Developing Corns & Callus
It is often unknown but many people maybe at a heighten risk of developing callus and corns. With cases being presented in age ranges from adolescents through the elderly, presenting more often than what we would expect. Some common populations:
Advanced Age
As you age the loculated fat padding in your feet thins out and compresses, decreasing shock absorption and increasing incidence of pathological forces. Fat padding is important as it decreases load on prominent plantar joints and bones during weight bearing.
Presence of an underlying bony deformity
Any bony deformity in the foot will have an impact on the function and ability of the foot to disperse ground forces. If there is a bony prominence from the deformity on the plantar (bottom) aspect of your feet, this will inherently increase pressure exponentially.
Diabetes and chemotherapy
People whom suffer from diabetes or have undergone extensive chemotherapy are at risk of developing peripheral neuropathy (where nerves in the feet become damaged) often resulting in numbness and/or weakness of the feet.
A lack of sensation and an inappropriate propioceptive response to loading of the feet will result in increased incidence of shearing and rotational forces occurring. It is important that patients with peripheral neuropathy monitor corns and callus daily as ulceration and potential for infection increases with neglect. It is recommended that at a minimum any patients suffering from peripheral neuropathy be seen and assessed by their podiatrist at least once every 6 months to proactively prevent complications.
Complications
In addition to what has been discussed, pain caused by untreated corns will cause the patient to alter the way they walk (to offload painful areas of the foot). This in turn may acutely decrease painful symptoms; however it will increase pathology and load on other areas of the body (knees hips and back) potentially resulting in further issues and long term symptoms.
Treatment
Any treatment for either corns or callus should include a patient history, to understand the condition and formulate a treatment plan.
With callus debridement and enucleation of corns this generally should not be too painful as a callus will typically have no neural innervations. With large corns or complications such as fibrosis, your podiatrist will formulate and discuss treatment options. Felt padding can be applied to offload treatment sites and promote comfort.
It is recommended (post treatment) the podiatrist review a patient for any return of corns or callus (1 month period), and discuss options to do the following:
- Conduct a Biomechanical to check skeletal health, and identify problem areas with walking gait. If a biomechanical pathology is found to be causing recurrent callus or corns, your podiatrist can recommend strapping or taping.
- Footwear assessment
- Lower limb strapping. After conducting a structural and musculoskeletal diagnosis, your podiatrist may suggest a strapping to correct the rear, mid and forefoot mitigation pertaining to the mechanical forces of your condition. If this proves successful the prescription of customized orthotics is clinically indicated.
- Custom Orthotics. Used as a permanent option to prevent the re-occurrence of corns and callus.
Other treatments
Should a corn become advanced, fibrosis (scarring) of the surrounding tissue can both heighten pain and decrease skin integrity. This scarring can resolve over time with appropriate offloading and periodic debridement however may remain.
Treatments of both prolotherapy and high powered laser can be performed by a qualified podiatrist may assist in the breakdown of fibrosis and stimulation of healthy tissue growth.
Often early intervention when a corn or callus presents from your qualified podiatrist, can lead to prevention and quality management of your feet.
Sound foot structure is the foundation for a healthy life
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