MSN RN PhD(c) CFCN CFCS
As the weather begins to cool down, to keep feet warm and comfortable winter behaviors start happening including snuggling into slippers or warmer, thicker socks. From a foot care nurse perspective, this is also a time when we see an increase in painful corns and calluses. These are conditions that are easily avoided with a little knowledge about foot care. Feet that hurt impact activities of daily living and can even lead to falls. Who wants to get off the couch or go for a walk with hurting feet?
With regard to foot care, it is actually true that an ounce of prevention is worth a pound of cure. But what does prevention actually look like? When it comes to corns, calluses, and blisters, it is typically shoes and socks that are to blame. In our practice, almost everyone who comes in with a corn or a callus is wearing shoes and socks that are not fitting well. We take care of a large variety of people including runners and walkers, elders and diabetics, so it isn’t just an elder problem, it’s a not “knowing” problem.
The main shoe culprit is that people think that their shoe size is from back of heel to tip of the longest toe. While this is somewhat correct, because you don’t want to purchase a shoe that is too small for your whole foot, the reality is that some people have long toes and some people have short toes. You can have the same total length but where your foot bends, at the metatarsal joint, is different for each person. Think short wheelbase vs long wheel-base. You want the shoe to bend where your foot bends. If your foot is not bending in the same place as the shoe, then you are at risk of developing a callus. If your foot is sliding in the shoe then you are at risk of developing a corn. Slippers and loose fitting socks are notorious for helping people grow corns. Shuffling those loosely slippered feet across a carpeted floor is hard on your skin. While those slippers may be comfortable while sitting, the loose-fitting materials cause friction on your skin every time you take a step. If you can put your finger in the back of the heel of your shoe or slipper then you are not properly positioned in that footwear. Shoes, slippers, and socks are supposed to be preventing injury not causing it.
Think about what happens to your hands if you rake leaves with loose gloves. Loose gloves cause blisters. Loose socks and shoes can give you blisters, calluses and sometimes corns. Corns are like thorns in the bottom of your feet. They are very painful and you don’t want them. Shoes and socks are like gloves for the feet. They are supposed to fit you well and serve the purpose you want them to. It’s much easier to change your shoes and socks than it is to change your feet
Socks should fit snuggly and be made of a material that wicks moisture away from the feet. They should not wrinkle up under the toes or fall down. The seams should not press into your skin. If they are leaving a mark then they are not doing their job.
Shoes that fit protect your feet. We have found that the best way to test your shoe fit then is to take the insert out of the shoe and hold it up to the bottom of your foot. With your heel in the back of the insole, observe – does the widest part of your foot match the widest part of the insole. If it does not, then that shoe is not designed for you. If it does, then that shoe is the right size and you also need to understand the volume of a shoe. Volume is adjusted by lacing not by moving up a ½ size, which is what many people are apt to do. Shoes work by securing your heel into the heel of the shoe. When this happens the shoe moves as one with you instead of flapping behind or flopping around. You want the shoe to be one with your foot because then it protects your foot rather than causing all sorts of problems.
Remember, your shoes and socks are supposed to be protecting your feet not hurt them. Hurting feet hurt people. Healthy feet are happy feet and we all deserve happy feet.
Please note – While not life-threatening, corns and calluses are not normal in healhty feet and should be treated and prevented. Corns and calluses can cause falls and may lead to wounds and infections. Our certified foot care nurses are trained to remove corns and dress calluses along with providing you an education about how to prevent them. While you are in charge of your own feet, seeking professional help to address corns and calluses may be in your best interest. Professionals who can help are trained in foot care and include podiatrists, foot care nurses, and medical professionals who can perform surgery.