During the past several years, more people have started participating in winter sports, especially outdoors sports. Skiing, snowmobiling, and tobogganing are all growing in popularity, but the country’s fastest growing winter sport is cross-country skiing.
Everyone participating in outdoor sports should be fully protected from the elements to avoid injury from the cold. It is especially important for the person with diabetes to be protected. Diabetes is linked with peripheral vascular disease (diminished circulation) and peripheral neuropathy (nerve damage) – two conditions that make a person more likely to suffer an injury from cold. Neuropathy can reduce a person’s ability to perceive pain from the cold. It is extremely important for people with diabetes to understand and be aware of the potential seriousness of thermal injuries to avoid the problems that they can cause.
The parts of the body most susceptible to the cold are the tips of the fingers and the tips of the toes. These areas are supplied by very small capillaries that constrict in the cold, cutting blood flow.
Many clothing materials are available today that provide the necessary insulation and also allow for the evaporation of perspiration from the foot. Evaporation of perspiration helps keep the skin from freezing by drawing moisture away from the skin and keeping the foot drier and warmer.
Polypropylene is a synthetic material that helps draw moisture away from the skin. It is available now in all types of garments. Cotton is an excellent material for providing warmth; however, it has the tendency to get damp with perspiration. The best combination to wear is a sock liner made of polypropylene with a cotton sock over that. This combination will provide the best of both worlds. The polypropylene liners are quite thin and do not add a lot of bulk to the inside of the shoe.
The fit of the shoe or boot becomes an important issue, especially in someone with peripheral neuropathy or vascular insufficiency. A tight ski boot or shoe may cause pressure on the skin that can deprive that area of the necessary blood and oxygen. A sore can develop at the area of pressure. A tight shoe or boot may also cause abrasions that someone with neuropathy might not detect. Shoes worn for all outdoor sports must fit properly.
When we think of shoe fit, we usually think of the dimension from side to side, but often forget about the length of the shoe. A shoe that is too short may exert pressure on the tips of the toes. This can cause either an ingrown nail, bleeding under the nail (sometimes called “runners’ toe”), or a corn on the tip of the toe. When the person has little or no feeling, the problem will go undetected.
Here are some helpful hints to avoid foot trouble during the winter.
- Rent boots several days before your trip. Wear boots around the house to be sure of the proper fit.
- When renting boots, wear whatever sock or sock combination you plan to use when skiing.
- Make sure your toenails are cut properly before exercise to avoid shoes pressing against the nail. Pressure can lead to an ingrown nail.
- During the day of the activity (regardless of what it is), remove the shoes at least one time to examine the feet. This will also give your feet a chance to warm. You should look for areas of extreme redness or swelling; cuts, abrasions, or cracking in the skin; and bleeding under the toenail.
If you have any of these conditions, stop the activity and seek appropriate care. Catching these problems early, before they turn into more serious problems, is easy to do and will help to avoid the more serious complications.
People with diabetes, regardless of type I or type II, should be able to participate actively in all winter sports as long as precautions are followed. Foot care for the person with diabetes is as important as insulin management and nutrition. As long as the appropriate care is taken, winter sports can be safe and enjoyable.