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Thread: How to avoid deep tissue injury at heels

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  1. #1

    How to avoid deep tissue injury at heels

    Warm hello to all of you! I?m C4 C5 quadriplegic from last 14 years. I?m a full-time teacher and use my motorised wheelchair to travel. Last year, I bought Permobil F5VS for mobility convenience and other comfort. But It is the 2nd time in one year I have got deep heel tissue injury. It was not due to lying in bed rather either by sitting or standing. It has taken 4 months to recover, but still the skin of the heels is pretty soft. Due to all this I have totally stopped standing? And even sitting properly has become a challenge. From next month I have to start to go to my job. Past and present photos are attached. Please suggest what I could do to get back to proper sitting and standing. Will Podus Boot with Ambulation Sole help? Please suggest! With love and regards

    Attached Images Attached Images   

  2. #2
    A correction… The 2nd image is the prior condition and the 1st image is proven condition.

  3. #3
    I would get a PT consult and see if they can do anything with your sitting posture. They might be able to help you figure out what is causing this.

    My questions to you are:
    1. what type of shoes are you wearing?
    2. Do you have heal guards on your foot plates?
    3. Are your feet swelling and staying swollen after getting out of your chair?

    The SCI-Nurses are advanced practice nurses specializing in SCI/D care. They are available to answer questions, provide education, and make suggestions which you should always discuss with your physician/primary health care provider before implementing. Medical diagnosis is not provided, nor do the SCI-Nurses provide nursing or medical care through their responses on the CareCure forums.

  4. #4
    Thanks a lot for your reply!

    I am using flat shoes with good quality Silicon heel cup. I do not get any swelling there is only redness in the heels region After getting shifted in bed. My main concern is that after 2 and half weeks I have to start my job. Is there any way I can keep sitting yet provide rest to heels. Your Inputs are always valuable. Thanks a lot

  5. #5
    Please let me know if the Following heel boot would be of any help In sitting for a few hours while have to go out. At least for a few months till I get proper strong skin at heels. Any experience! Any precautions while using them.You'll find the image on following link.

    Thanks and regards
    Last edited by Sam Dubai; 09-11-2019 at 05:27 AM.

  6. #6
    Senior Member julran's Avatar
    Join Date
    Mar 2002
    Gresham, OR
    Is that the back or your heel or the bottom of your foot in the heel area?

    I ask as I?ve had issues in both locations at different times... the one on the bottom of my foot in heel area turned out to be that my foot plate was too high for that foot so I was basically forcing my heel down onto the footplate all day. We lowered the footplate and added rubber to it to adjust for the height difference needed for feet and what chair allowed. Had never had problems with this on any prior chair in the 14 years prior to my current chair and haven?t had any problems in the years since we added the rubber.

    I do have to be careful if I wear thicker souled shoes than I typically wear as that can end up creating the same issue.

    If I wear shoes without backs on the heels I can develop sores on the back of my heel from my heels hitting the bolt area that holds the footplate on... fortunately this can be avoided by me just paying attention to the positioning of my feet or just putting a little padding on the bolt area on the days I want to wear shoes like that.
    Last edited by julran; 09-10-2019 at 11:42 AM.
    This too shall pass...

  7. #7
    Thanks dear for your reply!
    No it is not at the back. It is at the bottom of off my feet in the heel area.
    It might be because of the reason you have mentioned because I never had it when I was using my previous motorized wheelchair. do you also use permobil wheelchair?
    I checked that and also try to use look for the thickness of the sole. Any other suggestion…

  8. #8
    Senior Member julran's Avatar
    Join Date
    Mar 2002
    Gresham, OR
    I’m so sorry for your troubles... fortunately I discovered mine early. I check the skin on my feet & heels everyday when I check the backs of my legs and butt.

    I don’t use a permobil but it my motorized chair does have a very similar footplate setup as the permobil.

    I don’t know if that boot would help or make it worse, it would depend on the thickness of its sole compared to the thickness of your shoe’s sole.

    My only suggestion would be to find a handy friend that could crawl around under your chair while you’re out of it and drop the footplate down one notch... then you could add your own padding under your foot without increasing the pressure on it.

    oh, do you basically sit in one spot at work, as in not have to drive your chair around too much? I remember one time while I was working I had to have one foot up more to take pressure off of it (different chair, different issue) and so once I would get to work & was at my desk I would lift that foot and prop a pillow behind the calf area so that the foot basically had no pressure on it. I just had to pull the pillow out when I left my desk to go somewhere else in the office. Maybe that would work for you??
    This too shall pass...

  9. #9
    I have completely got your 1st suggestion and I will definitely try it as long as I will start sitting by keeping my legs on Footplate. It is quite easy to do as I can adjust the length of the leg rest from my joystick.
    By the way, I'm using your 2nd suggestion presently, as I'm on leave and maybe at home for next couple of weeks.
    Thanks a lot, it was quite useful. Take care

  10. #10
    Senior Member julran's Avatar
    Join Date
    Mar 2002
    Gresham, OR
    You are welcome. Hope it helps. ��
    This too shall pass...

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