Question

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-----Question-----
I have an employee who has been on a course wearing boots (normal day to day wear) which was quite vigorous.  He has a soft tissue injury at the back of his left heel.  He has been given red sorpothane insoles which seem to exacerbate the problem.  Can you give me any tips on his foot care?  He is expected to wear boots when on duty and is reluctant to wear training shoes in uniform.  Any advice welcome.

Rgds
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Louis,

When you say soft tissue injury, do you mean an open wound or pain at the back or beneath the heel?  Can you give me more details?

Marc Katz

Attn Marc Katz,

Hello again.  It's a soft tissue injury (I'd say bruising) caused by pounding the ground whilst wearing boots.  Most of us have experienced this injury at one time or another and don't know how best to help him.  He's limping and transfering the weight to the other foot which doesn't help the healing process.  He's had an x-ray to check for "march" fractures and there are none present.  The pain is inside rear of heel (pity I can't draw you a picture) where the curve is in the heel of a sock and takes up about 1 third of his heel.  No bruising visible but he's clearly in pain (and moaning about it).  Hope this helps.

Rgds

Louis

Answer
Louis,

The pain sounds like plantar fasciitis, inflammation of the fibrous band on the bottom of the foot.  Most pain is usually in the morning and after sitting or at the end of the day. This pain is usually on the large toe side of the foot.

Treatments are included in the attached article.

Let me know if this sounds similar to what he has.  An orthotic device would be the best long-term help.  Keep in touch.

http://ezinearticles.com/?Understanding-Heel-Pain-and-Treatment-Options&id=27028


Sincerely,

Marc Katz, DPM
Tampa, FL
Advanced Podiatry
http://www.thetampapodiatrist.com
http://www.tampacryosurgery.com