Fin Foot or DCS?

Q: After some recent dives, some of my toes were really sore. Within a few hours they looked bruised and were extremely painful; I could hardly walk. It took several days for the bruising and pain to go away. Could this have been decompression sickness (DCS)?
A: This was unlikely to have been DCS due to the location and the symptoms you described. DCS symptoms are not known to isolate in specific digits. Your presentation suggests a condition known as reactive hyperemia, which may result after a period of reduced blood flow to an area of the body. When circulation is fully restored following constriction, the blood vessels dilate and may become engorged with blood. This can cause discoloration ranging from dark red to the bruised appearance you described as well as intense pain.
If fin straps are too tight or a diver forces his foot into the foot pocket too firmly, a steady mechanical pressure on the blood vessels may result. This is colloquially known as “fin foot.” Colder water may also contribute to the constriction of the blood vessels, further reducing blood flow to the area. Usually this condition does not require medical intervention other than pain management. Staying off the affected foot as much as possible, elevating it and applying warm compresses will typically improve comfort. Ensure proper fit of your booties and fins, and don’t overtighten heel straps.
— Marty McCafferty, EMT-P, DMT
A: This was unlikely to have been DCS due to the location and the symptoms you described. DCS symptoms are not known to isolate in specific digits. Your presentation suggests a condition known as reactive hyperemia, which may result after a period of reduced blood flow to an area of the body. When circulation is fully restored following constriction, the blood vessels dilate and may become engorged with blood. This can cause discoloration ranging from dark red to the bruised appearance you described as well as intense pain.
If fin straps are too tight or a diver forces his foot into the foot pocket too firmly, a steady mechanical pressure on the blood vessels may result. This is colloquially known as “fin foot.” Colder water may also contribute to the constriction of the blood vessels, further reducing blood flow to the area. Usually this condition does not require medical intervention other than pain management. Staying off the affected foot as much as possible, elevating it and applying warm compresses will typically improve comfort. Ensure proper fit of your booties and fins, and don’t overtighten heel straps.
— Marty McCafferty, EMT-P, DMT
Posted in Alert Diver Summer Editions, Dive Safety FAQ, First Aid Training
Tagged with Feet, Footissues, Diving Feet, Fin Foot, dive injuries
Tagged with Feet, Footissues, Diving Feet, Fin Foot, dive injuries
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