Tag Archives: Flat feet

Corns and Calluses

Callus evolution.

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The foot is an engineering marvel that cannot be duplicated by robotics. It is composed of 26 bones, 33 joints and around a hundred tendons, ligaments and muscles of various sizes, well oiled and sliding smoothly over each other.

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The foot is encased in thick and leathery skin that protects it from injury. Our feet take us everywhere from the time we first learn to walk till we are finally laid to rest. Yet, somehow, we tend to take our feet for granted until they malfunction, cause pain or refuse to perform as instructed.

Some orthopaedic abnormalities of the feet, like clubfoot, flat feet, congenitally dislocated hips or knock knees, are present from birth. Sometimes shoes may be purchased for conformity to fashion disregarding the requirements of the feet. They maybe ill fitting, too tight or too large. Pointed toe stilettos are notoriously guilty. The gait becomes abnormal as pressure is applied unevenly to the skin of the foot. Irregularity may also occur in old age as a result of arthritis or injury.

When pressure is exerted unevenly on the foot, the skin tends to thicken abnormally. This callused skin may remain like that or develop into a corn. This happens in areas where the skin is rubbed persistently or where the skin is under uneven pressure. Common places are the heel, the ball of the foot and the sides of the toes.

The skin over the unsightly hardened area on the foot, a callus, is dead. So there is no inflammation or pain. Eventually the callus may harden to form a corn. The corn has a central area of inflammation and is painful and tender. It is usually situated near the base of the fifth toe. If the feet are pushed into tight fitting shoes, corns will form between the toes as well. Perspiration and moisture cannot escape from this area causing the corn to become macerated and tender.

If a callus or corn is beginning to develop, the first step would be to determine if there is any source of pressure which has set off the thickening of the skin. Sometimes it may even be due to a sudden increase in the level of exercise or interest in some new sport. Once the cause has been identified it should be removed, or else the callus will exacerbate.

The foot should first be soaked in warm water with rock salt and commercially available liquid soap. After 10 minutes the affected area should be gently rubbed with a pumice stone or a foot scrubber. Some baby oil or moisturiser should then be applied. This gets rid of the corn (or callus) at an early stage.

If the callus is hard and the punctum or tip of the corn is easily visible, commercially advertised OTC (over the counter) corn plasters may be used. Most of them contain salicylic acid — a keratolytic agent that softens and breaks down hard skin. They need to be applied on a dry foot and left in place till the corn softens and falls out. They should not be used on soft corns between the toes.

Wearing loose footwear with low heels and a well-cushioned insole can also relieve the pain. Slippers should be made of soft rubber like MCR (micro cellular rubber). Acupressure slippers are also helpful.

If the corn does not respond to these simple measures, it has to be surgically removed. A qualified dermatologist or surgeon can do it as an outpatient office procedure.

Newer, relatively painless techniques involve freezing the corn with liquid nitrogen or dry ice or removing it with laser technology. It is dangerous to perform “home surgery” — slicing off the corn with a knife or blade. Dangerous debilitating infections can occur due to such amateur attempts.

Diabetics need to take particular care of their corns and calluses and consult their physicians if they have a problem. They may have compromised blood supply to their feet or numbness of the nerves. This may make them insensitive to the pain making them inadvertently ignore the corn. Any self-treatment (especially salicylic corn plasters) is likely to result in dangerous infection.

Some simple rules one should follow:

• Wear proper footwear and socks

• Wash the feet well at night before going to bed

• Moisturise the feet with oil or cream once a day

• Keep the areas between the toes dry, particularly after a bath

• Treat arthritis, blisters, corns and calluses promptly

Appropriate footwear for various sports should be used. One pair of “canvas” shoes should not be used for all activities.

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Sources: The Telegraph (Kolkata, India)

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Cracked Heel

Definition:
Cracked heels are a common foot problem that are often referred to as heel fissures. Cracked heels are commonly caused by dry skin (xerosis), and made more complicated if the skin around the rim of the heel is thick (callus). For most people this is a nuisance and a cosmetic problem but when the fissures or cracks are deep, they are painful to stand on and the skin can bleed – in severe cases this can become infected.

What does a cracked heel look like:
The skin is normally dry and may have a thick callus which appears as yellow or dark brown discolored area of skin, especially along the inside border of the heel. Cracks in the skin are usually obvious.

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Consider a tomato on the bench … when you push on it from above, it wants to expand out sideways … eventually the skin cracks. This is what happens to the normal fat pad under your heel … as your body weight pushes down, the fat wants to expand sideways and the pressure on the skin to crack is increased. If the weight is excessive (eg prolonged standing) and the skin is not supple (eg callus and/or dry) and nothing is helping hold the the fat pad under the foot (eg open backed shoes)

The skin is normally dry and may have a thick callus which appears as yellow or dark brown discolored area of skin, especially along the inside border of the heel. Cracks in the skin are usually obvious.

Causes cracked heels:
Some people tend to have a naturally dry skin that predisposes them to the cracks. The thickened dry skin (callus) around the heel that is more likely to crack is often due to mechanical factors that increase pressures in that area (eg the way you walk).

Other factors that can be involved in the cause of cracked heels include:

prolonged standing (at work or home, especially on hard floors)
being overweight (this increases the pressure on the normal fat pad under the heel, causing it to expand sideways – if the skin is not supple and flexible, the pressures to ‘crack’ are high)
open back on the shoes (this allows the fat under the heel to expand sideways and increases the pressure to ‘crack’)
some medical conditions predispose to a drying skin (eg autonomic neuropathy in those with diabetes leads to less sweating; an underactive thyroid lowers the body’s metabolic rate and there is a reduction in sweating, leading to a dryness of the skin)
Some more causes are:
Obesity
Open backed shoes can be a contributing factor
Surgery to the lower extremities
Heel Spurs
Mal-aligment of the metatarsal bones (the bone structure of the sole of the foot)
Flat feet and high arched feet
Abnormalities of gait (walking)
Using excessively hot water is a contributing factor
Eczema and psoriases can also be contributing factors

Symptoms of cracked heels:
If the cracks are bad enough there will be pain on weight bearing, that is not there when weight is off the heel. The edges or rim around the heel will generally have a thicker area of skin (callus). Wearing open or thin soled shoes usually make the symptoms worse.

Treatment of cracked heel.
Flexitol Heel Balm treatment combines 25% urea formula with highly concentrated emollient base. With regular use, your feet will become soft and silky smooth to the touch.You may try this.
Apply Vaseline (petroleum jelly) two to three times daily on the affected heel.
Apply a moisturizing cream twice daily to the affected heels, such as flexitol heel balm
Use pumice stone to reduce the thickness of the hard skin.
Avoid open backed shoes or thin soled shoes
Buy shoes with a good shock absorbing sole
Never try to pare down the hard skin your self with a razor blade or a pair of scissors!

Ayurvedic care and remedy for cracked heel

Home remedy for cracked heel

Podiatric management of cracked heels:
The podiatric treatment of cracked heels may involve the following:

Investigating the cause of the problem, so this can be addressed
removing the hard thick skin by deb riding it (often the splits will not heal if the skin is not removed). This may need to be done on a regular basis. Regular maintenance may be the best way to prevent the problem.
if very painful, strapping may be used to ‘hold’ the cracks together while they heal (a maintenance program after this to prevent recurrence is very important).
prescription and advice regarding the most appropriate moisturizer or emollient.
advice about footwear and self care of the problem.
insoles may be used to alter the way you walk to prevent the thick skin from developing (these are indicated in cases of heel callus and are not suitable for all cases).
a heel cup may be used to keep the fat pad from expanding sideways. This is worn in the shoe and can be very effective at prevention if used regularly.
on rare occasions some Podiatrists and Dermatologists have used a tissue ‘glue’ to hold the edges of the skin together, so the cracks can heal.

Foot care for cracked heel

On line heel repairing cream

Disclaimer: This information is not meant to be a substitute for professional medical advise or help. It is always best to consult with a Physician about serious health concerns. This information is in no way intended to diagnose or prescribe remedies.

Source   :http://www.epodiatry.com/cracked_heels.htm