Feet, Socks, Shoes, and Other Foot Care Issues

June 29, 2009 by · 3 Comments
Filed under: Foot Care 

Feet, socks, shoes, skin, toenails, gaiters, foot care – all things that are a huge part of my life. Saturday and Sunday I worked at two aid stations and the finish line at the Western States 100 Mile Endurance Run. Nine hours at Michigan Bluff, a brief stop at Foresthill, and then five hours at the finish line. In this post, I will touch on a few things I saw and learned from the runners I saw and helped. Then in the weeks ahead, I will elaborate on each of the things.

  • Compression socks – quite a few runners wore compression socks
  • Gaiters – the majority of runners did not wear gaiters
  • Shoes – I realized many trail shoes have a huge flaw
  • Socks – I saw the good, the bad, and the ugly socks
  • Skin – lots of skin issues
  • Maceration – a huge, huge issue for many runners
  • Toes – lots of toenail issues
  • Patching – there are many ways to patch feet and they are not all equal
  • Expectations – many runners expect a lot from the podiatrity staff – sometimes, they want a miracle
  • Aftercare – a lot of different perspectives here
John and Catra at the Michigan Bluff aid station

John and Catra at the Michigan Bluff aid station

More than one of the above feet related items contributed, in my opinion, to runners being unable to complete the race. I did not count the number of runners we saw – but the numbers are always high.

Helping with podiatry care at an event of the caliber and size of Western States is always challenging. No matter what I know, I realize I can always learn something new.

In the coming weeks, I will write about each of the above items. Then too, I will be helping with foot care at Badwater in mid-July, and there will be more of the same. The one thing that amazes me is the energy and attitude of the runners, their crews and the volunteers. They are all great people. Congratulations to all the Western States finishers.

Healthy Feet Running the 100’s

June 22, 2009 by · 2 Comments
Filed under: Foot Care 

This next weekend is the grand daddy of all 100-mile trail runs, the Western States Endurance Run. There will be close to 400 runners toeing the starting line; the majority racing against themselves and the ever following demons of stomach problems, trashed quads, heat, being under trained, poor equipment choices, bad feet, and mental stresses. I want to talk about what I consider are two of the most important factors for healthy feet on trails runs. While their application here is a 100-mile trail run, they also apply to casual walking and hiking, and to extreme adventure racing and long distance hiking.

The number one factor is knowing what your feet need, and how to do it, before you have to do it. I have patched many feet at ultras and adventure races and have found that most racers have a fairly good knowledge base of what they should be doing. They know its smart to wear the right kind of socks and to have footwear that fits well. Many have also made footcare kits for their crews. I would make a rough guess and say about 30-40% are well versed in what their feet need and how to do it. The other 60-70% kind of wing it. They’ve read about footcare but somehow it falls lower on the priority list than does training, finding foods they can tolerate, the right flashlight for night running, and other choices. So they start their race and manage well for a while-until problems develop.

To have and keep healthy feet, you have to know what works for them in the sports in which you participate. You also have to know what to do when what worked no longer works. In other words, a fallback plan with the equipment to back it up and the knowledge of how to use it. Let me give some examples.

  • Learn what lubricant works but have a container of powder handy.
  • Learn what socks work but have one or two extra pair of other types.
  • Learn how to tape the hot spots that might develop.
  • Learn how to tape your toes, heels, and every other part of your feet just in case blisters form.
  • Learn how to tape like a pro and then practice taping and then practice some more, and then start over until your taping is perfect.
  • Learn that if you tape one toe, it may require a bit of tape on the next toe.
  • Learn how to lance blisters and patch over them.
  • Learn what happens to your feet when you don’t change wet socks and your feet become macerated and feels like there is one humongous blister on the bottom of each foot.
  • Learn that something simple like properly trimming and filing your toenails can prevent toe blisters and even black toenails.
  • Learn that in a 100-mile race, if you don’t control your feet, they will control you.
  • Learn that you may know how to patch your feet, but you crew may not unless you teach them.
  • Learn that an inexpensive shoehorn can prevent the formation of heel blisters when you try to shove your foot into your shoe because you are in a hurry to get out of the aid station.

The bottom line is that if you don’t learn what works for your feet, intentionally, you will learn the hard way. At mile 56, or 72, or even mile 96. It has become harder and harder each year to find volunteers to provide footcare for the racers. Medical care yes, but footcare, well, that’s a different story. If you need footcare the medical staff may be able to help, but they not know the finer points of footcare. You need to go into each race prepared.

The number two factor is real easy to solve. Keep your shoes free from trail debris. Small rocks, large rocks, sand, dirt, pine needles and other foliage, grit-all the normal stuff that finds its way into your socks and shoes. It starts with the debris causing a hot spot,which you ignore because it takes time to stop and clear out the offending junk. Besides, if you just shift your foot around inside the shoe, it may move and no longer be a problem. Then after a while, the hot spot has become a blister. Now you can’t stop because you don’t have the fixings in your fanny pack. So you have to wait until you get to an aid station. Once there you then hope they know what their doing and have the right supplies.

The solution? Gaiters. They can be store or mail order bought or home made. It doesn’t matter as long as they do the job of keeping trail junk out of your socks and shoes. Some runners are so light footed that they rarely get debris in their shoes. If that’s you then skip the gaiters. Just be sure that if you get something in your shoe, get it out. Many blisters and other foot problems come get started by an irritant in your shoe. A small pebble in your shoe works its way down to your forefoot. You shift your foot around and it seems to finally disappear. A few miles later it surfaces under the ball of your foot. After playing the shift-it-around-inside-your-shoe game, it gets the best of you and you stop to remove it. By then, some damage has been done. A hot spot or blister may have developed, or your foot may simply be sore and tender from the offending pebble. If you really want to be safe, tuck a spare pair of socks in your fanny pack or pin them to the outside. Dirt laced socks, caked hard with trail dust and whatever lubricant you are using  can cause problems too. The small particles of dirt or sand can cause as much damage over time as larger pieces of trail debris. Gaiters can help protect your feet.

Here are a few extra tips:

  • Use Hydropel on your feet to control moisture and maceration.
  • Trim toenails short and file them smooth so as you rub your finger over the tip, you don’t feel any rough edges.
  • File down your calluses – you don’t want blisters under them.
  • Add shoehorns in your crew’s foot care kit. This can save your heels when trying to put your shoes back on.
  • Before the race starts, pretape any know problem areas.

I truly believe that today’s trail runners are more educated than those of past years. Technology has improved shoes and socks. Products with names like DryMax, Smartwool, Hydropel, BlisterShield, and Body Glide have made it easier to take good care of your feet. I may see you at Michigan Bluff aid station at Western States or at the finish line, but I hope it’s only as you pass me by and say, Thanks, but my feet are fine!”

Feet, Compression Socks, and Your Veins

June 19, 2009 by · 2 Comments
Filed under: Uncategorized 

Last week I posted an article on compression socks. This is a short follow-up to explain a bit more of the benefits of these socks.

Leg problems are widespread throughout the world, but what most people don’t know is that approximately 90% of leg disorders originate in the veins. If you have tired, aching legs, or if you see the beginning of varicose veins, it is time to learn how to improve the health of your venous circulation. Vein problems can progressively worsen over time and can affect your health and well being for the rest of your life.

Compression therapy means wearing socks or stockings that are specially designed to support your veins and increase circulation in your legs. The socks or stockings are normally worn in the morning upon arising, and removed at night. Throughout the day the compression they provide prevents blood from pooling in leg veins, thereby helping overall circulation.

Remember that the heart attempts to pump blood against gravity up the veins of the legs, and as a person walks, the regular contraction and relaxation of the calf muscles around the veins are necessary to help the heart move blood up the legs efficiently. But, it is unlikely that a person will walk continuously throughout the day – most of us sit or stand some of the time. Also, some people have inherited weakness of the vein walls or valves, which create additional challenges to venous circulation. This is why wearing compression socks or stockings is vital for the treatment or prevention of varicose veins and other circulatory problems, especially for individuals who are at risk.

For more information on compression products, including athletic socks, visit AmesWalker.com.

Benefits of Compression Socks

June 12, 2009 by · 2 Comments
Filed under: Foot Care Products, Footwear Products 

Whether you are walking on the golf course, out for your regular workout or running a marathon, often times your legs and feet will feel swollen or achy when you are finished. There is an easy solution that can help your legs and feet feel better: compression socks. Wearing compression socks can help increase blood flow, more evenly distribute muscle strain and help legs feel less fatigued.

These products used to be considered only for people with medical conditions or circulatory problems but are now becoming more widely used by people who are catching on to the benefits. They can help those who practice more moderate exercises. Surprisingly, research shows athletes are at a higher risk than others for DVT (Deep Vein Thrombosis), a potentially fatal blood clot that forms in the deep vein system of the lower leg and can occur from sitting in the same position for an extended period of time. Trained athletes have a lower resting heart rate which can cause blood to stagnate and become thicker which could lead to problems like DVT.

Athletes should stay hydrated with both water and an electrolyte replacement. Dehydration from extended athletic activity causes glycogen and water to be pulled from muscles, and blood becomes more dense. Immediately following an endurance event, the body compensates for this by pulling water and glycogen back into your muscles. Better circulation drains lactic acid out of the blood system and legs. This is why a cool-down is necessary – it allows the blood in your working muscles to gradually move back to your internal organs instead of pooling in your legs.

Compression socks apply maximum pressure at the ankle and systematically decrease up the sock length, which maintains proper venous blood flow in the leg. This improves circulation and provides support. For runners, this helps to prevent the tightening of the calf muscles and helps the muscles recover much more easily.

AmesWalker Compression Socks

AmesWalker Compression Socks

A cushioned cotton support sock like AmesWalker.com E-Z Walker Sport (15-20 or 20-30 mmHg) will help improve circulation. E-Z Walker Sport have superior moisture wicking effects to keep feet cool, dry and prevent bacterial growth. The padded foot guards against blistering and skin lesions from foreign objects in the shoe and the double sole cushions the foot during strenuous activity. You should check with your doctor to see which firmness is best for you.

For more information on compression products, including athletic socks, visit AmesWalker.com. The website has great information on compression values and how to select the right compression sock.

AmesWalker sent me a pair to try and I wear them when golfing. I found that my legs have not felt as tired – and interestingly, my feet subsequently feel better too. If you use compression socks, I’d welcome your opinion on how the socks have helped. Drop me an email.

This post is the result of my asking them to send me an article I could use in this blog. I’d like to thank Danielle Robitaille from AmesWalker for her help. I have always said we need to keep our feet happy. Here’s a case where keeping our legs happy will also keep our feet happy!

Follow-up to Foot Care – Day after Day…

June 4, 2009 by · Leave a Comment
Filed under: Foot Care 

Last week I wrote a post about Foot Care – Day after Day after Day after Day. I told the story of, “Richard Donovan who ran seven marathons on seven continents in five days, 10 hours and eight minutes.” I added that, “I had received an email asking about how to manage feet in a multiday event. This is similar to what Richard Donovan must have been doing (hopefully).” I ended by saying, “I will have to investigate talking to Richard Donovan. He sounds like an interesting guy.”

Thanks to the beauty and amazing power of the Internet, I sent him an email and within two days he responded. Nice guy. I’d love to meet his some time. He wrote:

Ultrarunner Richard Donovan

Ultrarunner Richard Donovan

“Many thanks for the email. I haven’t even seen Men’s Journal – but the magazine had contacted me a few times all right. I had no issues whatsoever with my feet and actually didn’t pay any attention to them. I guess it would have been a different matter if I was preparing for a desert race or a jungle race. I had only put the general plan together a short time before I undertook the challenge. Most of my efforts went into logistical arrangements / making sure that appropriately qualified people could verify I was indeed running accurate marathon distances. And it was very much a work in progress even as I embarked on the first leg. As a result, I paid no attention to diet, potential injuries; anything else…. and just assumed the marathon runs themselves should happen without too much incident. But they were more difficult than I thought because of the hot temperatures in some places, snow drama in London and my generally feeling sick — probably due to airline food, sleep deprivation, jet lag and so on. But it was good fun and I was lucky.”

So, I was wrong. He spent little time and thought on his feet. From the information on his website, The World Marathon Challenge website, I found out that he really runs – a lot. I guess that he has his feet pretty well figured out. Some people are fortunate like that. Others aren’t.

On another note, I received a nice compliment about my Happy Feet Booklet. Thanks John M.

John M. wrote: John’s booklet Happy Feet! Foot Care Advice for Walkers and Travelers is a sort of Cliff Notes for feet — 36 pages of memory reminders that seem so simple when you read them again.

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