Why consult?

Corns and calluses are formed because of the thickening of the superficial layer of the foot’s skin. In most cases, they are the consequences of an excess of friction, rubbing or irritation depending on the foot type (flat or high arched) or as the result of the type of shoes worn.

Corns limit themselves to the soles of the feet, pressure points or boney areas of the foot. The corns that develop between the toes are often referred to as a “partridge­eye”. Corns are very hard and have a deep conical core and can be very painful.

Calluses characterize themselves by a thickening and yellowing of the skin in broader areas such as under the forefoot and around the heel.

Walking on tiptoe may simply be a passing phase – perhaps the child has developed an unconscious habit or is imitating behaviour he sees in others. However, walking on toes may also signal an immaturity of the neuromuscular system linked with certain pathologies or a localized contraction of the calf muscles.

For this reason it’s important to consult with your podiatrist. They will consider the family and perinatal history, perform a neurological exam and assess the way the behaviour is manifesting itself, whether unilateral, bilateral and/or intermittent in nature.

Walking with feet turned inward – known as “intoe” or “intoeing gait” – is a common and troubling concern for parents, especially when it leads a child to stumble frequently.

One or more things could be playing a part in the condition – high tension of the pubofemoral ligament at the hip or internal torsion of the femur, knee or leg can lead the feet into a “C” shape. The nature of the deformity, a child’s age and the severity of the problem are all factors in determining the prognosis and possible treatments for a growing child.

Heel pain can be sudden. It can be the consequence of inappropriate shoes, participation in a new sport or an increase in physical activity, a fall, an impact or an injury. Pain can also arise slowly, as the result of a progressive misalignment of the foot due to a flat foot, a high arch foot, recent weight gain or your type of work. It is possible that only one heel be affected as it is also possible that both heels cause discomfort and pain simultaneously.

Over the years, an adult, or even a child, may develop discomfort and pain related to muscle fatigue.  Knee and back pain are common and result from accident, sports injury, work, and very often bad postural alignment stemming from the biomechanics of a person’s feet.

Everyone is familiar with the common condition known as an “ankle sprain”. It occurs when a movement stretches the ankle ligament, whether during walking, running, sports or as a result of an accident. The ankle becomes sensitive to contact, bearing weight, or certain movements, and appears swollen and bruised (internal bleeding tissue gives the area a “blue” appearance that tends to change color over time following the injury). It is important to correctly assess the severity of an ankle sprain in order to begin the right treatment plan.

Ankle instability doesn’t appear out of the blue. It develops through a loss of muscular support from the leg muscles. Ligament deficiency in the ankle following multiple sprains can further weaken stability. Ongoing ankle discomfort and weakness could be caused by poor alignment of the feet, tendonitis, nerve compression, an infection, gout, arthritis or an internal fracture.

If a child frequently asks to be carried when walking it could be a sign that he or she is experiencing fatigue and/or pain. Of course, this depends on the age of the child and parents play an important role in recognizing and describing what is normal or a new habit in their child. Discomfort, fatigue or pain in walking is not normal in children. Evaluation at a young age is recommended in order gain a deeper understanding of the biomechanics of the child’s feet during their development.

Heel cracks are often a result of dry skin. Lack of skin hydration is frequently to blame. A dry indoor environment in winter or walking barefoot or in sandals during summer months can also lead to the problem. In some cases, dry skin or cracks could be linked to eczema or psoriasis.

Morton’s neuroma is linked to chronic irritation of a nerve through squeezing or pressure. The affected nerve is found between two bones in the forefoot, usually the third and fourth metatarsus. The nerve causes sharp intermittent pain under the foot and toes. Nerve inflammation can be experienced as electric shock sensations, burning, numbness, tingling, discomfort in narrow shoes or feeling as though a sock is misplaced on the forefoot.

Nerve irritation could be caused by wearing of narrow or high-heeled shoes, a change in foot biomechanics, worsening of flat or high-arched feet, an excessive stretching of the foot leading to the development of a wide forefoot or growth of an abducto hallux valgus (bunion), carrying excess weight or participation in a sport that puts pressure on the forefoot such as cycling, running, etc.

Bunion is the common term for a medical condition called hallux abducto­valgus. It is a bone deformity caused by a deviation of the big toe towards the second. Therefore, the metatarsal bone finds itself projected to the outside which creates an enlargement of the forefoot. This change can occur as early as childhood and throughout adulthood.

This diagnosis can be related to many causes such as heredity, flat or high arch feet, excess elasticity in the foot’s ligaments, or to the contrary, rigid ligaments, neurological disorders or joint conditions.
Unsuitable footwear can accelerate the deformation and worsen symptoms such as pain, swelling and redness.

Ingrown nail, onychocriptosis, refers to a condition in which the nail grows into the skin that surrounds it. The nail can cause mild discomfort to severe pain, redness, inflammation, clear discharge or puss. This condition could be the result of improper nail cutting, congenital deformity, a trauma to the affected toes, a large toe nail, sudden swelling of the feet, as may occur during pregnancy, or wearing tight and pointy shoes. The condition occurs most commonly in the big toe but the other nails can also be affected. It is essential to consult as soon as possible to avoid infection of the underlying tissue and bone.

Over the years, toenails change shape frequently as a result of a person’s genetics, stress from wearing shoes, regrowth after nail loss, poor trimming, chemotherapy, fungal infections (fungus, mycosis) and/or systemic diseases such as psoriasis or eczema. It can be difficult to completely remedy the situation once the cells responsible for regrowth of the nail (nail matrix) have been affected, permanently changing how the nail grows. Regular care for your feet will help when it comes to cutting nails, comfort, well-being and a better aesthetic appearance.

Onychomycosis is a fungal infection that can affect your nails. It is a microscopic organism that grows particularly well in warm humid places like your shoes. The infection can cause a mild peeling of a nail but it can be severe enough to access the root of the nail. The toe nail will typically change colour and become yellowish, brownish or whitish. Nail fungus is very common but not a health risk. If untreated the nail can thicken at which point discomfort, more serious pain and infection can occur. Treatment of the fungus is reliant on whether one toe or all of the toes has been affected.

Hammer toes are caused by changes in the alignment of the toe joints. From flexible to rigid, hammer toes will vary in shape depending on its progression and according to the specific affected joints. As the condition evolves, the affected toe becomes more rigid, elevates, rubs against the top of the shoe and causes discomfort. The deformation of the toe is often the result of a muscle imbalance caused by unfavorable biomechanics of the foot. Hammertoes may also be the consequence of a neurological problem, diabetes or inappropriate shoes.
A hammertoe present in the second toe and hallux abducto­valgus often coincide. In addition, the loss of ground support for the hammer toe, due to increasing rigidity, can cause pressure under the forefoot and create conditions such as metatarsalgia; pain in the ball of your foot.

A high-arched foot, sign of a prominent plantar arch, could be the result of a congenital, genetic and/or neurological problem. Very high arches are associated with the following symptoms, which appear alone or in combination – hard heel skin, calluses and corns, hammer or claw toes, pain in the feet, ankles or knees, or back pain from postural misalignment.

Athlete’s foot, tinea pedis, is an infection caused by a microorganism similar to onychomycosis. It affects the skin between the toes, the outside of the foot and the sole of the foot and grows well in hot, dark, moist places or after excessive sweating. It can be contracted after skin exposure to shared surfaces like floors in the locker room, public pools, hotels, spas, etc. The site is often itchy and creates skins changes such as desquamation, red spots or dots and cracks can occur. These symptoms are similar to other skin conditions. It is therefore important to consult.

Diabetes is a common but chronic illness that is generated by a high level of sugar in the blood.
Certain foot conditions are related to complications that can develop over time in diabetics. These conditions typically affect the nerves and blood vessels and can provoke a loss of sensation in the nerves of the feet and other extremities. This is referred to as neuropathy.
A condition called arteriopathy, that slows the blood’s circulation to the feet and toes, is also a risk factor of diabetes. Arteriopathy can affect the body’s ability to heal and increase the risk of infection therefore increasing the complications that could arise during the treatment. In some cases, when left untreated, the infection can result in gangrene or amputation.
Fortunately, the majority of complications due to diabetes can be avoided if the preventative advices of a general practitioner, a specialist doctor or a podiatrist are followed. It is strongly recommended that a patient with diabetic foot consult once a year in order to remain proactive about changes in their foot health. You should also be looking for the presence of corns, calluses, blisters, cuts, irritations, swelling, ingrown nails, etc.

Flat foot, also referred to as over pronation, is characterized by an abnormally flat foot arch in children or adults that will affect the alignment of the musculoskeletal system. This very common condition can be congenital, the result of hypermobility of the ligaments or rigidity of the calf muscles, an anomaly in the biomechanics between the forefoot and the heel or many other conditions that can affect one’s posture. With time, over pronation can cause foot and ankle pain. Repercussions can also present themselves in the knees, hips and back.
At birth, the arch of a baby’s foot is barely present. It is very important to have your child’s feet evaluated as soon as possible to ensure that the arch develops properly throughout childhood. The earlier they’re treated the greater the chance of correcting and preventing future pain.

Any tendon subjected to an increased work load can become inflamed and develop into what is known as “tendonitis”. This is more likely to happen if you are engaging in a repetitive motion, if endurance is low, if the intensity of an activity is increased too rapidly or, less commonly, if you have an inflammatory immune disease.

Tendinitis affecting the Achilles tendon is common, occurring behind the ankle where the tendon can be seen and felt as well as where it meets the heel bone, the calcaneus. Foot mechanics should be optimized for walking or sports as poor foot movement is a risk factor for tendonitis, whether you have flat or high-arched feet.

Excessive sweating (hyperhidrosis) causing smelly feet is called “bromhidrosis” and occurs regardless of good hygiene. The condition may occur at any age and at any time of  year. The smell comes from microorganisms such as bacteria that are found on sweaty skin, most often when wearing shoes. This can be a source of embarrassment to the person with the problem. 

Plantar warts are caused by a skin infection triggered by the human papillomavirus (HPV). The virus causes benign lesions on the sole of the foot and around the toes. It can be transmitted by direct contact and may take several weeks to a month before it appears. The plantar wart will be characterized by thick rough skin, a round shape and darker colouration in the center. They can be contracted at any age and typically after a bare foot has been exposed to the floors in a public place such as locker rooms, pools, hotels, spas, etc. The virus may also penetrate the skin by way of a small cut or abrasion. Unless it is located on a pressure point, they are usually painless. In some cases the immune system is able to heal the warts but in most instances the treatment by a medical professional is necessary.