Last week we had a patient return to our Brantford Podiatry office earlier than his usual 3 monthly routine care.
His concern was the rapid development of a painful lesion on the plantar surface of his right foot. It had become so painful in the last two weeks that he was forced to walk on the inside border of his foot. In the 48hrs prior, he had noticed some fluid staining his sock in the area of the pain. In response to this, he called the office to seek advice.
Upon examination, there was a very clearly defined, thickened, localized area of callous. There was evidence of fluid escaping from a cavity under the callous.
The patient reported no trauma, change in activity,! change in footwear or systemic health. Clearly a mechanical origin for such a localized rapidly forming lesion was the prime suspect. A quick look in his shoe revealed an interesting discovery.
Upon further discussion, he reported a kind lady friend had bought him the insoles to massage his feet and improve circulation! It was believed that this insole delivered a kind of reflexology therapy and upon a quick search, there are many variations available some hard, others soft and some with magnets incorporated.
Reflexology is a form of therapy widely practiced with roots in Chinese medicine. It is believed different body parts correspond with different pressure points on the body. Reflexologists use maps of these points in the feet, hands, and ears to determine where they should apply pressure. Many people report great benefits from this form of therapy others not. Should you wish to find out more specific information about reflexology click here.
Conclusion
Clearly there are a couple of lessons to take from this case.
Firstly, regardless of where you “stand” with regards to reflexology, one size cannot fit all and this delivery is at best a shotgun approach to what is proposed to be a very specific therapy.
Secondly, applying considerable localized pressure to the sole of the foot, regardless of where it is delivered, will eventually have a detrimental effect on the local tissue. Combine that pressure with a bony prominence and less-than-perfect circulation, and we have a likely potential for tissue breakdown, rapid infection and cellulitis.
Fortunately, Marilyn was able to get this debrided, the wound offloaded, the infection resolved rapidly, and the insoles dispatched to the garbage
We always encourage patients to be active in their care and self-maintenance where possible. When ever there is an alternative therapy or medicament that has been recommended we invite them to reach out to us. A moment of advice or consultation can avoid weeks of pain and immobilization.
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