Workplace Foot Injuries

“I was sad because I had no shoes, until I met a man who had no feet… so I took his shoes.” Or so the joke goes, except of course that foot protection and workplace foot injuries are no laughing matter.

When we think about foot protection we generally think about protection from a traumatic injury – something falling on our foot and breaking bones, severing toes, or cutting our feet – but foot protection can offer a much wider defence against a wide array of injuries.

Years ago I worked in a factory assembling seats for automobiles. Despite the company actually paying for safety boots and shoes, only a fraction of us took advantage of the offer. I did because I am a cheap, cheap man and the boots were expensive. When I got my new boots many of my peers advised me against wearing them, with specious reasoning and unfounded worry. Some told me that the steel toe of the boot would actually do more harm than good. Another helpful co-worker pointed out that if my foot was run over by a forklift truck my toes would be cut off. Numerous other co-workers gave me similarly bad advice, failing to see their own extraordinarily flawed logic. After all, losing toes would I imagine be the least of your worries after having a wrestle with a forklift truck.

As it goes, I found the steel-toed boots not only provided protection, but – having dropped a part (and a sharp one at that!) while installing – it saved me the pain of 7kg smashing directly into my foot. That incident could not only have easily injured my foot or toes; it was also a far more likely occurrence than a forklift truck careening through my work area and running over my foot – as had been the sole concern of my somewhat misinformed colleagues.

Additionally, I chose boots that extended to well above my ankle (think combat boot style) which provided me protection against twisting my ankle when I stepped in the many holes in the wood block floor of the ancient factory in which I worked. It wasn’t the primary purpose of the boot, but I appreciated the protection all the same. It’s worth noting that the boot didn’t provide complete protection, it still was incredibly painful to wrench my ankle in the hole made by a missing wood block, but it might have meant the difference between a sore ankle and a sprained or broken ankle, so for me at least, they were worth wearing.

Highs and lows

Some people criticise steel toecap shoes as getting hot in the summer and getting (and staying) dangerously cold in the winter. My work now takes me all over the world from frigid oil fields to the blistering hot temperatures of a steel mill, so I chose composite-toed shoes instead of steel-toed. In addition to being poor conductors of heat and cold they are also poor conductors of electricity, so while they aren’t likely to offer much protection if my foot gets struck by lightning or an arc flash, the composite does provide some modicum of protection against electricity. In addition to steel or composite toes, you should select a boot – with boots being preferable to shoes based on the added protection from their sheer height – with a steel or composite insole to protect you from puncture wounds that occur when you step on nails, broken glass, or any other sharp object on which you might tread.

Many people reading this will be thinking, “I don’t work in construction or a factory, why do I need protective footwear? Foot protection isn’t just for preventing foot trauma. If, for example, you routinely work around electricity, you should wear nonconducting shoes, with no metal or nails. Of course, it may not be obvious by looking at the shoe, so you should always enjoin the advice of a shoe professional; if not the manufacturer then a qualified and knowledgeable salesperson who specialises in safety shoes.

While one cannot rely on protective footwear for everything, in most cases where they are required they will provide good protection against injury from the hazards that you will typically face in your work environment. Your employer’s safety department is the best source of the specific footwear to protect your feet in your work environment, but just in case, here are some things to consider.

Another element of in foot protection is protection from dangerous chemicals. Chemicals can burn your feet, and your exposed skin can then act as a portal to your bloodstream. Neoprene or rubber boots can protect against many chemical hazards (again check with your Safety Department and/or the Safety Data Sheet (SDS) to see the appropriate material to protect against a specific chemical; here is a case where one material will not necessarily protect you against all chemicals and some chemicals can chew through certain materials like a hot knife through butter.

Even the most basic leather foot protection can provide protection against most thermal burns, and in cases where the heat source or duration of exposure is extreme one is still better off wearing boots than not wearing them. If you step in molten metal you’re going to injure your foot, so do your best to avoid stepping in molten metal. If you spill scalding water or hot grease on your feet a high-quality leather boot will offer some protection; it may not spare you from injury but it could mean the difference between a first and a third degree burn.

Despite all of the many ways in which you can injure your feet, many of the most frequent foot injuries are caused by poor fitting boots or shoes. So while getting the right type of shoe is important, so is getting shoes that are in good condition.

The most common injuries

According to Industrial Safety and Hygiene News (ISHN), the most common foot injuries are: plantar fasciitis, stress fractures, ankle sprains, bunions, turf toe, Achilles tendinitis, and heel spurs.

Plantar fasciitis

Plantar fasciitis is a painful condition caused by failing to warm up and stretch your feet and lower leg muscles before prolonged standing, walking or performing any repetitive task that puts excessive pressure on your heel. It is characterised by a stabbing pain in your heel at the beginning of the day, which gradually subsides as the day proceeds. If you don’t address this condition it can lead to chronic pain in your calves and hamstrings. If you suffer from plantar fasciitis apply ice to your heal for about 10 minutes a day and remember to stretch your lower legs daily – especially before work.

Stress fractures

Fractures are most commonly synonymous with a broken bone, but this is not the case with stress fractures. Stress fractures are tiny cracks in the bone that cause the area to hurt. Stress fractures are typically not caused by the kind of trauma from which safety shoes or boots will protect your feet. In the workplace this type of injury tends to afflict employees whose work requires them to walk or stand on a hard surface for most of their shift. Stress fractures can also occur when you make a sudden change from low intensity movement to high-intensity movement; just think of hospital workers who walk on hard surfaces only to be summoned into action to address an emergency. Many people who suffer from stress fractures are shocked at how easy it was to become injured in this way. The best way to treat a stress fracture is to stay off the affected foot and rest until the fracture heals itself. Stress fractures rarely require a cast, but a medical boot may be necessary.

For the most part, stress fractures heal on their own with rest. In some cases, wearing a medical boot may be necessary to avoid putting weight on the affected foot.

Ankle sprains Spraining your ankle is caused when the foot and the ankle move in opposite directions, with actions typically described as twisting, rolling, or wrenching. This movement causes damage to the ligaments which, while generally not serious, can cause immense, intense pain; roughly equivalent to having nasal hairs forcefully plucked. Ankle sprains can be caused by everything from walking on an uneven pavement to suddenly changing directions. In general you will want to seek medical attention to ensure you haven’t broken your ankle, but if it is just a “bad sprain” then elevating the ankle, applying ice to reduce the swelling, an ice bandage and of course resting the ankle are the best remedies.

“frequent foot injuries are caused by poor fitting boots or shoes”

Bunions

One common foot injury that is caused almost exclusively by poorly fitting footwear is a bunion. A bunion is a large bump on the side of the foot that is caused by wearing ill-fitting footwear. They’re typically red and make your foot look deformed. Avoid by buying and wearing the right shoes. Bargain basement boots will get you bunions, as will wearing the wrong size for years – like I did – and I myself am currently sporting bunions on both feet.

Bunions can be painful, and applying ice can help soothe the pain, but frankly, they don’t hurt that much. Consider using the pain to remind you to reflect on the much greater suffering in the world.

Achilles tendinitis

It’s the legendary Greek hero, Achilles, who gives us the name of the connective tissue between the leg muscles and our heel. Achilles tendinitis occurs when this tendon becomes inflamed, which causes an ache in this area. It is typically caused by tight calf muscles which, in turn, might be caused by plantar fasciitis, which can be caused by failing to stretch before working. Seriously, a couple of moments of stretching can help you to avoid a lot of pain, although I had an inflamed Achilles tendon years ago and it didn’t hurt that bad. As with many minor foot injuries ice and rest can usually be ample treatment.

Turf toe

While certainly not the most serious foot injury, ‘turf toe’ is far and away the coolest named injury. Turf toe is basically the sprained ankle of the toe world. There’s not much that can be done to speed its recovery and it will heal itself.

Heel spurs

While the name of this injury might sound vaguely equestrian, it has nothing to do with horses. Bone spurs are bumps on bones that occur because of arthritis or tendonitis, but the most common cause of heel spurs are tight ligaments associated with prolonged walking while working and are more common in people with flat feet. As heel spurs press up against tissue or other bones they cause pain while walking. Once again, pre-shift stretching –particularly calf stretches – will help to prevent heel spurs, but once you get a heel spur you may require surgery to have it removed.

Footwear requirements

So, what should you look for in foot protection?

Buy your boots from a reputable safety footwear outlets. Recently, discount stores have started selling foot protection both in stores and online at a fraction of the cost of reputable footwear outlets. It’s tempting to purchase safety boots for 50% or more less than you would pay for top quality foot protection. I have even heard people say that at that price they could throw them out in a couple of months and buy a new pair while still saving money. That’s a nice thought, but these bargain shoes don’t provide anywhere near the protection of their more expensive counterparts, and you put yourself at risk buying cheap knock offs. My feet are worth more to me than a quick, short term saving.

Next on the list is to look for shoes that fit properly. Don’t just walk up to the rack and pick out shoes you like the look of. Talk to the salesperson and get your feet measured. I spent most of my adult life telling shoe sales people my size and they went out and fetched them; I tried them on and if they felt okay I bought them. Last year I decided to get a pair of regular work boots and went to a nearby army surplus store that also sold work gear. I have feet like an elephant – short, flat, and wide – the sales woman measured my feet and unlike any salesperson in the past she measured not only the length and width but the height. My foot is high and so she recommended I go up a size. The results were a boot that fit better than any I have ever worn and wears like iron. I went through life wearing shoes that were ill fitting and painful simply because I failed to have my feet professionally and competently measured. In addition to that, footwear sizing can vary from manufacturer to manufacturer and even from style to style, so don’t rush through the sale; give yourself time to buy the right shoes.

When purchasing footwear, consider the following.

Most quality foot protection will have low heels and skid-resistant soles to prevent slips and falls, while also offering good traction.

Look for shoes that have good fastening mechanisms. Your boots should fasten completely and snugly, but should not be so tight that they impede circulation or cause discomfort at the end of a long shift.

Don’t buy shoes that are made to look like athletic apparel or trainers. Shoes disguised as trainers tend to be popular among younger workers, but what’s the point besides looking like you are out of compliance? Many organisations already ban such shoes, despite the protestations and whining of the workers wearing them. Despite manufacturers’ claims otherwise, this style of shoe often trades protection for style. If you feel strongly about wearing them I would urge you to grow up and stop endangering other workers by wearing these shoes. How, you may ask, are you endangering other workers? By making it nearly impossible for people to distinguish between actual trainers and safety trainers. One safety professional who I know well claims that for every worker wearing legitimate safety shoes made to look like trainers, there are three workers wearing actual trainers that provide no protection at all.

In addition to footwear there is more you can do to protect yourself:

• Walk smart –Take shorter strides to keep your centre of gravity low – the higher your centre of gravity the more likely you are to take a spill
• Slow your roll – Slowing down the pace at which you are walking increased your chances of detecting and avoiding hazardous surfaces
• Keep your work area clear of debris and hazards – You may know your area very well and be aware of the hazards within, but that isn’t always the case for other workers who may enter your workplace
• Test the walking surface to ascertain whether or not it can sustain your weight before committing your whole weight to it, especially if you are at heights. The worst way to discover that a surface on which you are walking has insufficient capacity to hold your weight is by falling to your death
• Practice walking in new work boots, especially walking up or down stairs. Many employees fall on staircases simply because they catch the toe of their boots on the lip of a stair or catch the heel of their boot on a riser. I have even caught the heel of my boot in a poorly grated stair. It sounds stupid, but the walking characteristics of work boots can be very different than the shoes we wear every day
• Care for your boots after every use. Cleaning and shining your boots every day may seem simple, but each time you clean and shine your boots you are by nature of the activity inspecting the boots for wear or damage. And don’t forget to remove any dirt or debris from the treads of your boots – even the best treads are nullified by mud caked between them
• Change your footwear when you leave or return to a job site. Driving in work boots can be significantly more difficult than in everyday footwear. You don’t wear your hard hat and safety classes while you drive, so why are work boots any different?
• Know where and on what you are walking, e.g. sometimes people will throw a board over a puddle or a muddy walkway as a makeshift bridge, and it’s important to visually inspect the surface before traversing it; if it feels as if it will collapse do not continue

In closing

To sum up, buy high-quality, professionally-fitted boots and replace them when they become thread-poor, worn, or damaged, and remember to stretch your feet, and legs before each shift and when returning from break.