FIXING YOUR FEET E-zine – Calluses, My Best Ever Blister Patch, and much more

August 30, 2007 by
Filed under: Foot Care, Footwear, Health, Sports, Travel 

FIXING YOUR FEET E-zine


Volume 7, Issue 8, August 2007
John Vonhof, Footwork Publications
Copyright, August 2007, All rights reserved


THIS ISSUE IN SUMMARY

The editorial this month is Are Calluses Really Bad? My feature article
is My Best Blister Patch Job Ever, about my most challenging blister
repair job in years. There is a bad feet photo and remedy, another bad
feet photo and story, information on a new gaiter strap, feedback on
the staph infection articles from last month, feedback from Badwater
runners, and an idea of what to do with the shoes you no longer use.


PURPOSE

The Fixing Your Feet E-zine is published monthly to inform and educate
athletes and non-athletes about proper foot care skills and techniques,
provide tips on foot care, review foot care products, and highlight
problems people have with their feet.

EDITORIAL: ARE CALLUSES REALLY BAD?
Over the seven years of this newsletter, one of the most written about subjects has been calluses. They are commonly found on the feet of athletes. They are more common in the spring and summer months. I believe they are more common on men‘s feet than women’s feet. They are common on heels, the ball of the foot, the sides of the forefoot, and sometimes under toes.
     They start thin and small, and can grow to be thick and large. They can become so thick that they interfere with the fit of shoes. They can lead to blisters at their edges. They can lead to deep blisters underneath the callus. They can also be protective against blisters for some people.
     Some people value their calluses. They want the extra buildup of tough skin. Many of these people know their feet and know the blister help them. They deal with the occasional blister at their edges. They may file down the rough edges. For them, the callus help prevent blisters.
     Other people, however, have found that the calluses are a problem because they lead to deep blisters, or even worse, issues as in my feature article this month. They may be painful underneath. They may crack and/or lead to open fissures (splits) in the skin. These are very painful and take a long time to heal. Here is a story on runner sent me after a race:
     “Today, I was able to take off a very thick large layer of dead skin on my foot, almost the entire distal 1/2 of the foot! It feels so much better now. It just kept peeling and peeling and the whole callouse and blister (which I thought was gone) seemed to "come to the surface" and I was able to remove them. (I had been filing the calluses frequently but couldn’t get through them completely.) Now, I have baby fresh skin! Yippee! I was worried for a while that I was going to have recurrent trouble. Now I’m not.”
     Personally, I am against callus buildup. I have found they lead to more blisters and deeper blisters than for those who do not have blisters. While calluses can be good, most often they are bad. Let me know what you think.

I welcome your opinion on this editorial. Send me an email.

BAD FEET PHOTO AND REMEDY
Jamieh_feet_1_2Last year at Badwater I had the honor of getting to know Jamie Honeycutt as a member of the medical team (registered nurse). I admired her southern drawl and found her to be one of the most upbeat and positive people I have known. This year she came to Badwater to run. She had a great run, coming in at a very respectable 41:24:10 – and was the 6th women. She sent me an email with this great picture of her feet. I know many of you will appreciate it. Jamie wrote: “I thought I’d send you a picture of my feet at their worst (Friday after Badwater) along with my favorite remedy. :-)”

FIXING YOUR FEET, 4th EDITION
The 4th edition of Fixing Your Feet can be ordered through my FixingYourFeet.com web site, ZombieRunner.com, or Amazon.com. Completely updated, it has three new chapters and lots of new sections. The new retail price is $18.95 but these days no one pays full price! So, whichever of the sites you choose, the price is comparable.

WRITE AN AMAZON REVIEW FOR A FREE COPY OF HAPPY FEET
Betsy sent me an email: “I just wanted to let you know that I posted a review of your excellent book, Fixing Your Feet, on Amazon just this evening. Of course, I’m hoping you will send me that free 36-page copy of Happy Feet, but frankly, even if you didn’t, your book has been such a wonderful resource for me that I’m telling everyone I know about it. Of course, people are sick of hearing about my feet by now, and the 3-Day event, and walking in general, unfortunately, but I’m gratified to know there are others in the world who are fascinated with bizarre blisters and foot injuries and how to prevent them. I couldn’t believe it when I read of yet another creative use for duct tape!  Thanks for writing the book!”

Just like Betsy, those of you with the 4th edition can get a free copy of my booklet, Happy Feet: Foot Care Advice for Walkers and Travelers. Click on Amazon or Barnes & Noble to go to the book’s page—and write a review of the 4th edition. Then send me an email telling me which site the review is on and your snail mail address. I will mail you a free copy of this 36-page booklet. Use it yourself, or give it to someone else. The booklet is described below and has a $5.00 value. Sorry, but because of postage, this offer is good only in the U.S and Canada.

LANCING A BLISTER ON YOUTUBE
In case you missed it last month, here is information to my YouTube video. Last year at the Badwater Ultramarathon, I lanced a huge toe blister. I handed my camera to one of the medical staff. As I lanced the blister, he shot the whole thing on video. So here it is on YouTube. A word of warning, YouTube has a number of videos that are questionable in nature. If you look at any other videos, they do not show good lancing techniques, much less good video or even language. Watch the others at your own risk.

SHARE THIS NEWSLETTER
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FEATURE ARTICLE: MY BEST BLISTER PATCH JOB EVER
Last month I did a bit of foot repair at the Badwater Ultramarathon in Death Valley. I have patched thousands of feet and many patch jobs are quite routine. I have refined my techniques over the years, and have my favorite tapes and patches. I’ve done lots of ball of the feet blisters and toe blisters. Heel blisters though, are the most common.

I was a few miles out of Furnace Creek, driving slowly while watching the runners, when one waved me over. It was Jan Herrmann, an experienced ultrarunner from Australia. He was about 20 miles into Badwater, a 135-mile road race. I pulled ahead and stopped off the road in back of his crew. Jamie Mieras, a 2nd year podiatry student pulled in back of me. Jan’s crew told me he was having problems with both heels so I pulled out my chair and foot care box.

Meeting Jan turned into one of the highlights of the race for me. He and his wife are great people, really nice. We removed Jan’s shoes and gently pulled off his socks, rolling them down over his heels to avoid Jan_herrmann_right_foot_25__miles_iany undo pressure. The first picture shows his right foot. The left looked almost identical. Both feet had, for lack of a better term, “pockets” of loose skin. Both feet, near forefoot, had a tear in the skin, which created an open pocket appearance. The right foot had a tear almost side-to-side while the left foot was about an inch in length. The loose skin was, by my estimate, at least five to six layers of skin! If you look at the picture, you can see the pocket of loose skin.   
     With every step Jan took, the loose skin was sliding against the skin underneath and opening up a larger pocket. I could only imagine how uncomfortable this was- and even painful. And of course, there was another 115 miles to go! Oh yea, and he also had one blister, I believe on the outside of each heel
     In all my years of patching feet, this ranked near the top of bad feet, and one that would be hard to patch. My goal in patching feet during an event is to always fix them so the runner can get back in the race.

I looked at his feet and tried to visualize what kind of patch I might apply. Finally I told Jan I knew of only one way to patch his feet so he could continue. With his consent, I applied the patch to each foot. Here are the 11 steps I took to patch his terrible heel blisters:

1. I cleaned the skin with alcohol wipes.
2. I drained and applied a thin layer of zinc oxide over each side of the heel blister.
3. I applied a thin layer of zinc oxide into each open pocket and at the edges.
4. I prepped the skin with tincture of benzoin. This required a coating of tincture around the sides and on the bottom of the heel – even over the loose skin.
5. I applied a strip of two inch Kinesio-Tex page around each heel from side-to-side around the back of the heel, with a slight bit of tape going onto the bottom of the heel. This tape also secured the side of the heel blisters. This strip formed the base for the next three pieces of tape.
6. I applied another strip of Kinesio-Tex tape over the forward edge of the open pocket – sticking the tape first on the bottom of the foot and then applying slight tension upwards towards the ankle as I laid the end over the base layer of tape around the heel. I had this end on the bottom of the foot about an inch forward from where the skin was torn.
7. The next two strips of tape were applied with at least a ½ inch overlap on the previous piece of tape, again going from the bottom of the foot upwards towards the ankle. The first of these was in the middle and the second and final strip of tape went up the back of the heel.
8. I rubbed the Kinesio-Tex tape to help it bond to the skin. The heat from the rubbing creates the bonding effect.
9. I applied a thin coating of powder to cut any remaining stickiness from the tincture.
10. I bunched up Jan’s new socks and rolled them onto his feet, being careful as they went over his heels.
11. I used a shoehorn to ease his feet into his shoes.

I knew I had to apply the tape under tension to hold the loose skin in place. The loose skin of the pocket also had to have tincture on it for the tape to hold the skin tight against the inner skin underneath. I Kinesio_beige_2inchknew Kinesio-Tex tape was the best tape for this job. It stretches in its length, and with a 30-60 second rub, it bonds with the skin. The tape is fairly thin and smooth, and waterproof – so it can stay on for days if necessary. If you want to try Kinesio-Tex tape, Zombierunner.com carries it.
     As the race progressed, I kept my eye on Jan. Going up to the finish out of Lone Pine; he changed shoes and made great time, even running some of the way. I later told Jan that I thought he would not finish the race because of his terrible feet. But the patches held and he completed a remarkable race in 50:09:23 for 68th place out of 78 finishers. It was an emotional moment when he crossed the finish line and the high point of my being a part of the event.

I saw Jan back in Lone Pine after he showered and rested, and treated blisters on both little toes (I’ll show those picture in another issue of the newsletter). I advised him on how to care for his feet now that the race was over.

Jan wrote after Badwater:
Jan_herrmann_right_foot_2_weeks_aft“First of all, I’d like to thank you again for taping up my feet at Badwater – I probably would not have made it to the finish without your help! And also thanks very much for volunteering at these ultra events and giving so generously of your time, knowledge, and experience. Having said that, I feel like a right fool for getting myself into such trouble and having to use your services; my only excuse for my ignorance is the fact that – as I told you – I never had any foot trouble before, not even during my two "sea to summit" 150 milers here in Australia. Anyway, I think I’ve learnt my lesson, the hard way, and I hope to be back next year for a REAL crack at Badwater.
     Following your recommendations, I left the tape alone and initially just did some soaking in water and Epsom salt. Last Monday, two weeks after the event, I removed the tape, which was starting to lift anyway.
     My wife Gabi took some photos. You can see that the left foot has almost completely healed, and even on the right foot the big loose flap has partly re-attached. The initial tear under the right foot had obviously continued upwards on the outside of the foot, some of the skin has come off, and this was the only spot that has given me some grief until last week. The photo here shows the loose skin and the light color skin is the old skin, which will come off. Now the feet are virtually pain-free. I have started (on the "good", left foot) the moisturizing foot-cream treatment you recommended to soften things up, including wrapping the lathered foot in clingwrap and leaving this on overnight. As soon as things have re-attached a bit more on the right foot, I’ll start the same there.”

I wrote back to Jan, “I have thought quite a bit about how this happened so soon into the race. I can’t recall how much callus you said you had on your heels. I know you mentioned the vacation, I think in Fiji, in the water and on the beach, and then hiking the Grand Canyon. If the sand was hot, and your feet really callused, that with the time in the water could have been a contributing factor. Then to hike the long ups and downs of the Grand Canyon could have stressed the callused skin against the softer skin underneath.”

Jan_herrmann_right_foot_17_days_aftJan responded, “I think the feet were quite callused, a bit like a callus "shell" all around the heel as well as a "plate" directly under the heel. In hindsight, it is conceivable that your theory is right and that the callus "plate" under the heel was already loosening relative to the softer tissue underneath when I was doing the Grand Canyon.
     I had some more photos taken a few days after the last set – maybe they are a bit more useful. While the "flaps" seem to have re-attached to some degree, a large fraction of the areas underneath feels "hollow", and some of the thick skin cover starts to crumble now, obviously because it’s dead. I have equipped myself with a callus file, and as soon as the crumbly bits have all fallen off, I will start the process of de-callusing.”
The photo here shows the skin healing on the side of the foot.

Is there a lesson here? I’ll let you be the judge of that – but allow me to comment. Jan was an experienced ultrarunner. In the days before Badwater, he and his wife had spent time vacationing in Fiji and the Grand Canyon. By his admission, he had some fairly defined calluses around his heels. I am certain that his activities in the days before Badwater stressed the skin on his feet, and contributed to the breakdown that lead to the skin separating. One lesson is to plan your run, race, or event first and extend your vacation afterwards. Another lesson is to get your skin in the best shape possible. Thirdly, be prepared for the unexpected and know how to patch your feet. Had I not been there, Jan would have not gotten much farther before his skin would have split even more, probably to the point of being too painful to continue. And finally, learn from what happened so it does not repeat. I know Jan will be back to Badwater, and he will be prepared. I know, because I’ll be there too for others who are unprepared for the unexpected.

I welcome your feedback on this article. Send me an email.

FOLLOW-UP TO STAPH ARTICLES
In case you missed last month’s newsletter, just click here to see the July issue that had a lot of inforation on blisters, blood blisters, infected blisters, staph infections, cellulitis. I am still convinced it was the most important issue I have done in seven years.

Many of my readers know or have heard of Denise Jones, the Blister Queen of Badwater. Denise works in a hair salon in Lone Pine. Last month’s newsletter feature story was about a lady, Cari, who developed a staph infection, partially from a blister. In early August, Denise emailed me and said, “You will NEVER believe who walked into my work yesterday. A lady was a walk-in at our salon yesterday for root hair color. My co-worker did her hair and I overheard the conversation. She began telling Veda about a blister that ended up causing her to have toxic shock. Veda told her I was the “blister queen” – and then I chimed in about talking to you – and she has your book. What a small world. She believes now that because she is a neo-natal pharmacist – and that she was already colonized to this strain of staph and the wrong set of circumstances came about that caused her to almost die from the resulting treatments. She told me that in her hospital in Texas they had lost several babies with this particular strain of staph. Cari is now back on the Pacific Crest Trail and she had her sandals on!"

A GOOD IDEA: SOLES 4 SOULS
Soles 4 Souls is dedicated to making a difference in people’s lives with the gift of shoes. Wayne Elsey founded the non-profit organization in 2004 after the tsunami disaster in Southeast Asia. Partnering with friends, local churches, and the media, over 250,000 pairs of shoes were collected. After hurricane Katrina, 750,000 shoes were distributed to needy people affected by the storm damage.
     By estimates, over 1.5 billion pairs of shoes are lying idle in American closets. If you have shoes, of any style or size, please ship them using UPS Ground (usually the most cost effective method) to one of the two warehouses. For East Coast shipments, send them to Soles4Souls, Inc., 2064 Highway 431, Roanoke, AL 36274, For West Coast shipments, send them to Soles4Souls, Inc., Foreign Trade Zone #89, 6620 Escondido Street, Las Vegas, NV 89119. For information on tax-deductible donations, please call their hotline at 888-840-7074.

BAD FEET PHOTOS
Brians_toes_2A great shot of Brian Wilson’s toes is this month’s Bad Feet Photo. Brian wrote, “I love your book and website, and thought you might enjoy this. This was the result of a dirt road 100k with some serious downhills. Both big toe nails are completely gone as is the nail on the left # 2 toe. There is the start of a new nail on right # 1 toe (Next to the big toe). The right # 2 toe is from previous loss (HURT 100) and starting to grow back. This race (Mt. Misery, technically 57+ miles) was in June of 2006. I run primarily trail and mountains, and this race had a ton of hard dirt road. I had right knee trouble around mile 20 that plagued me the whole way. I altered my gait, which I think set me for some extra pounding – especially on the long, hard packed down hill in the last 1/3 of the race."

Previous photos and their stories can be found in past issues of this newsletter (since July 2005). For photos before then, check here.
     Just think; your feet could be featured in this e-zine for everyone to see! Submit your photo or short story by email or snail mail. Stories should be no longer than 250 words. Send them to me by email.

FEATURED FOOT CARE PRODUCT
Gaiter_web2Upgrade your gaiter instep cords with "bombproof" GaiterAiders from DGI Outdoors! For $8.95, you can solve your gaiter strap problems. The straps are made from a tough polyurethane material easily outlasts standard cord – they may even outlast your gaiters! They provide better traction on wet rock, won’t ball up on snow, and easily attaches to all grommet style gaiters with unique, adjustable fasteners.

BADWATER FEEDBACK
It is always nice to get complements. Here are two from happy runners from Badwater:
     “Thank you so much for all your help again this year. You continue to be the most popular person treating runners!”
    “I just wanted to send a brief note of thanks for the minor post-event "surgery" you conducted on my blistered feet after Badwater. I’m happy to say that my feet have healed nicely, that the fluid contained in my sub-callous blisters has re-absorbed, and the out layers of dermis are starting to look somewhat normal. My race at Badwater was quite special, made even more so by folks such as yourself. You’re a gift to the athletic community…thanks so much for your contributions!”

IS SPEED YOUR AIM?
My son sent me an email link to Jean-Yves Blondeau, aka “Rollerman – Extreme.” If you are tired of doing things on foot, check out this video. When you go to YouTube to view this, you’ll see there are several more of him racing. It is fascinating to watch. I found it brought out the kid in me, saying, Hey that looks like fun.

MY HAPPY FEET BLOG
If you like to stay informed about foot care issues and information – on a more regular basis than this monthly newsletter, check out my blog, Happy Feet: Expert Foot Care Advice for People Who Love Their Feet. This is different from this ezine. The Happy Feet blog will have a new short topic every week.

READER FEEDBACK AND COMMENTS
Lisa wrote: “Thanks for the great article. After coming down with Lyme disease I am much more conscious of how something that happens on the trail is seemingly inconsequential turns into a life threatening or debilitating illness. By the way, StaphAseptic is giving out free samples on their website.”

Mark Zimmermann wrote: “Another great issue, congratulations!”

Dory Bixler commented: “Your book is awesome and I have learned so much! Thank you!  I’m going to be taping some toes and my heels before I attempt to hike ever again. Taking all the advice I’ve gotten, prevention will be key to my comfort and sanity.”

Reader feedback to this E-zine and its articles is welcome and encouraged. Please email any foot care ideas or tips that you have tried and would like to share with others, or ideas for an article for the e-zine.

HAPPY FEET BOOKLET    
My booklet, Happy Feet! Foot Care Advice for Walkers and Travelers is in stock and ready for the walkers in your life. This booklet is 3.75 x 8.5 and 36 pages in length. In an easy read format, it gives advice on biomechanics and gait, buying footwear, fit, lacing, insole and toenail tips, skin care, powders and lubricants, blister care, sprains, foot care kits, and more. It’s on sale at 20% off for $4.00. Click here to read more.

GOT A STORY TO SHARE?
I am always on the look out for stories to share about their adventures with some type of connection to feet. If you have something to share, please send me an email.

PRIVACY INFORMATION
You are subscribed to the Fixing Your Feet E-zine because you subscribed to it. If you wish to be removed from this mailing list, you can find instructions at the end of this email. We respect the privacy of all subscribers and will not disclose your email address or any information about you to any third party.

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ARCHIVED BACK ISSUES
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CONTACT INFORMATION
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