments, however, that risk can be greatly reduced.

“We can use orthotics to keep patients biomechanically in position while repositioning the weight off the area that has a wound,” said Dr. Goldbaum. “By offloading that pressure, the skin has a chance to heal properly.”

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The content on this website is for informational purposes only. Do not rely or act upon information from without seeking professional medical advice. If you live in South Florida and would like a consultation with Dr. Ian Goldbaum, a podiatric physician and surgeon with over 30 years of experience, please see our contact information below:


16244 S. Military Trail #290, Delray Beach, FL 33445



8198 Jog Road #100, Boynton Beach, FL 33472