1. By Simone Eisses Foot Forward team Hallux Valgus - Metarsalgia In this study case we will explain the treatment for toe deformities that causes corns and callus at the plantar side of the foot. This woman came to our clinic with pain at both feet, located at the plantar side. She has metatarsalgia and in the next few lines we investigated how it was caused. As you can see at the pictures, you see at the first picture a biomechanical problem (hallux valgus deformity left foot). This changes the total foot function, structure, and causes callus underneath the foot and corns. Knocked knees Callus Hallux valgus deformity

2. By Simone Eisses Foot Forward team 815 kPa390 kPa 485 kPa 330 kPa An example of high pressure values in the forefoot causes by a biomechanical problem and because of the deformities from the toes especially in the left foot. The red/pink colors are showing the highest values. The line in the middle shows the gait while the patient is walking. You can see that there is too much pronation: the gait line goes more to the medial site than lateral. Take a look at the measurements!

3. By Simone Eisses Foot Forward team Management of corns and callus: - Just remove the callus? -Biomechanical cause? -Are my shoes okay? -Genetic cause ? (hallux valgus) If there is a biomechanical aetiology, this needs assessing and managing with orthoses or surgery. If poor fitting shoes are the cause, then suitable footwear advice must be given along with goal setting and agreement with the patient. Literature: Excess mechanical stress and duration of loading of tissue during gait at foot-ground, foot-shoe or toe-toe interfaces damages the skin. The physical and biomechanical changes in skin result in callus and corn formation and slight fibrosis in the dermis with changes in subjacent microvasculature.

4. By Simone Eisses Foot Forward team Treatment patient study case: For this case study we made orthotics: Off loading the pressure at the front (fore foot) together with some biomechanical corrections to create at better way of walking. Pedar (in shoe) measurements with the orthotics we made for this woman. We can see the offloading effect together with the biomechanical changes. Our shoes with the orthotics. 815 kPa  298 kPa 485 kPa  253k Pa