Author Archives: MidMichigan Health

Preventative Foot Care in Diabetes

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When dealing with all of the aspects of diabetes, it’s easy to let your feel fall to the bottom of the list. But daily care and evaluation is one of the best ways to prevent foot complications. It’s important to identify your risk factors and take the proper steps in limiting your complications. Two of the biggest complications with diabetes are peripheral neuropathy and ulcer/amputation.

Symptoms of peripheral neuropathy include numbness, tingling and/or burning in your feet and legs. You can slow the progression of developing neuropathy by making it a point to manage your blood sugars and keep them in the normal range. If you are experiencing these symptoms, it is important to establish and maintain a relationship with a podiatrist. Your podiatrist can make sure things are looking healthy and bring things to your attention to monitor and keep a close eye on.

Open wounds or ulcers can develop secondary to trauma, pressure, diabetes, neuropathy or poor circulation. If ulcerations do develop, it’s extremely important to identify the cause and address it. Ulcers can get worse quickly, so it’s necessary to seek immediate medical treatment if you find yourself or a loved one dealing with this complication. Untreated ulcerations often lead to amputation and can be avoided if proper medical attention is sought right away.

There are important things to remember when dealing with diabetic foot care. It’s very important to inspect your feet daily, especially if you have peripheral neuropathy. You may have a cut or a sore on your feet that you can’t feel, so your body doesn’t alarm you to check your feet. Be gentle when bathing your feet. Moisturize your feet, but not between your toes. Do not treat calluses or corns on your own. Wear clean, dry socks. Never walk barefoot, and consider socks and shoes made specifically for patients with diabetes.

Kristin Raleigh, D.P.M., is a podiatrist who sees patients at Foot & Ankle Specialists of Mid-Michigan in Midland. Those who would like to make an appointment may contact her office at (989) 488-6355.


The Most Useful Pieces of Adaptive Equipment

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Occupational therapists strive to help their patients be as independent as possible with meaningful activities. Often times, when a patient sustains a bodily or neurological injury, they are left with weakness or paralysis. Other times, after a joint replacement or bone fracture, there are restrictions placed on the person that limits their safe movement.

Adaptive equipment presents a great way for occupational therapists to help people develop compensatory strategies in order to complete the tasks that are most meaningful to them. The items can be temporarily used until the person returns to their previous functional level, or they can be used indefinitely as a way for the patient to regain independence and control of their environment and self.

In my opinion, the top 10 most useful pieces of adaptive equipment are:

  • Built-up foam grips: These grips can be added to utensils to make the handles bigger, which helps people who’ve suffered from strokes, arthritis or hand weakness.
  • Long-handled reacher: These are great for getting dressed and managing the surrounding area around a person.
  • Sock aid: These allow people to get their socks on. It’s especially helpful for those who have had hip surgery with flexion precautions. Many people struggle to bend down for a variety of reasons, and this allows for the person to load the sock, and pull the sock on without leaving the seated position.
  • Universal cuff: This is a staple within the OT community. This cuff can substitute for grip dexterity and strength by strapping around the hand and allowing a utensil to be inserted. This way, the person can use the ability they have in their arm to feed themselves, brush their teeth, shave or comb their hair despite a weakened grip or dexterity. It’s often used in patients who have muscle atrophy or spinal cord injuries.
  • Scoop plate with suction pad: This is good to be used in tandem with a universal cuff, but can also be used on its own. It allows a person who has an upper extremity that is somehow affected to feed themselves with one hand, as the food can be pushed to one side for easier scooping. Models with a suction cup are nice, but otherwise using a non-slip material can help the plate not slide easily.
  • Adaptive cutting board: This is great for someone who is limited to one arm for functional use. It allows for the item to be fixated with the nails so chopping/slicing is easily accomplished. It can be used in a sitting or standing position.
  • Dycem (name brand non-slip material): This is another therapy staple, and a cost-effective, easy way to introduce more control with devices. It can be used as a grip to open jars. It can go underneath scoop plates so they don’t move on the table when eating. Basically, if you don’t want the item to slide, this material can be placed underneath to prohibit movement.
  • Elastic shoelaces: These are a great solution for those who struggle to tie their shoes. They can be used from pediatrics to geriatrics, and for anyone who might be struggling with hand weakness or dexterity issues. It can also be used for those who have cognitive delays or problems, so that the complex process of tying shoes can be bypassed.
  • Button hook/dressing aid: This is used to apply buttons with one hand when dexterity is an issue. Often they are equipped with a hook on the end that can be used to pull up a zipper.
  • Rocker knife: A great way to cut food with one hand. Often, this is used when the person does not have the strength to push/slice food conventionally. It can be used in tandem with the cutting board or scoop place, or normal plates.

Sam Penkala, O.T.R.L., is an occupational therapist at MidMichigan Health.


What’s the Difference Between Occupational and Physical Therapy?

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While occupational therapy (OT) and physical therapy (PT) might both be familiar terms, many of us aren’t quite sure of the difference between the two.

The role of a physical therapist is to diagnose and manage movement dysfunction and enhance physical and functional abilities. Their goal is to restore, maintain and promote not only optimal physical function but optimal wellness, fitness and quality of life as it relates to movement and health. In addition, a physical therapist works with his or her patients to prevent the onset, symptoms and progression of impairments, functional limitations and disabilities that may result from diseases, disorders, conditions or injuries.

Occupational therapists, as their name suggests, focus on occupations. Occupations aren’t just jobs, however. They’re meaningful activities that patients do in daily life. The goal of an OT is to get their patients regain skills to complete these occupations, as well as help them modify their occupations to make them achievable.

Some areas of occupations that an OT might focus on during treatment could include activities of daily living, rest and sleep, work, play, leisure and social participation. Daily activities can consist of anything from driving to shopping, managing finances, meal preparation, home management and more.

An OT will help patients focus on getting back to work, if that’s the goal. They’ll look at workplace ergonomics, and help patients prepare for any pertinent life changes.

Sam Penkala, O.T.R.L., is an occupational therapist at MidMichigan Health. Those who would like to learn more about MidMichigan’s comprehensive rehabilitation services, including PT and OT, may visit


Important Facts about Sleep Health

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Scott Ross, M.D., family medicine physician, identifies some common issues that keep us from sleeping well and offers tips to help combat those problems that may affect our getting quality rest.

Q. How much sleep do adults really need?

A. On average, adults should get between seven and nine hours of sleep each night. Some people feel best with eight consecutive hours, while others do well with six or seven and a nap.

Q. What happens when we don’t get enough sleep?

A. Short-term problems can include lack of alertness, impaired memory, relationship stress, diminished quality of life and a greater likelihood for car accidents. Long-term problems can become serious. Chronic sleep deprivation is linked to high blood pressure, diabetes, heart attack, heart failure, stroke, obesity and depression.

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Diabetes Can Lead to Non-Healing Wounds And Amputations

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Approximately 29 million Americans are living with diabetes, and about 25 percent of them will develop non-healing wounds that require specialized wound treatment.

Diabetes Infographic
[click image to enlarge] Every hour, ten Americans will undergo an amputation due to diabetes. Of those, 50% will die in five years.The good news is that most of these amputations can be prevented through education, regular clinical visits and proper shoe wear. Those who do develop non-healing wounds should seek specialized treatment right away.

Without treatment, these wounds can lead to amputation or even death. Every hour, ten Americans undergo an amputation as a result of diabetes. What’s even more startling is that 50 percent of people who have an amputation will die within five years.

The good news is that most of these amputations can be prevented through education, regular clinical visits and proper shoe wear.

MidMichigan’s Wound Treatment Centers in Alma, Alpena, Clare, Midland and West Branch specialize in treating non-healing wounds, offering leading edge treatments including hyperbaric oxygen therapy. Specialized Wound Treatment Centers have better outcomes because they bring together many disciplines to not only treat the wound, but to also address underlying barriers to healing. including the special circumstances of people with diabetes.

Take Action. Seek Specialized Treatment.

If you or someone you love is living with a non-healing wound, don’t wait – seek specialized treatment. Call the Wound Treatment Centers toll free at (877) 683-0800 or visit


My Child Walks on their Toes – Should I be Concerned?

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While toe walking is normal for periods during early walking, toe walking that persists greater than six months from mastery of walking could cause issues as a child develops. We don’t know why some children persist with toe walking.

Often, a child will have shortening of their heel cords, because they don’t stretch out when they walk. This tightness increases as a child grows. To compensate, they may turn their feet out, and start to stand and walk with their heels down.

If a child walks on their toes, it can lead to changes in their foot structure due to abnormal forces from landing on their forefoot. This in combination with heel cord tightness can lead to foot and knee pain as an adult.

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The Benefit of a Warm-up Program for Athletes

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It is well documented that a warm-up program that is implemented correctly, with good form, has the ability to reduce the amount of injuries in athletes. The WellSport team has sifted through some of this research and has developed a warm-up program that can be adapted for athletes in many different sports.

Athletic trainer Jared Slater, A.T.C., and Physical Therapist Jacob Hart, P.T., D.P.T. were instrumental in implementing this program within their community. In the spring of 2018, they began working with a high school girls soccer team. First, the athletes participated in a dynamic test so the team could see how their bodies responded to the normal demands of sports.

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What is the Rotator Cuff, and Why are There So Many Issues with it?

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So, what is the rotator cuff? Cup? Rotary cup? While most people have heard some form of the term rotator cuff, less really understand what it is, how it relates to shoulder function and why there are often so many issues involving it.

First of all, what is it? The rotator cuff is comprised of four muscles in your shoulder. They are the supraspinatus, infraspinatus, subscapularis and teres minor. All of these muscles attach from your scapula (shoulder blade) to your humerus (arm bone).

What does it do? The primary goal of the rotator cuff is to provide dynamic geometric centering of the humerus. In other words, your shoulder joint is a very shallow ball and socket joint. When you attempt to reach out and move your arm, the rotator cuff muscles work to keep the ball and socket of the joint in the correct position. Without this, when you try to reach overhead, for example, your humerus would rise up instead of staying in position. This can cause shoulder pain and impingement.

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When Should I Worry About the Shape of My Baby’s Head?

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Congenital torticollis is a shortening of the sternocleidomastoid (SCM) muscle in the neck of infants. There is a small lump seen in the muscle at times. This can be genetic, or from the baby’s position in the womb. It’s commonly seen in twins or larger babies where space may be tight and the baby can’t move his or her head around as easily.

The SCM muscle performs two movements. It tips the head to one shoulder and turns it to the opposite shoulder. Most commonly, a doctor will notice a flattening on the back of the head on one side due to the baby keeping their head turned one way. The flattening may be worse in babies who spend a lot of time on their back, or in car seats and swings. As a baby’s head control improves, the tipping of the head to one side may become more noticeable.

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September is Pain Awareness Month

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Did you know that more people suffer from pain than cancer, heart disease and diabetes combined?

Nearly one fourth of Americans suffer from pain annually, making pain the major driver of primary care physician visits.

There are various factors that cause and create pain, such as:

  • Family history. You may be more likely to develop arthritis and some other conditions if you have a family history of the disease/diagnosis.
  • Age. The risk of many types of diagnoses and pain injuries increases with age.
  • Gender. Women are more likely than men to develop rheumatoid arthritis.
  • Previous injury. Some people who have experienced previous injuries have pain related to those injuries throughout their lives.
  • Obesity. Carrying excess pounds puts stress on joints, particularly your knees, hips and spine.
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