Common Foot Problems

Calluses – Hard Skin

One of the most common foot problems, associated with women and men equally, is the growth of calluses otherwise known as hard skin.

What is the cause of a callus and why do we get hard skin?

The skin is formed of many micro layers, all layers have a significant role, for renewing and shedding skin. This incredible process is in continuous action throughout your life. Occasionally, the rate in which the renewable and shedding becomes unbalanced with the introduction of forces like pressure and friction. The imbalance of the process causes a dysfunction which allows the skin to build up; this is what a callus is. The skin develops callus also as a safety precaution to protect the skin of trauma which can come from footwear. Best example is to think of a mechanic using his hand with tools regularly which often results on having callused hands.

It is understanding that over time this build up can develop in excess which can become uncomfortable and sometimes painful. A easy and pain-free solution would involve thorough debridement by DG Podiatrist leaving your feet soft and supple at touch. Application of cream thereafter will keep your feet velvety for weeks; far more effective than a pedicure.

What factors contribute or cause calluses and hard skin?

  • Footwear not suitable for your feet.
  • Bone rubbing on skin.
  • Pressure.
  • Friction.
  • A combination of the above.
  • Surface upon which you walk on.

Blisters

Here are a few steps you can do to help with the blisters and to prepare you for the walk, hike, run or marathon.

Firstly, blisters are caused by friction, so it is important to  keep your feet dry, clean and reduce to friction as much as possible. Initial assessment should be focused towards your walking footwear. Make sure no aspects are rubbing or too tight. Approximately a thumbs width with be sufficient at the end of your shoe. Making sure to  allow sufficient space for the height of the front of your shoe; this is called the toe box.

Secondly, socks-layering in two can help to prevent blisters. Also wearing polypropylene and other synthetic wicking fabrics can help with reduce moisture. Avoid cotton socks as they can be abrasive when moisture is absorbed. Nylon socks, also reduce friction.

Thirdly, we can try and toughen your skin up, try walking barefoot around your home and outdoors where safe. Id say the garden. This will toughen your soles. This is not suitable for diabetic patients or those who have experienced a loss in sensation within their feet. Application of surgical spirit can help toughen skin too.

Now actual topical prevents include mainly lubricates. Petroleum jelly does work.  But also try body glide and Compeed anti blister stick. This has proved to show good results. To keep your feet dry, powders like talcum and corn starch are effective. There are also tapes you can apply like moleskin and zinc oxide tape to prone areas. 

If you have a blister or several already, avoid from using non sterile techniques to pierce it. Leave the skin attached if the blister has drained itself. If you have any concerns see DG podiatrist at your earliest convenience.

DG wishes the best for you foot journeys. 

Heel Pain: Chronic Heel Pad Inflammation

Another common foot pain associated to the heel is chronic inflammation of the heel pad. The heel pad acts as a cushion for the heel bone. The cushion is comprised of fat also known as fatty padding. The greatest form of natural shock absorbance for your heel. 

Occasionally the fatty padding can become thinner and also moves to the sides of your heel. When this happens it leaves a thinner layer where inflammation is more likely to occur. Like most heel related problems the cause is usually that of repetitive stress, high intensity, long duration and lack of support. The thinning of the fat pad is commonly associated to old age.

The classic symptoms are described as deep heel pain and bruised like sensation. Rest, Ice, Compression and Elevation is essential. DG Podiatrist highly recommends heels pads for extra cushioning for extra comfort. 

Heel Pain: Stress Fracture

Heel stress fractures are caused by high impact, high intensity and long duration activities. The best way to appreciate what the stress fracture is, is to visualise it. Looking at the picture above on the right gives a good estimation of what it looks like. The way in which it fractures can variate in many ways; length, dept and point of fracture on the heel bone.

This type of heel pain can be intense and requires offloading and plenty of rest. In order to diagnose the stress fracture you will be referred to get a Xray. The Xray will be able to see the extent of damage and its exact location. There are other factors, such as the environment, bone composition and even training executed in a improper way can cause for heel stress fractures.

Bone takes approximately 6-8 weeks to heal depending on your health status. 

Heel Pain: Sever's Disease

Heel pain continues with Sever's disease which is a heel pain associated with kids. As children grow so do their bones; at an immature bone stage the cartilage cells are yet to develop into bone cells. When there is a union between the cells this forms bones. Fun fact: another name for a growth plate is epiphyseal plate. I agree,  lets stick to growth plate.  When children experience pain in the heel it is usually the inflammation of the growth plate at the back of the heel. Remember that inflammation is a swelling. So naturally the heel will feel tender and due to the location and heel structures in the area painful on any form of activity. The child will experience pain when walking, stiffness in the morning and usually feel better walking on his or her tiptoes to alleviate the heel.

Active kids tend to complain of this foot problem the most.The typical onset of this heel pain is during the growth spurt stage in their lives. This is when they grow the fastest.  For boys the age range is approximately eight to thirteen and for girls it is between ten to fifteen. After fifteen years of age the bone cells are usually fully grown. Therefore the heel bone will now be mature.

But surely, bones developing is a normal thing so why does it hurt? Sometimes the heel bone grows quicker than the surrounding muscles and tendons. This makes leg muscles and tendons tight and overused in the heels. Naturally places stress on the heel bone.

Other factors that increase the likelihood of developing sever's disease are; a foot that rolls in (pronation), flat or high arches, obesity and having one leg longer than the other. Believe it or not the last one is not so uncommon. 

DG Podiatrist highly recommends that children are attended to promptly with the correct care and advice the heel pain can be resolved in little time as 2 weeks to 2 months. DG will talk through and explain all stages of recovery and aid the child at every step to ensure a speedy recovery. it will be required to have a Xray to fully diagnose the pathology.  With long term care the chances of recurrence are minimal. If you feel your child has this, act immediately to provide the best outcome for him/her. DG Podiatrist believes that children are at their best when they are happy. Lets keep that bounce in their step!

Heel Pain: Heel Bony Bumps

Commonly known as Haglunds deformity, pump bump and bauers bump. Even though it may hold many names, the reason behind the heel pain lays ironically behind the heel bone. The enlargement of the bony prominence of the heel, as can be seen in the picture below, causes irritation to the surround structures like Achilles heel, which causes pain.

There are many factors that contribute to haglunds deformity but majority lays in bony structure. This is inherited and you will have this bone growth since birth. Being overweight, having had injuries, ill-fitting footwear and activities that stress that areas of your heel are also contributors to heel bump pains.

This pump bump came about not just as a tongue twister but also by the style of shoes worn by woman known as “pumps”. The rigid surface at the back of the shoes rub from pressure causes the discomfort. Women known to wear shoes like them are the common sufferers from this problem. Men can equally develop Haglunds deformity with ill-fitting footwear too. The tighter the shoe the more inflamed the bump becomes, which can also cause for a heel bursa.

Initially the onset of this heel pain is redness, tenderness and inflammation of the back of the heel. Like most heel conditions it is crucial for a early diagnosis to provide a quicker resolution of the problem.

How to treat heel bony bumps? Remove the main source of friction and pressure; the tight shoes or shoes with a rigid back. It is advised to ice the back of the heel to help reduce inflammation. DG Podiatrist recommends encourages you rest the heel as much as possible. If you feel you require more information or would like to be seen, please feel free to enquiry and book a consultation.

Heel Pain: Plantar Fasciitis

Plantar Fasciitis-Heard of it? Pleasantly surprising? You are one step closer to knowing what plantar fasciitis is and just how common it is. Around one in ten people get this type of heel pain at least once in their lives. Affecting more women than men usually between the ages of 40-60, but can occur at age. Athletes are prone to attaining this form of heel pain as well as individuals that are overweight. A change in surface and poorly cushioned unsupportive shoes are other factors that lead to plantar fasciitis. Lastly, a tight Achilles tendon can have the same affects as the other factors. Why would a tight Achilles tendon cause for plantar fasciitis? The tendon is responsible for connecting the calf muscles to the heels and its dysfunction decreases foots’ optimum ability to flex.

Right, hopefully you’ve read plantar fasciitis enough times to be able to pronounce it. Plantar is easy but the next part can be pronounced like “fashii-it is”. Perfect. What is plantar fasciitis? It is the inflammation of the tissue band called the plantar fascia. This ligament like structure attaches at the bottom of the heel bone, calcaneus. As it goes up this tissue band separates into strands and attaches to the forefoot in the balls of your feet. The plantar fascia is in motion at all times. Hence long periods of standing, walking and running can damage the tissue.

What types of symptoms are common for plantar fasciitis? Typically the first steps in the morning can be increasingly painful. As the day progresses the pain decreases with gentle exercises. This pain can be described as sharp and tender to touch. This pain can be anywhere on the bottom side of your heel but usually one area can be pin pointed to be the most painful.

What is the treatment for plantar fasciitis? Before receiving treatment, it must be diagnosed first. DG Podiatrist assesses the heel to check for all forms of heel pain. Once established, they’re many treatments for this pathology. Plantar Fasciitis is a self-limiting condition, meaning it tends to go on its own accord but its speed of resolution can be heavily influenced by treatments. Why have treatments if it is likely to go on own accord? The trouble here is no one can predetermine the exact duration of the pain. Some people may experience the pain for a month and others up to two years or more if untreated. Treatments can range from footwear, insoles, ice therapy, exercises, rest, shockwave, steroid injections to surgery. DG Podiatrist will arrange the best plan for your individual needs. 

Heel Pain: Heel Spur

Heel Spur heel pain is another common foot problem that can be easily confused with plantar fasciitis because of its location on the foot. To get a better understanding of the pathology we need to take a closer look at the heel bone. Looking at the image below you can see the point of insertion for the plantar fascia is also where the heel spur would be located.  But before we get stuck in to the science of it all- What is a heel spur? A heel spur is a build up of calcium deposits that result into bony growth at the underside base of the heel bone (the calcaneus).

These growth can take months to years to develop and usually cause little to no pain at all.  So what makes the heel spur symptomatic? Most heel pain causes are related to high impact increased activity. Various activities like walking, jogging, running and having abnormal gait can cause excessive pressure on the heel.  The increase in activity stretches the muscles and ligaments and tissue in the area. This in turn causes inflammation. Your physique is another contributing factor, the heavier you are the more inclined you are to having this condition. Like  dominos  all steps eventually lead to painful heels. 

What would you feel if you had heel spurs? Commonly described as sharp, stabbing pain on activity. Usually worse when carrying heavier things. Also the pain is worst in the morning or after rest where stiffness is experienced. 

What type of footwear should you be wearing? Excellent question. A shoe or ideally a trainer that has full arch support will provide much comfort to the foot. The flatter the foot or surface the more pain you are likely to encounter. This is because the flatter the surface the more stress is placed on the plantar fascia. The plantar fascia pulls the heel bone. So it can be most beneficial to wearing tie up and shoes with a strap also. If foot wear is not suitable it would be thoroughly advisable to look into insoles. DG Podiatrist aims to give all patients the best advice to reduce pain and help resolve the condition at hand. 

DG Recommends: Moisterizer For Dry Feet and Heels

Your skin is capable of doing many things, one of which we rely on a daily basis is renewing and shedding. This wonderful process occurs via several layers of skin cells. In the process of carrying out their daily functions skin also plays a large part in the water evaporation and retention. When the balance is tipped from one extreme to another, the feet can become excessively dry. This dryness results in a tight uncomfortable feeling.

Dryness along with other factors can cause further problems like dry cracked heels.These can be painful, unsightly and sites for infection. To prevent dry skin it is essential for us to utilise what is readily available to us, moisturisers and creams. Simple daily applications will result in flexible skin, softer touch and generally happy feel. 

There are several creams DG Podiatrist recommends for the best foot care. You can learn which cream would be best for you after a consultation where your skin type will be assessed. Everyone can have happy feet. It just takes team effort.