Bunions, hammertoes, corns, and calluses all make shoe buying a chore. But the wrong shoes can impair your mobility and independence. "Pain from any of those conditions can alter your gait," says Dr. James Loli, assistant professor of orthopedic surgery at Harvard Medical School.
Corns and Calluses
A corn is a protective thickening of the skin on a toe, usually on a bony portion. Corns may be hard (on top of the toes) or soft (between the toes). Corns typically develop from friction, often from tight-fitting shoes.
A callus is another type of protective thickening of the skin, and can develop anywhere on the foot. It's a flat, yellowish, hard layer. This, too, is the result of friction, either from shoe irritation or walking problems that place stress on the foot.
Treatment for corns and calluses involves softening the affected areas with warm water or a product that contains salicylic acid, reducing the dead skin by rubbing a pumice stone on it, moisturizing the area, and also wearing shoes that relieve pressure on the affected area. If you are diabetic or if you have peripheral vascular disease, you should not use any salicylic acid on your feet, because it could put you at risk for ulcers or infections, or both.
Bunions and Hammertoes
A bunion develops at the base of your big toe when two bones no longer connect properly, causing the base to jut out-ward. Some people are genetically vulnerable to getting bunions. However, bunions are more likely to develop in people (often women) wearing shoes that crowd the toes.
Hammertoes are deformed, bent toes that may result from poorly fitting shoes, a ligament problem, or a bunion that pushes one toe over another.
If bunions and hammertoes don't bother you, there's no need to treat them. "I have many patients who are runners with hammertoes and bunions who successfully compete without any trouble. It's all a matter of individual mechanical issues," says Dr. L
oli. If the deformities bother you, surgery to realign the bones is possible, but that is a last resort.
All of these ailments have something important in common: you'll need comfortable shoes to keep walking. That means avoiding shoes that are pointed, too tight, too short, high-heeled (more than one inch), or painful in any way.
Instead, look for these hallmarks of good fit:
a wide, roomy toe area (what shoe salespeople call the toe box)
length at least half an inch beyond your longest toe
a sturdy area around your heel (called a heel counter), so your foot stays in place and doesn't slip around, which can cause friction and pain
a wide, flexible sole to help support your foot.
"A soft inner sole will take the pressure away from your foot, like a neoprene-type sole or an air-pillow inner sole," says Dr. Loli. For hammertoes and bunions, he recommends using a shoe stretcher to spot stretch or widen tight toe boxes and relieve pressure.
Good shoe candidates are those with uppers made of soft leather or materials with some stretch, such as mesh fabric. Athletic shoes and sandals with adjustable straps are also good possibilities.
Even a roomy toe box may cause a little friction when you walk. That's when using moleskin pads on your toes or feet can help. These soft pads have an adhesive backing that you attach to an affected foot or toe area, or to the inside of your shoe. It protects against friction. You can find moleskin pads in drugstores. Toe separators can help relieve pain from corns be-tween the toes.
Some shoes are designed specifically to relieve pressure on bunions. You can find them in specialty shoe stores. But prepare to pay more for these kinds of shoes. They typically run $100 to $200 per pair. Are they worth it? "If they relieve pressure points and decrease pain on the bunion or hammertoes or any deformity, that's good," says Dr. Loli, "but you can find comfortable shoes for less if you do a little detective work."