Put A Spring in Your Step without Winding up Wounded
Spring has sprung! And there are many new activities that you’ll want to join in, this spring. So how can you be sure that you’re putting your best foot forward? We have recently been focusing our series on pressure ulcers that occur because of immobility. Now we will focus on a common skin condition caused by too much mobility: calluses. Are they friend or foe?
All of us have probably had the experience of doing a new activity or something we haven’t done in a while, like raking leaves or playing guitar or walking in a new pair of shoes and experienced some blisters or calluses on the thin-skinned areas of our feet or hands. Conventional thought says that we should just keep doing this and our skin will toughen up. IF you have normal sensation and circulation, calluses can just be thickened layers of skin that come with repetitive activity. They initially protect the skin from breakdown.
But what about the “high risk” foot? What about those who have peripheral neuropathy, loss of protective sensation in the foot? What about those with peripheral arterial disease or decreased blood supply to the foot? Are calluses safe for these feet? First, let’s take a few steps back.
What is a callus?
Callus is defined as a “common, usually painless thickening of the stratum corneum at locations of repeated, external pressure or friction” (AAWC Wound Glossary).
There are 2 types of pressure on feet:
Direct pressure: standing, weight bearing pressure
Friction: resistance between two surfaces rubbing together.
If the callus gets too thick and goes unattended, then the callus itself that starts out protecting one’s skin can become the problem itself, many times causing a wound. Remember: pressure wounds are caused by tissue usually stuck between a rock and a hard place – the bone and the callus. No oxygen can get to the tissue and so it erodes and can cause a wound.
Callus can actually be a pre-ulcerative lesion. Many times there are speckles of bruising or blood in the callus and it is actually hiding a wound beneath it. One study by Sage found that 82% of diabetic foot ulcers are preceded by calluses.*
Take a look to the left at what is lurking beneath this callus: