Heel calluses, also called plantar calluses, develop when one metatarsal bone is longer or lower than the others and it hits the ground with more force than it is equipped to handle. As a result, the skin under this bone thickens. The resulting callus causes irritation and pain.

In most cases, heel calluses can be treated without surgery. In severe cases, however, a surgical procedure, called an osteotomy, is performed to relieve the pressure on the bone. The procedure involves cutting the metatarsal bone in a "V" shape, lifting the bone and aligning it with the other bones. This alleviates the pressure and prevents formation of a heel callus.