Category Archives: Education

Vitamin D and the Foot

Vitamin D and the Foot

I have been doing my weekly update on research and views for a few years now and you start to see patterns in the research and the literature. One that really stood out like a sore thumb was vitamin D. At one stage a year or so ago, I was commenting at least weekly on something to do with vitamin D and the foot. I even got feedback that I was some sort of vitamin D junkie (I’m not). More lately its probably once a month or so, but that is still a lot compared with other topics. Its hard not to miss how much research has been regularly and recently added to the threads on Podiatry Arena on vitamin D and the diabetic foot and the thread on vitamin D and foot and ankle injuries. With that sheer volume of content and research one can not help but think that it might be important and relevant.

What is obvious from all that research is the frequent correlation between lower levels or a deficiency of vitamin D and wide range of foot and ankle problems (from diabetic foot ulcers to stress fractures to muscle strains to the outcome of trauma etc). There are strong correlations between low vitamin D and a whole range of general medical conditions. Even more recent is all the research showing strong correlations between getting COVID-19, the seriousness of COVID-19, the outcomes of COVID-19 and vitamin D.

It is from there that there is a divergence between the science and the pseudoscience. The research has clearly and strongly demonstrated the correlation with low vitamin D and a whole lot of problems. We all know that correlation is not causation, but those promoting pseudoscience or selling vitamins do not get or understand the difference. That science is generally not so strong on the causation which has not stopped the cranks promoting the pseudoscience. There is generally very little evidence that prospectively links vitamin D to a higher risk of problems. There is also limited research showing that taking vitamin D fixes the problems that a deficiency is correlated to. That general lack of prospective evidence does not mean that vitamin D is not important, it just means that we need to be cautious about claims made for it and that context needs to be acknowledged.

Of course, generally, if someone is deficient in vitamin D, they probably should be taking supplements to get that up to normal. What should not be done is promoting vitamin D as a treatment if vitamin D levels are normal. Take any more than the required amount and the body just tries to excrete it. Vitamin D toxicity from over-supplementation (rather than an overdose of sun) is a thing and carries risks.

The COVID-19 case is an interesting one to observe. I have seen vitamin D supplements advocated to help prevent catching the coronavirus, probably from those selling vitamin D. There is no evidence that will work, despite the high correlation between COVID-19 and the vitamin D deficiency. Of course those sick with COVID-19 and are deficient should be given supplements as it just makes sense. The line has to be drawn at claiming vitamin D as a treatment for it, which certainly has not stopped the cranks with no experience in treating COVID-19 from claiming. While, I have doubts that this is the case, but it could well be that COVID-19 increases the demand for vitamin D, so the infection causes the deficiency rather than the other way around. These types of conclusions or hypotheses can not be made or excluded based on the current state of the science.

This area also attracts more than its fair share of clueless cranks, especially those who talk about vitamins boosting the immune system. If you hear anyone talking about that, stop listening or (preferably) call them out for their dribble. The last thing I want to do is boost my immune system.

Yes, vitamin D is important for foot and ankle problems; and yes, getting out in the sun and taking supplements is important. Just stop listening to the cranks. The buzz about vitamin D is overblown.

Disclaimer: I take a low dose of vitamin D as I have one of the conditions that correlates to low levels of vitamin D.

The issue is important enough that we have an upcoming episode of PodChatLive on it.

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  • Stealth Sponges are designed with proprietary "flared" angles to offer significantly reduced artifacts during viewing. Flared sides will increase overall size. Non-Stealth Sponges are formed with traditional angles and do not feature our proprietary "flared" angles to offer significantly reduced artifacts during viewing. Non-stealth (or non-flared) sides may show artifacts when imaging, specifically when coating is applied.
  • Returns of this item can be made within ten (10) business days from delivery and are subject to a 25% restocking fee. All genuine Techno-Aide products are guaranteed for one year from the initial date of purchase for defects in material and workmanship. Proudly made in the USA and sold by a Veteran Owned Small Business.
SaleBestseller No. 7
Watkins' Manual of Foot and Ankle Medicine and Surgery
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  • Watkins, Leon (Author)
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  • 732 Pages - 12/21/2016 (Publication Date) - LWW (Publisher)
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Foot and Ankle Radiology
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Why Podiatrists Should be Concerned About Concussion in Sport

Concussions have always had a particular interest for me. The politics around concussion in sport and the alleged cover-ups and the significant public health consequences have long been a fascinating issue to follow. Will Smith’s 2015 movie, Concussion and the 2013 book, League of Denial highlighted just how political and controversial it has become. Who remembers or knows what the Lonergan Shuffle is?

Why should Podiatrists be concerned about concussions?

  1. Concussion in sport is a major public health issue, with significant long term societal and personal health and mental health effects. All health professionals should be concerned about and be proactive in all public health issues and educating the community about the issues and advocating for those issues. Smoking and obesity are other public health issues.
  2. There is a significantly increased risk for lower limb injury following a concussion and that risk can last for at least a year or so. There is a very large number of studies that have shown that. You can follow this thread which lists all those studies: Concussion and the lower limb and as a public health issue
  3. We are parents, we are members of the community; our kids are involved in community sport. We could be the first responder to a head injury in the community, especially at our kid’s sport.

On the third point above, I had a daughter who spent a few years playing full-contact rugby in a boys’ team. By default, I became the de facto ‘team doctor’. I freaked out every time one of the boys (or girl) went down with a potential head injury – mainly because I knew the consequences of a concussion. I always acted quickly and made sure play was halted until I took an appropriate action for a sideline HIA (Head Injury Assessment) and ruled out other trauma and then made the call to escalate or continue play, following appropriate guidelines. Luckily, they were a tough bunch and I never had to deal with one that was a concussion. Yes, I know my lane and I stay in it; but I am also a member of the community and in the context of the lack of other appropriate or more qualified cover, I was the first responder. We are required by Podiatry Board of Australia to be re-certified regularly in first aid. There is a reason for that.

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Postscript:
No sooner than I write the above, this study appears showing that those who have a time loss lower limb injury are more likely to go on and get a concussion.

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  • BIG, BRIGHT & DIMMABLE MAGNIFYING LIGHT TO SEE SMALL DETAILS EASILY: This magnifier lamp was designed to ease your close up focus, even with vision problems such as aging eyes or macular degeneration. This lamp includes a built in dimmer switch so you get exactly the right light. The 3" wide, diopter glass magnifying lens will magnify whatever you are working on up to 175%. The LED lights don't get hot so you can enjoy your hobbies comfortably.
  • COMFORT & EASE OF USE FOR PROFESSIONALS: HANDSFREE USE & SMOOTH ROLL EVEN ON BAD SURFACES: Free both hands to work thanks to the flexible arms and pivoting head get the light and lens right where you want it; the powerful springs then keep it in place. The 6 wheels roll easily, making it perfect for spas and salons, estheticians, dermatologists, beauticians, jewelers, tattoo artists, dentists etc. Facials lash extensions and other treatments are a cinch.
  • REVIEWS: GREAT FOR READING, SEWING, KNITTING, QUILTING, PUZZLES, CROCHET, CROSS STITCH etc: Reviewers say this light helps them enjoy hobbies by reducing eye strain and avoiding headaches. Plus they feel greater pride and achievement in as a result of more precise detail work. Beside those mentioned, soldering, painting (e.g. minis), woodworking, drawing, repair of small electronics and fly trying are other common uses.
  • REAL DIOPTER GLASS MAGNIFIES 1.75X & 20 YEAR LIFE LED LIGHTS FOR MAX DURABILITY - AVOID REPLACEMENT HASSLES - The genuine diopter glass means the lens doesn't warp with time or heat, and is also scratch resistant. So it lasts longer than cheap acrylic/plastic lenses. This model features 1.75X magnification with things in focus at a distance of 13 inches. The 9W & 800 lumen LED lights are built in and last 20,000 hours - about 20 years if you use the Brightech Lightview Pro 3 hours every day!
  • BRIGHTECH'S 3 YEAR PRODUCT WARRANTY: We proudly stand behind all of our products 100%, which is why we offer a full 3 year warranty. If your lamp has any defect or stops working within 3 years, we help you troubleshoot and/or send replacement parts or a whole new product. If any problems arise, please contact us because our number one goal is customer satisfaction.
SaleBestseller No. 2
McGlamry's Comprehensive Textbook of Foot and Ankle Surgery, Volume 1 and Volume 2
  • Used Book in Good Condition
  • Hardcover Book
  • English (Publication Language)
  • 2112 Pages - 11/17/2012 (Publication Date) - LWW (Publisher)
Bestseller No. 3
CYTING Foot Doctor Keychain The Human Foot is A Masterpiece of Engineering and A Work of Art Podiatry Keychain Graduation Gift for Podiatrist Appreciation Gift (Podiatrist Keychain)
  • 👣"The human foot is a masterpiece of engineering and a work of art" Podiatry keychain - Whether you're a Podiatrist, Podiatrist student or grad, or looking for a gift for one, this podiatrist keychain is a perfect keepsake!
  • 👣Are you looking for a fantastic gift that a Podiatrist will remember forever due to its uniqueness and thoughtfulness? Do you want an amazing looking gift dedicated to Podiatrists that will make their eyes light up as soon as they see it? A gift to a podiatrist and original gift for a surgeon.
  • 👣The podiatrist keychain is packed in a velvet bag ready for giving. This foot doctor keychain would be perfect for a podiatrist or for someone who works in a podiatrist office.
  • 👣Material👣: Stainless Steel and alloy, they are lead free and nickel free. Stainless steel is hypo allergenic, it doesn’t rust, change colour or tarnish.
  • 👣Measure👣: bar pendant: 5cm (1.97") * 1.2cm (0.47"), key ring diameter: 3cm (1.18"). A great design for yourself or your favorite Podiatrist!
SaleBestseller No. 4
The Podiatry Practice Business Solution: Everything You Need to Know to Flourish in Your Podiatry Business
  • Hardcover Book
  • Wishnie, Peter (Author)
  • English (Publication Language)
  • 174 Pages - 02/28/2020 (Publication Date) - Stonebrook Pub. (Publisher)
SaleBestseller No. 5
Mann’s Surgery of the Foot and Ankle, 2-Volume Set: Expert Consult: Online and Print (Coughlin, Surgery of the Foot and Ankle 2v Set)
  • Mosby
  • Hardcover Book
  • Saltzman MD, Charles L. (Author)
  • English (Publication Language)
  • 2336 Pages - 11/06/2013 (Publication Date) - Mosby (Publisher)
Bestseller No. 6
Podiatry Axial/Sesamoid Weight Bearing Sponge (Closed Cell)
  • Closed Cell - 13" x 8" x 4"
  • Closed Cell Sponges are made from a lightweight, radiolucent, non-porous foam. The perfect solution for any positioning need. These positioning sponges are entirely fluid resistant, easy to clean and extremely durable! Featured in a non-coated, premium charcoal grey color.
  • Closed cell sponges are 100% Radiolucent for artifact free imaging. Cleanable, fluid resistant surface. Lightweight and comfortable. Closed cell is the number one option in positioning sponges.
  • Stealth Sponges are designed with proprietary "flared" angles to offer significantly reduced artifacts during viewing. Flared sides will increase overall size. Non-Stealth Sponges are formed with traditional angles and do not feature our proprietary "flared" angles to offer significantly reduced artifacts during viewing. Non-stealth (or non-flared) sides may show artifacts when imaging, specifically when coating is applied.
  • Returns of this item can be made within ten (10) business days from delivery and are subject to a 25% restocking fee. All genuine Techno-Aide products are guaranteed for one year from the initial date of purchase for defects in material and workmanship. Proudly made in the USA and sold by a Veteran Owned Small Business.
SaleBestseller No. 7
Watkins' Manual of Foot and Ankle Medicine and Surgery
  • LWW
  • Watkins, Leon (Author)
  • English (Publication Language)
  • 732 Pages - 12/21/2016 (Publication Date) - LWW (Publisher)
SaleBestseller No. 8
Foot and Ankle Radiology
  • Hardcover Book
  • English (Publication Language)
  • 624 Pages - 12/31/2014 (Publication Date) - LWW (Publisher)
SaleBestseller No. 9
Operative Techniques in Foot and Ankle Surgery
  • Hardcover Book
  • English (Publication Language)
  • 1394 Pages - 10/19/2016 (Publication Date) - LWW (Publisher)
SaleBestseller No. 10
Professional Double Ended Nail Curette 1.5/2.5mm Dermal Ingrown Toenail Cleaner Scoop Chiropody Podiatry Tools
  • Manufactured from High Quality Medical Grade Stainless Steel
  • Nail Cleaning and Care Instruments
  • One End Has 1.5mm Scoop While the Other Has 2.5mm Cup
  • Dual-Use Tool is For Trimming Cuticles, Cleaning Fingernails and Giving Manicures Pedicure
  • Removes Non-living Tissue Around the Cuticles, Cleaning Under the Nails and Along Side Walls

I get commissions for purchases made through links on this website. As an Amazon Associate I earn from qualifying purchases