(517) 487-5171
Fax (517) 908-0172
March 2026
Risk Factors for Falls

Falls are a leading cause of serious injury, especially among older adults, and many risk factors are linked to foot and ankle health. Weak foot muscles and reduced ankle flexibility affect balance. Certain health problems, such as nerve damage that reduces sensation in the feet, may prevent people from feeling the ground properly. Arthritis can cause joint stiffness and pain that limits movement and coordination. Foot deformities, like bunions or hammertoes, may change weight distribution and increase instability. Vision problems, certain medications, and chronic medical conditions can also affect balance and reaction time. In addition, hazardous work environments, substance use, and physical inactivity may raise the likelihood of falling. A podiatrist can evaluate foot structure, joint motion, and gait, which is the pattern of walking, to identify problems that increase fall risk. Treatment may include medical care, exercises, bracing, or custom orthotics aimed at improving stability. If you are at risk for falling, it is suggested that you make an appointment with a podiatrist for an exam, diagnosis, and treatment.
Preventing falls among the elderly is very important. If you are older and have fallen or fear that you are prone to falling, consult with Dr. Gary Cesar from Michigan Foot and Ankle Center. Our doctor will assess your condition and provide you with quality advice and care.
Every 11 seconds, an elderly American is being treated in an emergency room for a fall related injury. Falls are the leading cause of head and hip injuries for those 65 and older. Due to decreases in strength, balance, senses, and lack of awareness, elderly persons are very susceptible to falling. Thankfully, there are a number of things older persons can do to prevent falls.
How to Prevent Falls
Some effective methods that older persons can do to prevent falls include:
- Enrolling in strength and balance exercise program to increase balance and strength
- Periodically having your sight and hearing checked
- Discuss any medications you have with a doctor to see if it increases the risk of falling
- Clearing the house of falling hazards and installing devices like grab bars and railings
- Utilizing a walker or cane
- Wearing shoes that provide good support and cushioning
- Talking to family members about falling and increasing awareness
Falling can be a traumatic and embarrassing experience for elderly persons; this can make them less willing to leave the house, and less willing to talk to someone about their fears of falling. Doing such things, however, will increase the likelihood of tripping or losing one’s balance. Knowing the causes of falling and how to prevent them is the best way to mitigate the risk of serious injury.
If you have any questions, please feel free to contact our offices located in Lansing and Mt. Pleasant, MI . We offer the newest diagnostic and treatment technologies for all your foot care needs.
Falls Prevention
Elderly Americans are very susceptible to falls as they get older. Everyone experiences decreases in flexibility, balance, strength, and the senses as they age. This correlates to some eye-opening statistics. 1 in 4 Americans aged 65 and older fall each year. An elderly American is being treated for a fall in an emergency room every 11 seconds. In light of these striking statistics, one can see the importance of taking steps to prevent falls.
Finding an exercise program for the elderly is an excellent way to reduce the likelihood of falls. Look for an exercise program that improves strength and balance. Elderly people who live a more sedentary lifestyle, with little physical activity, are at an increased risk of falling. Wearing well-fitted footwear that provides good foot support and cushion will help prevent falls from poorly fitted shoes. Talking to a podiatrist about your susceptibility to falls and about inspecting your prescriptions will help to avoid any medication that could make falls more likely. Due to a decline in the senses among the elderly, having your eyes and hearing checked is recommended.
Around half of all falls occur in the household. Removing tripping hazards in the home and making it more accommodating to older persons can significantly reduce falls. Some notable household changes include increasing lighting around the house, installing grab bars in the shower and bathroom, and making sure the floor is clear of clutter. Other smart options include installing a shower chair, using rubber-bottomed rugs, and placing railings on both sides of stairwells.
Finally, discuss with a doctor and your family about your fear of falling. This will help to increase awareness among the population on the need for fall prevention. A lack of awareness on the matter, and a downplaying of importance are what increase the risks of falling. Following these tips can help to reduce the risk for yourself and your loved ones.
Reminder: When Was the Last Time...?
Diabetic Foot Ulcers and Podiatric Care

A diabetic foot ulcer is an open sore or wound that develops on the foot as a serious complication of diabetes-related nerve damage and poor circulation. Reduced sensation in the feet may prevent a person from noticing small injuries, which can gradually develop into ulcers if untreated. Symptoms include redness, drainage, swelling, and slow-healing skin breakdown. Risk factors involve long-term diabetes, nerve-related changes, reduced blood flow, wearing poorly-fitted footwear, and inadequate foot care. Proper care includes daily foot inspections, maintaining clean and dry skin, supportive footwear, and seeking early medical attention for any skin changes. A podiatrist can evaluate circulation, treat wounds, and guide preventive care. If you have diabetes and if foot wounds or skin changes appear, it is suggested that you are under the care of a podiatrist who can help you to manage this serious condition.
Wound care is an important part in dealing with diabetes. If you have diabetes and a foot wound or would like more information about wound care for diabetics, consult with Dr. Gary Cesar from Michigan Foot and Ankle Center. Our doctor will assess your condition and provide you with quality foot and ankle treatment.
What Is Wound Care?
Wound care is the practice of taking proper care of a wound. This can range from the smallest to the largest of wounds. While everyone can benefit from proper wound care, it is much more important for diabetics. Diabetics often suffer from poor blood circulation which causes wounds to heal much slower than they would in a non-diabetic.
What Is the Importance of Wound Care?
While it may not seem apparent with small ulcers on the foot, for diabetics, any size ulcer can become infected. Diabetics often also suffer from neuropathy, or nerve loss. This means they might not even feel when they have an ulcer on their foot. If the wound becomes severely infected, amputation may be necessary. Therefore, it is of the upmost importance to properly care for any and all foot wounds.
How to Care for Wounds
The best way to care for foot wounds is to prevent them. For diabetics, this means daily inspections of the feet for any signs of abnormalities or ulcers. It is also recommended to see a podiatrist several times a year for a foot inspection. If you do have an ulcer, run the wound under water to clear dirt from the wound; then apply antibiotic ointment to the wound and cover with a bandage. Bandages should be changed daily and keeping pressure off the wound is smart. It is advised to see a podiatrist, who can keep an eye on it.
If you have any questions please contact our offices located in Lansing and Mt. Pleasant, MI . We offer the newest diagnostic and treatment technologies for all your foot and ankle needs.
Wound Care
Diabetics must be wary of all wounds, regardless of depth or size. Diabetes, a chronic disease in which the body cannot properly use glucose the way it normally would, causes various complications that make wounds difficult to heal. Nerve damage or neuropathy will cause diabetics to have trouble feeling the pain of a blister or cut until the condition has significantly worsened or become infected. A diabetic’s weakened immune system can make even the most minor of wounds easily susceptible to infection. Diabetics are also more prone to developing narrow, clogged arteries, and are therefore more likely to develop wounds.
Wounds should be taken care of immediately after discovery, as even the smallest of wounds can become infected if enough bacteria build up within the wound. To remove dirt, wounds should be first rinsed under running water only. Soap, hydrogen peroxide, or iodine can irritate the injury and should be avoided. To prevent infection, apply antibiotic ointment to the wound and cover it with a bandage. The bandage should be changed daily. The skin around the wound may be cleaned with soap.
To prevent further exacerbation, see a doctor—especially if you have diabetes. Minor skin conditions can become larger problems if not properly inspected. As the wound heals, make sure to avoid applying pressure to the affected area.
How Nerve Damage Contributes to Serious Foot Complications in Diabetic Patients

Long-standing high blood sugar can injure the small nerves in the feet, leading to reduced feeling or complete numbness. This nerve-related damage makes it difficult to notice cuts, blisters, or pressure sores. Without normal sensation, minor injuries may worsen before they are discovered. At the same time, circulation problems can slow healing and increase infection risk. Diabetic foot syndrome refers to a combination of nerve loss, poor blood flow, and skin breakdown that can lead to deep wounds or even bone infection. Dry skin, callus build-up, and foot-shape changes may add further pressure to vulnerable areas. What begins as a small sore can quickly progress without proper care. Daily foot checks, blood-sugar control, and wearing well-fitting shoes are critical protective steps. Early medical attention reduces the risk of serious complications. If you have diabetes and notice numbness, tingling, color changes, or a slow-healing sore on your foot, it is suggested that you see a podiatrist for a proper diagnosis and appropriate treatment.
Neuropathy
Neuropathy can be a potentially serious condition, especially if it is left undiagnosed. If you have any concerns that you may be experiencing nerve loss in your feet, consult with Dr. Gary Cesar from Michigan Foot and Ankle Center. Our doctor will assess your condition and provide you with quality foot and ankle treatment for neuropathy.
What Is Neuropathy?
Neuropathy is a condition that leads to damage to the nerves in the body. Peripheral neuropathy, or neuropathy that affects your peripheral nervous system, usually occurs in the feet. Neuropathy can be triggered by a number of different causes. Such causes include diabetes, infections, cancers, disorders, and toxic substances.
Symptoms of Neuropathy Include:
- Numbness
- Sensation loss
- Prickling and tingling sensations
- Throbbing, freezing, burning pains
- Muscle weakness
Those with diabetes are at serious risk due to being unable to feel an ulcer on their feet. Diabetics usually also suffer from poor blood circulation. This can lead to the wound not healing, infections occurring, and the limb may have to be amputated.
Treatment
To treat neuropathy in the foot, podiatrists will first diagnose the cause of the neuropathy. Figuring out the underlying cause of the neuropathy will allow the podiatrist to prescribe the best treatment, whether it be caused by diabetes, toxic substance exposure, infection, etc. If the nerve has not died, then it’s possible that sensation may be able to return to the foot.
Pain medication may be issued for pain. Electrical nerve stimulation can be used to stimulate nerves. If the neuropathy is caused from pressure on the nerves, then surgery may be necessary.
If you have any questions, please feel free to contact our offices located in Lansing and Mt. Pleasant, MI . We offer the newest diagnostic and treatment technologies for all your foot care needs.
Neuropathy
Neuropathy is the weakness, numbness, and pain in the hands and feet due to damage to the peripheral nerves. The peripheral nerves are responsible for sending information from the brain and spinal cord to the rest of your body. Causes of Neuropathy include: traumatic injuries, infections, metabolic problems, exposure to toxins, and diabetes.
Diabetes is the most common cause, with more than half of the diabetic population developing some type of neuropathy. There are several types of neuropathy and they vary based on the damage of the nerves. Mononeuropathy is classified as only one nerve being damaged. When multiple nerves are affected, it is referred as polyneuropathy. One of the types of polyneuropathy is distal symmetric polyneuropathy. It is the most common for people with diabetes and starts when the nerves furthest away from the central nervous begin to malfunction. The symptoms begin with pain and numbness in the feet and then they travel up to the legs. A rarer form of polyneuropathy is acute symmetrical peripheral neuropathy, which is a severe type that affects nerves throughout the body and is highly associated with Guillain-Barre syndrome, an autoimmune disorder that attacks the peripheral nervous system and can be fatal. Although there are many types of neuropathy, most of them share the same symptoms such as pain, extreme sensitivity to touch, lack of coordination, muscle weakness, dizziness, and digestive problems. Since neuropathy affects the nerves, those affected should be careful of burns, infection and falling, as depleted sensations disguise such ailments.
The best way to prevent neuropathy is to manage any medical conditions such as diabetes, alcoholism, or rheumatoid arthritis. Creating and managing a healthy lifestyle can also go a long way. Having a healthy diet full of fruits, vegetables, whole grains and lean protein can keep the nerves healthy. These types of food have the nutrients to prevent neuropathy. Regularly exercising can help as well, but it is best to consult with a doctor about the right amount. In addition to diet and exercise, avoiding risk factors will also prevent neuropathy. This includes repetitive motions, cramped positions, exposure to toxic chemicals, smoking and overindulging on alcohol.
Blisters
Blisters are small pockets of fluid that occur on the top layers of the skin for several reasons. Friction, burns, and diseases are all known causes of blisters. Smaller blisters are known as vesicles, while larger blisters are referred to as bulla. The fluid inside the bubble can be blood, pus, or serum; which is a clear liquid that protects the skin. In most cases, blisters are not a major health issue, but they can be an indicator of a more serious condition.
Causes of blisters vary. Blisters are commonly caused by wearing poorly fitted shoes that rub against the foot. However, there are many other causes besides from friction; including burns, sunburn, insect bites, frostbite, poison ivy/oak, chemical exposure, impetigo, eczema, viral infections, and more.
Most blisters heal by themselves and do not require immediate medical care. If you have a blister, do not pop it since this may cause infection; it is advised to put a bandage over the blister to protect it. If the blister is large, causes pain, or if you have a fever, it is recommended that you see a doctor who can provide proper care. Blisters are easy to diagnose, and if considered prudent by the doctor, can easily be drained of fluid with a sterile needle as well.
To prevent blisters on the feet, wear shoes that fit properly and don’t cause rubbing. Socks can help prevent friction and it is recommended that you wear them if you are wearing shoes. Hand blisters can be avoided by wearing gloves during activities that cause friction against the hand. If you have a blister that pops, do not remove the dead skin, wash the area, apply antibiotic ointment, and cover with a bandage. It is okay in most cases to not seek immediate medical care for a blister if it was just caused by friction. However, if the blister causes pain or does not go away, it is suggested that you see a doctor for a diagnosis.
Blisters Can Become a Bigger Problem

Blisters on the feet develop when friction, heat, or moisture causes the upper layer of skin to separate and fill with fluid. They are common after long walks, wearing new shoes, or increased physical activity. Although they may seem minor, blisters can become painful and interfere with normal movement. The area often appears raised, clear, and tender to the touch. If the blister breaks, the exposed skin underneath can feel raw and sensitive. In some cases, redness, warmth, or drainage may signal infection. People with diabetes or circulation concerns should be especially cautious, as even small skin injuries can lead to complications. A podiatrist can evaluate the blister to determine whether it should be drained safely, protected with proper dressing, or treated for infection. Treatment may also include guidance on footwear, moisture control, and targeted exercises to reduce friction and pressure. If you have painful or persistent blisters on the feet, it is suggested that you make an appointment with a podiatrist for proper evaluation and care.
Blisters may appear as a single bubble or in a cluster. They can cause a lot of pain and may be filled with pus, blood, or watery serum. If your feet are hurting, contact Dr. Gary Cesar of Michigan Foot and Ankle Center. Our doctor can provide the care you need to keep you pain-free and on your feet.
Foot Blisters
Foot blisters are often the result of friction. This happens due to the constant rubbing from shoes, which can lead to pain.
What Are Foot Blisters?
A foot blister is a small fluid-filled pocket that forms on the upper-most layer of the skin. Blisters are filled with clear fluid and can lead to blood drainage or pus if the area becomes infected.
Symptoms
(Blister symptoms may vary depending on what is causing them)
- Bubble of skin filled with fluid
- Redness
- Moderate to severe pain
- Itching
Prevention & Treatment
In order to prevent blisters, you should be sure to wear comfortable shoes with socks that cushion your feet and absorb sweat. Breaking a blister open may increase your chances of developing an infection. However, if your blister breaks, you should wash the area with soap and water immediately and then apply a bandage to the affected area. If your blisters cause severe pain it is important that you call your podiatrist right away.
If you have any questions, please feel free to contact our offices located in Lansing and Mt. Pleasant, MI . We offer the newest diagnostic and treatment technologies for all your foot care needs.
Congenital Foot Problems
A congenital foot problem is a problem affecting the feet, toes, and/or ankle that a child is born with. Several issues with a child’s feet can occur congenitally. Such problems include clubfoot, vertical talus, tarsal coalition, polydactyly, macrodactyly, and cleft foot. Some of these problems have a genetic basis, with someone in their family history having a gene causing the condition, and some are simply an anomaly.
The following are specifics about a few of these conditions:
- Clubfoot, also called congenital talipes equinovarus or talipes equinovarus, is When the tendons of the foot shorten, the bones are of an unusual shape, and the Achilles tendon is tight, causing an inward and downward pointing of the foot. The soles of the feet might also face each other. In most cases of clubfoot, both feet are affected. If not treated, the affected child will walk on the sides of their feet or ankles.
- Polydactyly is a condition where the child has more than five fingers or toes on either or both feet. Presentation usually consists of a nubbin or small lump of tissue without a bone, a toe that is partially formed but has no joints, or an extra toe.
- Vertical talus is where the talus bone forms in the wrong position, other bones in the foot do not line up properly, the front of the foot points up, and the bottom of the foot is stiff, has no arch, and usually curves out. This can occur in one or both feet and if left untreated, can lead to serious disability or discomfort as the child grows.
- Tarsal coalition is when there is an abnormal connection of two or more bones in the foot leading to severe, rigid flatfoot. The tarsal bones, located toward the back of the foot and in the heel, are the ones affected. This condition is often present at birth, but signs of the disorder usually come on in early adolescence.
- Cleft foot is a rare condition where the foot has missing toes, a V-shaped cleft, and other anatomical differences. Surgery can often help improve the foot’s function since the heel remains normal and is what is most needed for walking. The main issues with this affliction are whether the affected foot can fit into a shoe and the shape and appearance of the foot.
- Macrodactyly is when the toes are abnormally large due to overgrowth of the underlying bone or soft tissue. Having this condition makes it harder for the child to use the affected foot for certain activities.








