Pressing Issues – Effective Help for Pressure Ulcers on the Foot

Almost all of us have experienced those annoying pressure points on our feet. These skin changes are not only unsightly, but can also be really painful. They form if the tissue is subjected to constant strain and is continuously exposed to friction and excessive pressure. If we wear unsuitable footwear – such as shoes that are too tight or have a toe box that is too pointed – or are on the move barefoot in shoes after a long break, then straps, heel counters or toe bars can quickly start rubbing against delicate, unprotected areas of skin.

The first reaction to irritation is usually the formation of blisters, particularly on the heels and toes: the skin swells and fills with fluid. This can be so painful that walking any further is out of the question. Nevertheless, you should never pierce the blisters yourself in the hope of quick relief, as this increases the risk of infection!& nbsp;

Relief can be achieved with special blister plasters: they deliver a gel layer over the affected area, which maintains a moist environment and protects against further friction while promoting healing. For especially strenuous activities or sports, they can protect against further friction and promote healing. peclavus-podocare-hautschutz-stick-23-g/5401801/" title="View product">peclavus® PODOcare Skin Protection Stick with deer tallow protect the skin from chafing inside shoes and excessive callus formation.

Calluses as a protective shield

The fact that calluses are reinforced by pressure and friction is initially a protective mechanism of the skin – to prevent blisters and sore spots. External stimuli stimulate cell division in the epidermis. It sheds more dead cells outwards thanks to cell division. It sheds more dead cells outwards until thickened layers of keratin appear.& nbsp;

Hyperkeratosis typically forms on the balls of the feet and the heels; however, it can also form on the toes, the tips of the toes, between the toes or near the nail fold. However, it should not, if possible, stay in this state, as otherwise the protective layer itself can cause further problems.

Corns – pressure from all sides

Corns (clavi) can be especially debilitating and painful. These rounded, sharply defined calluses with a central, deep-seated spur – a tissue change resembling a thorn in shape – form if continuous pressure is exerted on skin close to the bone. Professional removal of the corn can be carried out using a scalpel, medical blade, skin forceps and/or a hollow bur. During treatment, any orthopaedic changes to the foot (spread foot, flat foot, hammer toe and claw toe) should always be addressed as well.

Corns (clavi) can be especially debilitating and painful. These round, sharply defined calluses with a central, deep-seated spur – a change in the tissue that resembles a thorn in shape – form if continuous pressure is exerted on the skin close to the bone. Professional removal of the corn can be carried out using a scalpel, medical blade, skin forceps and/or a hollow bur. During treatment, any orthopaedic changes to the foot (spread foot, flat foot, hammer toe and claw toe) should always be addressed as well.

Skin cracks as a risk factor

Thanks to heavy pressure and friction, calluses can split open. These cracked skins (rhagades), which tend to form on the heel, can extend deep into the dermis, cause severe pain and even bleed. They provide an ideal entry point for a wide variety of germs, which can contribute to the formation of fungal infections, for example.

To manage the cracks, regular care is essential. An occlusive dressing, which provides a highly regenerative care product, provides an ideal solution as an intensive professional treatment. A suitable option is, for example, the peclavus® PODOcare Anti-crack Balm, which promotes the skin’s metabolism and elasticity with natural propolis extract and carnauba wax. It can be used as a base for an occlusive dressing with the RUCK® DRESSINGS Occlusive Dressings, which can allow the care product to take effect in an airtight environment over two to three days. It goes without saying that the skin should also be consistently treated at home with ointments containing ingredients that balance the skin’s oil and moisture levels. Besides carnauba wax, these can include lanolin, urea, panthenol or bisabolol.

The consequences of foot deformities

Redness, calluses, corns and hard skin are inevitable if foot deformities are present, whether these are congenital or result from long-term use of unsuitable footwear and untreated foot conditions, e.g. hallux valgus, splayfoot, hammer toes and claw toes along with other conditions.

In the case of hallux valgus, the big toe is pathologically misaligned, bending outwards at the metatarsophalangeal joint. Yet, a splayfoot is usually in place, which means the bunion on the big toe protrudes noticeably on the inner edge of the foot. Pressure from the shoe upper often leads to painful inflammation. The pressure from the big toe can also cause hammer and claw toe malalignments in the neighbouring toes.

In the case of hammer toe, the middle joint of the toe is bent upwards then so severely that the tip points towards the base ‘like a hammer’. Claw toes, on the other hand, are characterised by highly severe hyperextension at the metatarsophalangeal joint and flexion at the middle and distal joints. The tip of the toe does not touch the ground. Typical foot problems arise because the affected toes become progressively shorter over time yet take up more vertical space. This leads to pressure points inside the shoe and, consequently, calluses and corns along with them. Hammer toe pads, available in various designs and materials, deliver relief. Along with this, silicone toe caps, which relieve pressure all around the problematic areas, along with toe rings, toe sleeves and felt rings, are recommended.

In her latest video, Elisabeth Prinz explains in detail how to prevent common pressure-related problems through appropriate care and footwear, and how to provide individual relief in acute cases using suitable pressure-relief measures. She also demonstrates which small aids can be particularly effective for conditions such as heel spurs or forefoot pain. 

See with your own eyes!

Elisabeth Prinz is a podiatrist and alternative practitioner specialising in podiatry, and runs a thriving practice in Neustadt an der Weinstraße. A passionate podiatrist, she gives her extensive expertise to anyone interested through her videos. You can find a collection of videos by and featuring Elisabeth Prinz on the HELLMUT RUCK GmbH YouTube channel.