Why did “heel spurs” exempt people from military service?

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The New York Times released an article (https://www.nytimes.com/2018/12/26/us/politics/trump-vietnam-draft-exemption.html) that claims President Trump was given the diagnosis of “heel spurs” so he would be exempt from military service. Putting aside the ethical, moral and political components of this story; one might wonder why heel spurs would disqualify someone from service.

A heel spur is actually an abnormal outgrowth of bone of the calcaneus (heel bone). They may occur on just one foot or both. The tissue on the bottom of the foot called the plantar fascia attaches to the bottom of the heel bone and when stressed, can produce a spur of the bone due to the traction that is occurred with the stress of the fascia attachment. It is the plantar fascia that actually causes the pain.

Heel pain is VERY common. One estimate is that there are 5 million Americans that have heel pain at a given time. Approximately 35-40% of patients at Family Podiatry Center present with the complaint of heel pain.

Plantar fasciitis developed as a diagnosis to more accurately define the source of the pain over time and it takes on definite course with consistent symptoms of pain in the morning and after periods of rest. More recently, some podiatric physicians that specialize in heel pain recognize that there are two forms of plantar fasciitis including a chronic version called plantar fasciosis. “The plantar fascia is much easier to treat before it becomes chronic”, Reid explains, “and it’s important to seek treatment from a qualified podiatrist once the pain cycle changes.” Chronic plantar fascial damage will not respond to the traditional treatments and may require regenerative medical treatments.

Family Podiatry Center is a leader in regenerative treatments for chronic pain for the plantar fascia as well as tendons and ligaments. Drs. Reid and Kosova were among the first trained in the US on high energy shockwave and continue to offer new technology such as radio frequency and biologic injections to expedite healing. Dr. Lawrence Kosova and Dr. Marlene Reid have been treating foot and ankle pain in the western suburbs for over 25 years and are committed to returning patients to being pain free as soon as possible

So why did “heel spurs” exempt people from military service? Aside from being very painful, heel pain was often associated with “flat feet” which tire easily. Nowadays, both flat feet and heel pain are easily maintained using custom orthotic devices and no long pose a threat to our soldiers.