Bad Feet in Namibia

March 28, 2009 by · Leave a Comment
Filed under: blister care 

Lisa de Speville, from Johannesburg, South Africa, is a friend I met at the Washingon state Primal Quest several years ago. She is a journalist and photographer in addition to an adventure racer. She’s pretty much a jack of all outdoor trades. I know I can count on Lisa for great bad feet photos. While you may not like the graphic images, they’re good to teach lessons. Check out Lisa’s website here.

Lisa recently wrote that she had just completed the 5-day, 200km RAW Namibia event. Here is a link to her blog where you can see some photos of the region and by clicking backwards on her posts, you can read more about the race.

She sent me an email saying, “It was fabulous! This one guy from the UK had BAD feet. Here are three sequential photos.

Day 2 foot damage

Day 2 foot damage

The first picture is after day 2. Day 1 was 41km. Terrain decent. He got grit in his shoes and didn’t deal with it at all. A heavy guy with an unnecessarily overloaded backpack (inexperience). By the end of day one, the foot looked like the photo I took on day 2. The doctor opened up the open part and bandaged him up. He got a dose of methiolate after day 1. Agony, as you know. His maceration was very severe already on day 1. I would have expected this kind of blistering – only later on – progressive. But he did it on the first 39km stage.

The piece of skin was cut off by the doc. I suggested that she leave it on but she took it off and padded the foot with bandages. Your comment on what to do – on or off – with this severity would interesting.

I think the primary problem was that he got sore feet during the stage, a bit of grit in his shoes and he didn’t deal with it then and there. I can’t remember now what shoes he was wearing… I’ll ask him to give you feedback. I have a sneaky feeling they were road shoes… on off-road terrain… I don’t know what socks he was wearing. And then you look at things like shoes being his normal road shoes and perhaps that half-size too small for long off-road stages in the heat; and also he wouldn’t have loosened his laces to accommodate swelling… Recipe for trouble.

Day 2 was about 40km. Also good terrain, mostly even footing. It obviously worked on the raw part of foot.

Day 3 foot damage

Day 3 foot damage

Day 3 was 44km. again nice terrain. This is picture 2. One river crossing so shoes got wet just over halfway. He was wearing quite thick socks from what I could see. He would have gotten his feet wet once mid-way through the stage. We had one river crossing and I think he went straight through it because even if he took off his shoes there would have been the bandages to deal with. That was the only water place the whole race.

If you look closely, you’ll see the dark spot under the skin under the middle toe. That’s sand inside the blister. How sore it must have been to be walking on the sand, which would have been rubbing on the raw flesh. Ow! I’m not that brave – I would have been out of the race after day1 – I just don’t know how these people manage to keep going with such injured feet!

Day 4 – 50km. Bit of sand. Hot as hell. He took a detour – went down the correct dry riverbed but didn’t get out of it to look for the finish. Must have been parallel to the finish. Turned around and started walking back to last waterpoint. He was found hours later (moving slowly). He didn’t want to be disqualified so they dropped him on the road and he walked to the finish. Almost 16-hour day for him! Picture 3 was taken in the dark, after he’d been out there for almost 16-hours!

He did start day 5 but when it got to climbing big dune he then withdrew. It’s obviously difficult to climb a dune when you can’t put pressure on foot. How he got so far past day 1 is beyond me.

Day 4 foot damage

Day 4 foot damage

Also check out the progression of the little piggy’s “toe-sock” syndrome.”

John’s comments: Thanks Lisa for sharing these great photos. The images show the destructive power of sand, the raw skin, the extreme maceration – and the worsening deterioration of the foot over several days. Lisa indicated there was only one water crossing so I suspect most of the maceration came from sweating feet. The heavy weight in his pack was a huge factor too as it adds stress to the feet. I don’t know if he wore gaiters. And be sure to check out the baby toe in pictures 1 and 3. You can see the progression of the maceration of the bottom of the toe. Lisa said she thought he wore road shoes in a desert race and that they may have not been large enough to allow for swelling. This too is a huge factor.

Regarding cutting off the skin, I am usually not in favor of doing this as the skin underneath is raw and very tender. I suspect he had callus at the ball of the foot and a blister formed underneath. The thick edges of skin where it was cut shows that the skin removed was not a single layer. I probably would have left the skin intact, applied a coating of zinc oxide and antibiotic mix, and covered it with Kinesio-Tex tape with an anchor figure eight piece on the side and between the toes.

Clean Feet with Wysi Wipes

March 20, 2009 by · 1 Comment
Filed under: Foot Care, Foot Care Products 

Wysi Wipes are the perfect traveling companion for your feet – whatever your sport and wherever you are. Add a few Wysi Wipes to your fanny pack, drop bags, duffle bags, backpack – anywhere you might need a wipe. When you need a refreshing and durable wipe, you simply add a tablespoon of liquid.

Wysi Wipe

Wysi Wipe

These wipes, the size and weight of an Alka-Seltzer tablet, are handy for trailsides, rest areas, aid stations, or transition areas – when you need to wipe powder or lubricant off your feet, or clean off caked dirt. Whether fixing a hot spot or blister, or applying tape or a patch, feet need to be clean and Wysi Wipes are perfect. Using a bandana that has been around your neck and is caked with sweat doesn’t work!

Wysi Wipes, almost instantly, turn into a durable and reusable cloth. They expand and unroll like magic! Click to Play Video and see a Wysi Wipe in action.    

They’re purely practical & weigh only 2 grams each. And they’re biodegradable and land-fill friendly! They are 100% natural. No chemicals and no artificial smelly scents.

Wysi Wipes come in re-sealable bags, a bag of 12 for $2.50, or a bag of 100 for 11.95.

Sample Engo Blister Prevention Patches?

March 12, 2009 by · 1 Comment
Filed under: blister care, Foot Care 

Those of you who have followed me for while know I am a fan of ENGO Blister Prevention Patches. These slick oval patches are applied to your insoles or inside your shoes, to reduce friction.

An ENGO patch in the heel counter of a shoe

An ENGO patch in the heel counter of a shoe

I have applied them at many of the races where I have patched feet and have given away many as samples. The larger rectangles are great to apply to the front of an insole to reduce friction at the ball of the foot. When I have had an athlete with bad forefoot blisters or tender feet from hot spots, I will cut one to the shape of the insole. I have also used them under heels. The ovals are great for heels and sides of the foot – although getting them into the front of a shoe to relieve side of the foot friction takes work.

Jason M. Pawelsky, the Marketing & Sales Manager at Tamarack Habilitation Technologies, the makers of the patches, recently wrote me with an offer for my readers. Jason said, “I’d be happy to send a free ENGO Blister Prevention Patch sample to any Fixing Your Feet subscribers who emails me their contact information.” Here’s your chance for a free trial. Send your request to: info@goengo.com. In the subject line put: Happy Feet. Include your full name and snail mail address.

While you wait for your sample, check out the GoEngo website. They have a page of tips and techniques that is worth reading and shows typical applications.

ENGO’s adhesive is pressure-sensitive. Therefore, as pressure increases so does patch conformance & adherence. Patches will eventually need replacement. Replace your ENGO patch when the blue top layer wears through, or completely releases from, the white support layer. These patches can also be applied to your socks.

Over the years, I have narrowed the list of products I carry. Blister patches like those made by Spenco, are always in my bag. ENGO patches compliment whatever patch I have applied or a tape job. Wherever I go on a foot patching expedition, I always carry a supply of ENGO patches.

I invite you to give them a try. I have even suggested that runners take one of two and pin them to their bib number during a race (if they don’t have a small pack). That way you always have a patch handy for the unexpected hot spot or blister. You’ll make your feet happy!

Comfy Crocs for Your Feet

March 8, 2009 by · Leave a Comment
Filed under: Footwear, Footwear Products, Health 

This past Christmas, I received a pair of Crocs as a gift. Years ago I had a pair of Holey Soles but they were too small and I tended to wear sandals instead. They are tucked away in the back of my closet. Then I got Crocs.

For those who have never worn Crocs, they are extremely light, with lots of room in the forefoot and toe area. It’s like not wearing anything on your feet. They started in 2002 as footwear for boating, with nonslip tread and waterproof design and materials. Now days, however, you see Crocs worn everywhere.

WebMD  has an article on Crocs: Healthy Shoes or Just Comfy?  They were designed to eliminate plantar pain and achy feet. Those with injured feet, bunions, toe problems, and diabetes are helped by the inner support, heel cups, massaging nubs under the feet, and arch support. They also breathe well and are odor resistant and anti-microbial. An advantage of Crocs over sandals is the protection given the foot, especially the toes. They are also stable with little side-to-side twist.

Crocs Rx

Crocs Rx

The Crocs Rx series offers additional features to relieve heel pain, plantar pain and metatarsalgia; and can accommodate custom orthotics and moldable inserts.

I have worn mine for several months and I love them. They are light and comfortable. I have been wearing them with a lightweight pair of socks during he winter months. As the weather warms, I anticipate wearing them outdoors when gardening. If you look at the images, you’ll notice the air holes in the front and side of the Crocs. These vents provide a lot of air circulation.

Crocs are great instead of flip-flops and may be more comfortable than many sandals. After a run, around the house, after a workout, after whatever your sport is, Crocs are worth trying. I know of a few runners who have worn them running. On my next backpack, I’ll consider clipping them to my pack for use around camp.

Rick Cheever is a Crocs wearing ultrarunner. He relates, “I tell you what, if I had a dollar for every time someone commented on my Crocs, I would have enough to cover next years entry fee! I did end up running most of the race (about 85%) in Crocs. After the first 12 hours, my feet had taken a beating, the muscles were all cramped up and I had received some very painful deep inner blisters on the balls of both feet. Every step was a cramped stinging feeling. This had to stop so I tried on my Crocs I had brought for before and after the race. Boy was I surprised. They felt so light and cushiony – the freedom was wonderful. All the cramping went away and the deep inner blisters did not hurt as much. Of course I wore Drymax Trail Running socks the entire time, changing pairs ever morning. Drymax socks are wonderful and prevented my feet from getting any friction blisters due to moisture build up. I would say a combination between Drymax Trail Running socks, and Crocs saved my feet. They would have been pretty gnarly without the combination.

Regular Crocs' Clogs

Regular Crocs' Clogs

     Further more, I was able to run effortlessly with the Crocs, perfect for running on a flat surface. I must have run over 100 miles with my Crocs. Toward the end of the race I saw a couple of other people wearing them too.

     I think we might be on to something here folks. Anytime I got a pebble in the Crocs, I would move the pebble around and it would fall out the holes in the front, so debris was not an issue, making gators obsolete. My deep inner blisters never got worse and my feet felt so cozy in the crocs. I will wear them again at my next multi-day race!”

So check out Crocs. There are Crocs for sport, casual, work, boots, sandals, fleece lined – even ones with laces. These are great to relax your feet and keep them happy and healthy.

Be Good to Blisters

March 2, 2009 by · Leave a Comment
Filed under: blister care 

Last week I wrote about a piece in Runner’s World magazine, which gave four foot care tips. I commented on the Clip with Care tip – referring to trimming toenails.

One of the other tips was called, Be Good to Blisters. It gave several tips.

One was not to pop blisters. It’s bad advice to make such a general statement. Whether to pop a blister depends on two things. First, if the blister is larger than ½ inch, it is better to drain it than allow it to grow. Second, if the blister is in an area where pressure will likely pop it or the pressure will cause it to grow, then draining it is recommended.

 

Drained side of heel blister

Drained side of heel blister

Another was to use moleskin with a hole cut in it to cushion a blister. Moleskin does not adhere as well as other patches. I never use moleskin because I drain every blister on the feet of those I work on. Moleskin is thick and that thickness can easily cause further irritation as well as problems as the gait is changed to accommodate the uncomfortable patch.

 

The thing you should notice in what I wrote above is that I drain all blisters. Over the years, as I have patched feet, I have found it is better in the long run (no pun intended), to drain all blisters. The athlete is able to run again, with much less discomfort, and the blister is taken care of – not to refill or grow larger.

That’s better advice on blister care. Sorry Runner’s World, but you got it wrong!

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