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Aug 19

Written by: Larry Huppin, DPM
8/19/2013 6:53 AM

 I had a patient in my office today with complaint of posterior heel pain, right, when wearing several different pairs of his dress shoes. He had a fairly large retrocalcaneal exostosis on the right calcaneus at the proximal aspect of the posterior calcaneus.

There are obviously a number of ways to address the retrocalcaneal exostosis. Our primary goals are to reduce pressure and reduce friction. Reducing pressure in this area is always a little tough without changing shoes. Although you can attempt to stretch shoes in this area, it is usually not particularly effective.

Friction can be controlled in a couple of different ways. Orthotic devices can be helpful for limiting calcaneal motion. This patient was already wearing orthotic devices that are very controlling so we have already eliminated any excessive motion that might be contributing to his symptoms.

We can also reduce friction locally with the use of the PTFE Patch. I did apply a large oval PTFE Patch to the back of the shoe. You can see a picture of it below. I then had the patient wear the shoe and walk up and down the hall. He reported essentially a 100% relief of his pain simply by applying the patch.

This is a good example of how to use friction management to help treat posterior heel pain.  

He has not been having any posterior heel pain in his athletic shoes, so we do not need to address those right now. He was having some pain in his bicycle shoes, so we will have him bring those in on the next visit and apply a PTFE patch to those also.

You can learn more about the PTFE Patch and friction management at

 ProLab takes a scientific approach with our orthoses by integrating evidence-based medicine into orthotic therapy. Our team of Medical Consultants regularly evaluates the medical literature pertaining to orthotic therapy and biomechanics. ProLab clients are encouraged to contact a medical consultant whenever they have questions about an orthotic prescription.

For an easy way to stay up-to-date on evidence-based orthotic therapy, subscribe to our free E-Journal. Your will receive a monthly email synopsis of the research that impacts your practice.   


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