Stroke rehabilitation is a race against time. The first weeks and months after a stroke represent a critical window for neurological recovery, when intensive therapy can make the greatest difference to long-term outcomes. Anything that delays or limits that rehabilitation—including preventable complications like heel pressure ulcers—costs the patient precious time.

Yet the very factors that make stroke rehabilitation urgent also make heel protection challenging. The hemiplegic leg lies immobile. Sensation may be impaired. Muscle tone may push the heel into sustained contact with the mattress. The patient cannot feel the damage as it occurs.

This article examines why stroke survivors face particular heel vulnerability and how to balance protection with the mobilisation that recovery requires.

The terms get used interchangeably in clinical practice. Pressure reduction. Offloading. Heel protection. Redistribution. But they are not the same thing. And the distinction matters to clinical outcomes —particularly at the heel, where anatomy conspires against us.

The 2025 International Pressure Injury Guideline makes this explicit. For heels, the recommendation is unambiguous: heels should be "fully free from contact with the support surface." Not reduced pressure. Not redistributed pressure. Zero contact.

This article explains the biomechanical difference between pressure reduction and complete offloading, why it matters specifically at the heel, and what the evidence shows. Let's be clear about definitions first.

When treating denervated muscles with electrical stimulation, a common assumption is that stronger is better—that maximum current intensity will produce the best results. However, clinical evidence tells a different story: optimal outcomes come from finding the minimum effective intensity, not the maximum tolerable one.
I generally advise clients at the beginning not to worry too much about the specific current level, but to increase the current intensity until they start to see a contraction, and then increase by about 10% over that. I would call that the minimum effective intensity. 

In this article, I'm going to look at some of these reasons why electrical stimulation devices, that are regulated medical devices, cost what they do. The price disparity between consumer TENS units and medical-grade devices may seem vast, but it is grounded in real, tangible differences. By demanding higher standards for quality, efficacy, and patient outcomes, medical electrical stimulation devices play a critical role in modern healthcare. Next time you encounter the steep price of a medical device, ask yourself—what’s the price of safety, innovation, and a clinically proven outcome?

This article discusses how to counter Goodhart's Law in healthcare, focusing on quality metrics and patient outcomes. You might not have heard of Goodhart's Law, but it describes an extremely common tendency that has almost certainly affected us all at some point.
The temptation with complex services such as healthcare, is to focus on some simple metric that might reflect overall performance. Unfortunately this often results in misrepresenting the true performance of the system.
This article offers strategies to balance care quality with quantitative measures, enhancing rehabilitation services.

The STOP Pressure Week (13-17 Nov) initiative aims to combat pressure ulcers by emphasising the significance of 'Every Contact Counts'. In this article, we aim to raise awareness and take proactive measures to safeguard individuals at risk, with a specific focus on preventing heel pressure ulcers. Additionally, we will delve into the discussion of the PRAFO range of devices, which play a pivotal role in both prevention and treatment.