Don’t let hammertoes and corns get in the way of enjoying your activities and doing what you love. Read below to find out why this is occurring and what to look for when shopping for your next shoe!

The most common cause of corns is excessive pressure on a particular area of the body. For a hammertoe, this occurs on top of the “knuckle” of the affected toe (on the proximal interphalangeal joint). The joint bends upwards, causing the toe to “curl” downwards. Often the corn forms at the joint that is raised, which leaves a hardening of the skin on the surface that can cause irritation and pain. Keep in mind that corns can occur anywhere on the foot where there is pressure!

Why Am I Getting a Corn?

There are two main reasons that corns tend to form due to shoes:

• Your shoes are fitting too tight or not deep enough!
  • Tight fitting shoes lead to more pressure on the foot because as you move your foot expands. If there is nowhere for this to occur, pressure is put onto the foot by your shoe. And as the foot moves, the excessive pressure placed on your foot increases the risk of a corn forming. But it’s not just width that matters, but also toe box depth. With hammertoes, if there isn’t enough extra space to accommodate them in the toe box, rubbing can occur as well.
• Loose shoes!
  • On the contrary, shoes that are too loose can cause very similar issues as shoes that are too tight. Often this occurs when shoes are either not tied up tight enough or are just way too big for your feet. This leads to too much extra movement in the shoe and rubbing occurs, leading to blister, corn or callus formation.

What Do I Look For?

First things first, get properly fitted. Sitting down with a BioPed lower limb clinician is key in determining the proper fit. Getting a shoe that fits both in length and width is essential in reducing pressure on your hammertoes and other problem areas.

Next, find a shoe with the extra depth toe box feature. Especially with hammertoes, having extra space in the toe box will keep friction and pressure on the joint at a minimum. An alternative is to find a leather-based shoe. A leather shoe can be more easily stretched at problem areas to create pockets of relief and keep you comfortable all day long.

Another great idea is to look for shoes that have few seams or have mesh/stretchy material over problem areas. Often sites of corns or blisters occur at the location of seams. By reducing the amount of seams or even switching to a meshed shoe with more give can be a great way to keep those feet happy.

In some cases, orthotics might be necessary to control your hammertoes. A sulcus pad in orthotics provides support to the toes and minimizes gripping, which worsens hammertoes over time. If orthotics are required, having a shoe that has a removable insole is essential to giving your orthotic and foot extra space in your shoe.

BioPed Chiropodists/Footcare Nurses offer corn trimming services to reduce the pressure and pain on your toe if a corn is present.

Finally, BioPed clinics sell toe accessories, such as silicone toe sleeves to minimize pain associated with toe corns when wearing closed toe shoes.

Come See Us!

Footwear can be tough! If you can’t quite find that perfect fit and are experiencing corns or blistering, please book an appointment with us today! At BioPed Footcare, whether its bracing, shoes, or footwear we are here for you. With our on-site lab there is nothing we can’t do! Meet with one of BioPed’s lower limb clinicians to see how you can keep your feet and legs healthy!

If you’re experiencing common painful foot conditions like plantar fasciitis, bunions, or flat feet, a Registered Chiropodist can help you in many ways! However, if you are struggling with more skin and nail-related concerns, such as ingrown toenails, calluses, corns, or warts, seek the expertise of a Registered Chiropodist or an Advanced Footcare Nurse.

But when should you opt for a chiropodist vs a footcare nurse?

In simple terms, choose a BioPed Registered Chiropodist when you require orthotics, a prescription (for medicine or orthotics, shoes or bracing), have an infection, have a foot wound, may require surgery or numbing (by injection), or are neuropathic (have little to no sensation in your feet). Chiropodists can prescribe oral and topical medications and administer injections into the feet. They can also offer surgeries on skin and toenails.

An Advanced Footcare Nurse provides trimming for calluses, corns, thick or ingrown toenails, and treatment for foot warts. They perform most of the same skin and toenail treatments as a Chiropodist, except for surgeries, injections and prescriptions.

If you are suffering from any of the following conditions, then medical footcare at BioPed is the right service for you!

Fungal toenails

Fungal nails can be thick, misshapen, discoloured, crumbly and smelly. They can occur on the big or small toes and are treated with regular debridement, topical or oral antifungal medications.

For topical solutions to be effective, the nail must be thin enough for the treatment to penetrate to the nail bed where the fungus resides. A Chiropodist or Footcare Nurse can significantly reduce the thickness of the nail plate. If necessary, a Chiropodist can remove the nail plate altogether.

Ingrown toenails

A painful toenail border (or edge) due to the nail growing into the soft tissue is considered an “ingrown toenail.”

You may experience pain when the nails are significantly curved or when a spike of a nail punctures the skin at the side of the nail. Ingrown toenails usually respond well to correct nail cutting techniques, properly fitted footwear and patient education.

BioPed Chiropodists and Footcare Nurses can opt to apply a toenail brace, which helps alleviate pressure at the sides and retrains the nail edges to grow straighter. Registered Chiropodists can also perform toenail avulsions to remove the offending nail edge and prevent a recurrence.

Corns & calluses

Corns and calluses appear as thickened skin on the bottom or tops of the feet and in between the toes.

Corns and calluses can be painful because of the high pressure or friction caused when skin builds up in local area. To offset the pain in the feet, a person might alter how they walk, creating other issues, such as knee pain.

BioPed Chiropodists and Footcare Nurses will trim corns and calluses and recommend a topical moisture regime that will help with hard and dry skin. Chiropodists can also prescribe custom foot orthotics, which can correct gait and offload high-pressure areas, reducing the corn / callus pain and need to return for frequent trimming. BioPed clinicians can also recommend properly fitted footwear appropriate for specific activities and your foot type, to increase comfort and function.

Plantar warts

Plantar warts are found most commonly on the bottom of our feet and are contagious. 

Warts have a cauliflower-like texture, black dots centrally, and are usually painful when lateral pressure is applied. They are caused by the human papillomavirus (HPV) and can be challenging to cure.

Registered Chiropodists and Advanced Footcare Nurses will debride wart tissue to allow chosen treatments to work better. This could include topical solutions such as salicylic acid and Cantharidin. In addition to conservative treatments, Chiropodists can also perform wart needling and wart excision.

Toe deformities

Hammertoes, claw toes and mallet toes are all forms of toe “deformities”. They refer to toes that bend at one or both toe joints, creating a toe that is not straight. They can cause calluses, corns, pain, and discomfort, making finding the right footwear a seemingly impossible task.

To address toe deformities, a silicone sleeve may be recommended, or Chiropodists can make a custom toe prop, which can help straighten the toes and prevent rubbing, when weight-bearing. BioPed clinicians will also address any calluses or corns that have arisen due to the toe deformity and makes recommendations for footwear.

Diabetes & foot health

People who have diabetes are more susceptible to infection, cold feet and other complications, such as peripheral neuropathy. To ensure proper foot health is maintained, BioPed Chiropodists and Footcare Nurses will perform routine nail and skin care. Diabetic Risk Assessments are 3-minute evaluations performed in clinic to determine a person’s risk for foot complications. Following this evaluation, the clinician will provide education on how to inspect feet at home in between appointments to ensure they stay healthy.

Biomechanical treatment

Registered Chiropodists are trained in assessing gait (walking pattern/style) and the quality of movement of the foot and lower limb joints and muscles. Depending on the lower body mechanics, a Chiropodist may prescribe custom foot orthotics to correct alignment and/or provide protection to the foot or improve the way someone walks or runs.

Whether you’re an elite athlete, a recreational runner or just someone who wants to stay active and healthy, a BioPed Chiropodist can help you move better and more efficiently, which can prevent injury and alleviate discomfort.

How do I book an appointment?

BioPed Registered Chiropodists and Advanced Footcare Nurses can help improve your foot health and comfort, alleviate foot pain, and get you back to doing more of what you love in life.

Contact your local BioPed and schedule an appointment to find out how a Registered Chiropodist or Advanced Footcare Nurse can help you today!

Our toes play an important role in our posture and balance, supporting body weight, and propulsing our body forward when we walk.  In doing this, they endure a considerable amount of pressure as they bend and grip to stabilize the feet and lower body.  Walking on uneven terrain, such as hiking through the woods can be challenging to navigate.  Our toes help to stabilize us to keep us from losing our balance.

Our feet are a complex part of our body with dozens of bones, ligaments and muscles.  The body’s muscles have an agonistic and an antagonistic action.  In other words, for active movement to occur in our body, one muscle pulls in one direction, and another pulls in the opposite direction.  When it comes to our toes, this creates movement such as flexion and extension.  If the muscles attached to the toes are unbalanced and one pulls more than the other, a toe deformity can occur.

What are hammertoes & mallet toes?

A hammertoe describes any toe that is bent at the first “knuckle” or joint from the base of the toe, causing the tip of the toe to make contact with the ground, instead of the padded, pulpy underside.  A hammertoe can develop on any toe on the foot, but most commonly affects the second toe.  A mallet toe is one which is bent at the second joint from the base of the toe. Just like a hammertoe, the tip of the toe will be subjected to pressure and friction from the ground.  Pressure and friction can cause calluses or corns and subsequent pain and discomfort on the tip of the toe and / or on the top of the toe joint. Toenails are also at risk of injury and damage, which can lead to thickening or ingrown toenails.

What causes hammertoes & mallet toes?

Hammertoes and mallet toes can be caused by genetics, toe injury, ill-fitting footwear, or an issue with how the foot moves when walking.  If there is an issue in the lower body mechanics, the muscles around the toes may become unbalanced as they compensate due to instability in the foot.

What can help hammertoes & mallet toes?

Toe deformities are mobile and can be moved and straightened when they first develop.  Over time, joints may develop arthritis and stiffen, becoming rigid and fixed in a bent position.  When toes are mobile, toe props can be worn to help “prop up” the tips of the toes and reduce contact with the ground.  Toe props are typically made of silicone and are available off-the-shelf or can be custom made.  A custom made toe prop is a functional device that can help straighten the toes when standing and walking.  This device will offload the pressure and friction on the tips of the toes and reduce the likelihood of painful callus, corns and wounds. Silicone toe sleeves can be worn over the toe to protect the skin over a bent joint.  Sleeves provide a buffer between the skin and footwear, reducing friction and discomfort.  Hammertoes and mallet toes can make finding comfortable footwear challenging.  Footwear with an extra depth toe box will accommodate toe deformities and allow toes to move freely.

The lower limb clinicians at BioPed Footcare can help you find the right footwear that fits well and is suitable for your feet and toes.  Custom foot orthotics are also effective at correcting issues in lower body mechanics that can lead to unwanted foot issues.  If your skin or nails are bothersome, BioPed’s medical footcare clinicians can provide treatment and an array of solutions to help you do more in life!

Toes come in all shapes and sizes.  They can vary in length and can even be bent, curly or crossed over another toe.  A toe that crosses over another toe is not necessarily problematic, but it can be if it is ignored and left untreated.

Crossover toes & possible complications

Genetics play a big role in how our feet move and look.  If your parents have a toe that crosses over another, you may be more predisposed to developing one at some point in your life.  Crossover toes can also be caused by injury or trauma, flat feet, high arches, lower body mechanics, tight calf muscles or a more serious underlying medical issue such as rheumatoid arthritis. Crossover or overlapping toes are considered a toe deformity because they are not typical or “normal.”

Crossover toes that are flexible can still be straightened with supports and devices.  Over time, they may become stiff or rigid which can lead to pain and discomfort.  Complications caused by crossover or overlapping toes can include:

• Callus and corns
• Blisters
• Difficulty finding footwear that fits well
• Hammer toes
• Metatarsalgia or pain on the ball of the foot
• Toe wound +/- infection

The most common toes that may become crossed over are the second and baby toes.  A bunion deformity in the big toe joint typically causes the big toe to deviate laterally or point towards the little toes.  As the big toe deviates more and more, it will press up against the second toe which causes it to lift up out of the way.  When this happens, the second toe may override the big toe.  An overlapping baby toe is commonly seen in newborns and oftentimes will spontaneously correct with development and walking.  It can also be treated early with buddy taping to the adjacent toe.

Treatment of crossover toes

Taping & splinting

A toe that is flexible can be moved and manipulated.  Taping or splinting can be useful to help straighten the affected toe.

Toe spacers

Toe spacers made of foam or silicone act as a buffer between toes.  They are beneficial as they protect the toes from excess pressure from being too close together.

Footwear

Shoes that have a deep toe box will allow more room for the toes and will accommodate toes that are crossed over.  This will help alleviate any discomfort due to pressure and can prevent skin irritation, such as blisters and corns, from developing.

Orthotics

If the crossover toe is caused by a biomechanical issue such as flat feet or high arches, custom foot orthotics and off-the-shelf insoles can be effective in correcting the position of the foot and making walking more efficient, which can slow down the progression of this common toe deformity.  They may also help reduce callus build-up.

Stretching

Tight calf muscles reduce the range of motion in our feet and ankles, which may change the way the foot moves when walking. Stretching increases flexibility, protects against injury and can also help custom foot orthotics work more effectively.

Surgery

Surgery may be required if pain and discomfort is severe and negatively impacts activities of daily living.  It is also a more permanent solution for those who have developed a chronic wound from their crossover toes.

Pain and discomfort due to crossover toes may cause you to alter the way you walk, which can create other issues such as knee or hip pain.  If you are experiencing any pain and discomfort because of a crossover or overlapping toe, give your local BioPed a call today to make an appointment with one of our lower limb clinicians to learn about what can be done or what you can do at home to feel more comfortable.

People become patients of BioPed Footcare for many different issues, but all for the same reason. They want to feel more comfortable and be able to do more in life. This month I sat down with a new client of mine who booked an initial assessment with me to talk about his foot pain. He mentioned that the pain on the sides and bottoms of his feet began when he changed his footwear recently.  He purchased a new pair of shoes for work which he felt were the right fit, but his foot pain gradually worsened after wearing them daily.  It became clear that his wider-set foot was being stuffed into ill-fitting shoes with a narrow toe box. Continuing to wear shoes that do not fit well or are not appropriate for your foot type could lead to biomechanical and structural issues.

We had a discussion about his lifestyle and activity level.  His job is physically-demanding and he spends a significant amount of time on his feet during each shift.  I noticed corns on his 4th and 5th toes on both feet and he complained of a sharp shooting type pain in his left forefoot.  I suspected a neuroma which is a ball of nerve tissue that results from chronic irritation of the nerve between the metatarsals or long bones.  I performed a test to determine if he did in fact have a neuroma in his foot by squeezing the forefoot bones together from each side of the foot.  The test was negative.  The pain he felt in between these two metatarsal bones was likely due to a neuritis or inflammation of the nerve.

During his appointment, I treated the corns on his toes by removing the hard and thickened skin layer by layer.  This provided instant relief.   To complete his footcare treatment, I applied an emollient to soften the skin and restore moisture.   The second part of his appointment was a biomechanical assessment, which included evaluation of the range-of-motion of the joints in his feet, which were all normal. My Pedorthist colleague and I conducted a gait analysis.  I like to watch my patients walk with one of the Pedorthists I work with because I value their perspective and skill set.  We consult with each other and problem solve how to best serve our patients.

Watching him walk, we noticed his arches were fallen and his feet appeared even wider. We decided to fit him for new shoes, by measuring the length and width of his feet.  He tried on a few different options and decided on a pair that provided comfort and stability.  The toebox was wide and allowed his toes and forefoot to splay and move without restriction.  These shoes gave him immediate relief from the pressure and pain he was experiencing.

I am thankful I met this particular patient and had the opportunity to speak with him about his foot pain.  Foot pain can be debilitating and can have a negative impact on work and life.  Two weeks after our initial appointment together, we saw each other again.  I was thrilled when he told me his feet were significantly better.  He was comfortable and the pain on the sides of his feet was dissipating every day. He was wearing his new shoes for work and was nowable to do more in his free time.  As a Registered Chiropodist, this is music to my ears!

At BioPed, our lower limb clinicians will provide thorough assessments and make recommendations for treatment for your individual needs. Give us a call to book an appointment today!