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A Tailor’s Bunion is a complex deformity that involves the following foot pathology:

Tailor’s Bunions are a progressive deformity, and if left untreated the bump will become larger, and the little toe will eventually lie over or underneath the fourth toe.

The most common causes of lax (flexible) foot ligaments are:

Tailor’s Bunion progression may be hastened by:

This will allow the feet to function normally. As a result, the deformity should not worsen, and the pain should gradually subside. If the foot is not re-balanced, the deformity and pain will become worse. In addition, comfort is also provided to the arch, shins, knees, and lower back by the use of modern materials. These unique materials provide semi-flexible support to the arch by absorbing the shock of each step, rather than our foot absorbing the shock. When your weight is removed from the orthotic, the arch returns to its original height since the material we use has a built-in “memory.”

Short-term pain relievers include the following:

Of Note: Corns not treated in patients who may be neuropathic and or diabetic may not feel the discomfort of the corn. These patients are at risk for ulceration of the affected corn. Ulceration may be serious as it can cause infection to reach the underlying bone. Ulceration in vascular compromised patients can lead to serious complications including infection and even possible amputation.

Types of Corns

Hard corns (heloma durums) are the most common type. They are caused primarily by ill-fitting shoes and toe deformities such as hammertoes. They usually develop on the tops and tips of toes. These corns are usually hard and dry.

Soft corns (heloma molles) usually are the result of bone spur formation in the toes. They are found between the toes and usually are white in color and frequently appear moist or macerated.

What Are The Differences Between Corns and Calluses? The two biggest differences are the location and size of the lesion. Corns are small and round and are located on the top, tips, or between the toes. Calluses on the other hand, are larger, flatter, and can be found on the bottom of the feet.

The thicker the hard dead skin of the corn, and the more it is irritated, the more noticeable are the symptoms.

Common symptoms of corns include:

Predisposing Factors: Those factors, which increase your chances of developing corns:

Regardless of the cause, the painful corn must be protected from shoe pressure for the pain to subside. Buying shoes with a wide and deep toe box (the part of the shoe where the toes sit) may give some relief. The following remedies are prescribed by doctors to relieve shoe pressure, toe pressure, and pain in these toes, or to help the toe lie straight, thus alleviating pain and preventing the corn from becoming worse:

Relief and prevention of corns due to hammertoes (corns that form on the top and tips of toes):

Relief and prevention of corns due to bone spurs (soft corns that form between toes):

Self-treatment with the use of razor blades, knife blades, or nonprescription preparations of acids should not be attempted because of the risk of injury and infection.

If Conservative Care Fails

If conservative treatments fail and your symptoms persist, the doctor may recommend a surgical option. The procedures vary greatly, depending upon the reasons for the corn. If a hammertoe is responsible, the podiatrist can perform surgery to straighten the toe. There are a number of different operations to straighten the toe, the most common ones involve:

Because of the possible complications involved with any surgery, one should be sure to understand the risks that may be involved with surgery to treat corns, correct hammertoes, and remove bone spurs.

Sweat is basically composed of just salt and water, so it does not have a smell of its own. The smell occurs when bacteria that normally live on the skin eats the sweat and excretes waste that has a strong odor. The bacteria combined with sweat produce Isovaleric acid which actually causes the odor.

So why don’t our hands, which have about the same number of sweat glands per square inch as our feet have, produce foul odors? Because hands are exposed to the air and the sweat has a chance to escape into the air, or evaporate. Sweat does not accumulate on our hands as it does on our feet.

Feet on the other hand, are trapped inside socks and shoes, where temperatures can easily reach 100 degrees Fahrenheit. The perspiration, which cannot escape into the air (evaporate) due to lack of airflow in the shoe, combines with the dark warmth of the shoe to create a breeding ground for bacteria. When the increased numbers of bacteria feed on the sweat, more foul smelling bacterial wastes are produced. The more waste produced, the worse the foot odor.

The two most common causes of pain in the bottom of the heel, the arch, or both the heel and the arch, are heel spurs and plantar fasciitis.

A Heel Spur is a piece of calcium or bone that sticks out from the bottom of the heel bone, and lies within the fibers of the plantar fascia. When walking, the spur digs into the plantar fascia and causes small micro-tears in the plantar fascia. This produces inflammation and pain in the heel, which at times may radiate into the arch.

Plantar fasciitis is an inflammation of the plantar fascia. The plantar fascia is a thick ligamentous/fibrous band on the bottom of the foot that is attached to the heel, and runs forward to insert into the ball of the foot. Plantar fasciitis is a painful inflammation of this band, which usually occurs at its attachment to the heel; however, the inflammation and pain of plantar fasciitis can occur anywhere on the plantar fascia.

Frequently the heel pain that is experienced is due to the presence of an ““adventitious bursa””. The bursa is a thin walled cystic like lesion that is meant to be a response to pressure and irritation. It is referred to as being ““adventitious”” as it is not anatomical. It is only present as a response to chronic irritation and pressure. When the patient steps down for first weight bearing the bursa is distended. Weight bearing compresses the bursa causing pain. As walking continues, the pain lessens somewhat. If overuse occurs, pain returns.

The chief diagnostic sign of these problems is pain in the bottom of the heel or arch when first standing, which gradually improves with walking. This pain may later return with continued walking. The pain usually subsides after a period of rest.

The treatment involves correcting the underlying causative problems. Please read the following sections for more information on the problem and its treatment.

The pain that is experienced with Iliotibial Band Syndrome is located on the outer aspect of the knee. It is not a pain felt within the joint, as it does not affect the knee joint itself. If you flex the knee about 30 degrees, and apply pressure to the outside of the knee with your fingers, and if you experience pain, then you may have Iliotibial Band Syndrome. Another way to test for this condition is to walk stiff-legged (not bending the knee); if this produces no pain but walking normally (bending the knee) does produce pain, then you may have Iliotibial Band Syndrome.

What is Iliotibial Band (I.T.B.) Syndrome? The I.T.B. is a thickened strip of fascia or muscle cover. It begins as a thick band that covers the outer thigh muscles, and travels down the outside of the leg to the knee joint, where it attaches to the outer edge of both the tibia and fibula, just below the knee joint. In so doing, the I.T.B. must lie against the protruding outer edge of the femur, just above the knee joint. As the knee is flexed and extended, the I.T.B. rubs against a thin fluid filled sac (a bursa), between it and the femur. The bursa acts to reduce friction, and to protect the I.T.B. However, when the bursa does not function properly, or there is a change in your running or cycling pattern, or a biomechanical foot or leg problem begins acting up, the I.T.B. becomes inflamed and painful.

Biomechanics: As an athlete runs or pedals a bicycle, flexion and extension take place at the knee. When the knee is flexed 30 degrees or more, the I.T.B. passes over the outer protruding edge of the femur, shifting posterior behind the edge of the femur. As the knee is extended, the I.T.B. passes back over the edge of the femur, and shifts anteriorly in front of the femur. It is this motion that commonly leads to irritation and pain of the I.T.B. and its protective bursa. If a biomechanical defect is present, such as bowlegs or pronation in the feet, the I.T.B. rubs against the edge of the femur with more force, causing greater irritation and pain.

A Neuroma, or Morton’s Neuroma, is a benign soft tissue mass that forms on the nerve that runs between the metatarsals, in the ball of the foot. It is not actually a tumor but a perineural fibrosis. There is a confluence of the medial and lateral plantar nerve between the third and fourth metatarsal heads and often at this junction the nerve is somewhat thicker. An intermetarsal neuroma can affect other spaces; the most common however is the third intermetatarsal space. The deep transverse ligament lies over this area and it is thought to apply some additional pressure. When two metatarsal bones rub together, they pinch the nerve that runs between them. This repeated pinching, or continuous minute trauma to the nerve, will cause the nerve to swell, and eventually a benign mass occurs at the site of the repeated injury. This mass is known as a Morton’s Neuroma (named after the physician who first described this mass, Thomas Morton in 1876).

Nail Fungus (Onychomycosis) is a progressive disease of the toenails and fingernails. Nail fungus is the most common cause of discolored, thick, and deformed toenails. Not all discolored and thickened nails are fungus infections. There are other conditions that will cause the nails to have a similar appearance i.e. psoriatic nail disease, dystrophic nails as maybe present in patients with compromised circulation. Toenails are affected more often than fingernails because the fungi that cause this disease thrive in the dark, warm, moist environment that is found in our shoes. Infected nails may first appear as a yellowish, white, or green discoloration of a small area of the toenail. If left untreated, the entire nail may eventually become discolored, thick, flaky, detached from the underlying nail bed; and an accumulation of dead, white, dry material may form between the nail and underlying nail bed. The infected toenails are usually not painful until the nail becomes so thick that it rubs against the toe box of the shoe.

What is a Fungus? Fungi (plural) belong to a group of primitive organisms that includes mushrooms, yeasts, rusts, and molds. The most common species of fungi that attacks the skin and nails of humans fall within the category known asdermatophytes. Dermatophytes are the parasitic fungi that attack and cause diseases of the skin and nails.

Rate of Nail Growth: Nails grow from the day we are born until we die. The rate at which nails grow becomes slower as we age; certain diseases, poor circulation, dietary deficiencies, some medications, and chemotherapy can also affect growth rate. Fingernails grow faster than toenails, at a rate of 3mm per month. It takes 6 months for a fingernail to grow from the root to the free edge. Toenails grow about 1 mm per month, and take about 12 months to be completely replaced.