A Caregiver’s Guide to Circulation and Foot Health

When your parents cared for you, odds are good that you would try to hide or downplay the truth on something you thought might be scary. You know you did it. They know you did it.

But we humans tend to act in cycles. You may very well be on the parental side of things now with your own child. But also, if you are now helping to take care of your parents or other loved ones, they might be back to trying to downplay problems, themselves.

Whether it is a matter of pride or “not wanting to cause any trouble” is moot. What is important is being watchful for signs of trouble, and being as open as you can be with the one you are caring for in discussing any potential dangers to their health.

Circulation problems are one of these important factors, and our topic du blog.

From Foot Health to Full Body Health

Why would a podiatry practice be concerned with affairs of the heart, you ask? Because the feet tend to be among the first to suffer ill effects from circulatory problems, that’s why.

The heart and lungs are the center of your circulatory system—the hub from which oxygen and a bunch of other stuff your cells need for optimal health and function get distributed throughout the body. Your feet are on the outskirts of these routes, so it’s already a bit more of a challenge for your arteries to get blood there, and even more of a challenge for your veins to bring things back!

So when a condition such as peripheral arterial disease (PAD) starts to constrict and narrow blood vessels, the feet and lower limbs tend to feel that strain first.

PAD is not a sudden condition, either. It is something that can silently build for decades, then jump out overnight to bite you. When signs start to show, it’s time to take action.

Also, if PAD is in the picture, that also means other circulatory conditions, such as coronary artery disease (CAD) may be, too. Identifying and addressing these problems are paramount to maintaining better overall health.

What Should a Caregiver Be Looking For?

There are certain signs of PAD—or poor circulation in general—that can help indicate the need to discuss the matter with us, or with a cardiologist.

One particularly bright warning sign is claudication. This term refers to pain and cramping that can happen during activity, then tends to subside with rest. Most people feel it in their calf muscles, and usually only one side at first.

Claudication is a likely sign of constriction or blockage. However, not everyone moves enough for claudication to arise as a symptom, even if they have the type of impeded circulation that would typically cause it. You will want to be aware of other potential symptoms if your loved one is not very active.

Remember that the feet tend to see effects of circulatory problems first, so many of these signs center in that area. Look for:

  • An absence of hair on the feet
  • Very slow growth in toenails (e.g. having 2-3 months between trimming instead of 2-3 weeks)
  • Thinning, almost translucent skin
  • Weakness
  • A family history of PAD, CAD, or other circulatory conditions

Additionally, if your loved one is over the age of 50 and has been diagnosed with diabetes, the American Diabetes Association recommends they receive periodic circulation testing regardless of whether they show any symptoms or signs.

The effects of diabetes on both circulation and nerve health can lead to very dire circumstances—especially when it comes to wounds and injuries to the feet. A diabetic person with an open foot wound has a mortality risk higher than someone who has colon cancer, breast cancer, or prostate cancer. Both circulatory and foot health must be matters you stay one step ahead of!

And, as we noted earlier, we take these matters seriously. We have the means to test circulation right in our Indianapolis office.

How We Test Vascular Health

We employ both basic and advanced methods for testing vascular supply (i.e. how much blood certain areas of your body are receiving).

We can often reasonably determine vascular supply through a physical exam, gently squeezing the skin in certain areas and seeing its reaction.

However, there are situations where we may need more direct determinations, or someone’s vascular supply is more difficult to detect. That is where our SmartABI system comes in.

ABI stands for “ankle-brachial index.” It is a quick test where we compare the blood pressure at your ankle to the blood pressure at your arm. Through the miracle of modern technology, we get to do this with cool, Bluetooth-connected cuffs!

The lower your leg pressure is compared to your arms, the more of a problem there may be. We may recommend seeing a vascular surgeon or cardiologist in certain situations.

These tests measure arterial supply (blood heading out from the heart) and not venous supply (blood going back to the heart). Venous problems tend to be different from the dangers of PAD and CAD, and should be treated differently. You are much more likely to find swelling as a symptom of a venous problem, for example.

If circulation is a concern, we may recommend ABI testing every 6 months or so. The test is so quick, easy, and important that we do not charge for this service.

Addressing Vascular Concerns (and Just Talking with Your Loved One About It)

As noted above, there are some cases where we will refer you to a vascular expert or cardiologist for further treatment. It’s very important to do so if a condition has reached a certain point.

Otherwise, we may recommend certain changes and behaviors to help increase circulation and maintain better health.

Even if moving may cause some cramping, it is still important to keep moving within your abilities. In many cases, the body can navigate around narrowed and blocked areas by creating new vessels—but you need to be active for this to happen. This can mean gently pushing yourself to the point of claudication and then resting, if safe.

Of course, not everyone may be able to do this. We may need to consider changes in footwear, activity, medication—anything within reason to help circulation. And if these would not be effective, then vascular surgery may be necessary.

However, none of these steps can be taken if the problem remains undetected. And for this, we know you can only do so much with a parent or other loved one who may want to dismiss the concept of there being a problem. Try to make your argument as gently and explicitly as you can, but ultimately the choices for care may remain with them.

If you do suspect potential circulatory problems are affecting your loved one’s feet, please do not hesitate to give us a call or send us questions. You may reach our Indianapolis office at (317) 545-0505 or fill out our online contact form.


9505 E. 59th St., Suite A
Indianapolis, IN 46216

Phone Number

(317) 545-0505

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