Calluses on your feet are more than just a sign you need to visit Linda, our foot care nurse, at the office. Foot Calluses or, "hyperkeratosis", is a condition where the body lays down extra layers of skin to an area of the foot that is getting excessive wear, rubbing, or irritation. It is a natural way for your body to protect itself, but if calluses are not addressed they can cause decreased sensitivity, change your gait, reduce your mobility of even result in corns.
Why do I have Calluses?
There are three main reasons why you develop foot calluses:
1. Poor Footwear
The most common cause of callusing is tight fitting shoes such as high heels. We like to wear great looking shoes but that often comes with a price to our feet. Narrow fitting toe boxes cramp the toes and cause them to rub together. High heels or flip flops don't allow the foot to go through the proper mechanics of gait and causes us to place excess pressures onto the wrong areas. Purchasing the wrong type of shoe that doesn't match your foot type can also be a cause of callusing.
2. Foot Abnormalities
Bunions, hammer toes, and bone spurs can all cause calluses and corns due to a change in your gait and the proper mechanics of your foot. Crowding of the toes due to the first toe deviating inwards can cause a lot of callus problems. Bunions are often a genetic condition that require a trained professional to evaluate and determine if you need surgery.
3. Improper Biomechanics
Calluses formed by abnormal foot biomechanics generally indicates that your gait is not optimal. The position of the calluses can indicate how your gait is compromised. Normal gaits typically don’t lead to callus formation. If your foot is not going through the proper mechanical steps due to a foot deformity or a weakness, the foot will apply excess pressure to areas and cause a callus.
During a normal gait, the heel strikes the ground first and the foot is briefly rigid. The foot then immediately turns into a flexible structure as it unlocks the ankle hinge joint, adapts to the ground beneath it, then again becomes a rigid lever you use to push off the ground. Your big toe area takes most of your body weight for push off, while the other toes pick up the balance.
An abnormal gait, often caused by structural changes in the bones and joints of your foot, can cause undue pressure and irritation on specific areas of your foot and the development of calluses. Where calluses form can frequently pinpoint where the problem lies:
A. On ball of foot beneath second toe: Caused by an elongated second toe or shortened big toe
B. On the ball of the foot beneath the second and third toes: Caused by hypermobility of the first ray; On the outer edge of the big toe, known as “pinch callus:” Caused by altered movement patterns during gait cycle
C. On ball of foot beneath the big toe and fifth toe: Caused by rigid plantarflexed first ray or a forefoot varus type foot
D. On ball of foot beneath big toe and second toe: Caused by semiflexible first ray
E. On ball of foot beneath fifth toe: Caused by uncompensated rearfoot varus or rigid plantarflexed fifth toe
F. On entire center portion of ball of foot: Caused by ankle equinus condition and tight calves
How to Solve the Callus Problem
The first step to decrease your odds of getting calluses is to go shoe shopping for a pair of good fitting shoes. If you are buying athletic shoes, talk to the sales person and make sure you purchase the right type of shoe that matches your foot type.
Secondly, get your foot assessed by your health care professional. A Chiropractor, Podiatrist, some Medical Doctors, and a Chiropraodist, all can take a good history and evaluate your foot biomechanics and determine the treatment plan. In some circumstances, a stretching and strengthening plan is needed such as when you have a weak arch or an equinus type foot where your calf muscle is very tight. You will need custom orthotics if you have foot deformity such as forefoot or rearfoot varus, a rigid first toe, or plantar flexed first ray. Not everyone needs orthotics but, often when you have major callusing, the underlying cause is your foot needs some extra support from a custom insole.
Activity fact: The foot has the thickest skin in the body, the most dense fat, and over 25,000 sweat glads!