Toes and Toenails

July 30, 2009 by · 3 Comments
Filed under: blister care, Foot Care, toenails 

As you might guess, there were lots of toe and toenail issues at Western States and Badwater. There were blisters on and between toes, blisters under toenails, toenails floating on top of fluid filler blisters, and toe blisters with blood inside. Some were major and some minor – but to the runner whose feet they were on, they were bad.

Toe blisters with toenail lifted off nailbed

Toe blisters with toenail lifted off nailbed

Here are two photos I took that shows what is often common at race finish lines. Neither is pretty. The first shows a foot with a large blister under the big toenail. The nail has lifted off the nailbed and there is trauma to the whole area. You can see how the back of the nail is pushed backwards and upwards. The second toe also has a blister. Both have blood inside. The big toenail is thickened.

The second photo shoes a foot with some gnarly toenails. These nails are possibly inflicted with nail fungus, which has gone untreated. You can see the irregular nail surfaces and how thickened some have become. There is some tissue damage but it is hard to tell from the photo if blisters are present. The nail on the second toe may have a blister under it.

Gnarly, thickened toenails

Gnarly, thickened toenails

These show a common problem that many athletes have not learned – proper toenail care. Thickened nails should be filed down to reduce their height and raised forward edge. Typically, all nails could use some degree of filing to clean up any rough edges. The front edge of all nails should be filed smooth so that when you draw your finger up and over the front of the toe, there is no edge felt.

Any nail rough edge can catch on socks and cause nailbed trauma leading to blister formation. Raised, thickened nails and rough edges lead to problems when the shoe’s toebox is too short or not high enough. Wearing a thick sock, or two socks can add to the bulk inside the shoe and cause pressure on the nails and nailbed. Additionally, socks catching on rough edges of toenails force the nail backwards. Any of these three conditions can lead to toe blisters and blisters under the nail, commonly referred to as “black toenails.”

Care of your toenails should be a regular part of your daily hygiene. Trim them and file them smooth. It a new nail is coming in to replace one lost, file it thin and wrap a Band-Aid around the toe to shape it. New nails often come in irregular in shape and height. While you are at it, use a pumice stone on any toe calluses, especially on the bottom of the baby toe.

If you have toenails that are discolored (with white, yellow, or even brown and black) patches on or under the nail, are thickened, or the nail is crumbling, you may have toenail fungus. The earlier you take care of this, the better. Schedule an appointment with your doctor. Toenail fungus can get worse over time.

If nothing else, before a big race or event, spend some time trimming and filing your toenails to give yourself a better chance of completing the race without problems.

My Foot Care Clinic in Colorado

July 25, 2009 by · Leave a Comment
Filed under: Foot Care 

Subscribers to this Fixing Your Feet blog live all over the world. If you live in or near Denver Colorado, I invite you to a free foot care clinic on August 10th.

Runners Roost

Runners Roost

The Runners Roost, in Lakewood, will be hosting me for a clinic starting at 7:30 pm on Monday, August 10th. The store is located at 437 Wadsworth Blvd, Unit B.  Click here for a map and directions to their store.

I will be doing a hands-on clinic talking about blister prevention and patching, taping, calluses control, socks, insoles, gaiters, and more. I’d love to see you there. Please pass this on to friends in the area.

Tomorrow I will continue with an article on toenails, citing examples of issues from Western States and Badwater. Stay tuned.

Feet at Badwater – and Two Tips to Heal Your Feet

July 18, 2009 by · 1 Comment
Filed under: Foot Care, Health 

As you may recall, several weeks ago I helped at Western States and patched a bunch of feet. Afterwards I listed 10 items that I had observed and wanted to share with my readers. The first was Trail Shoes – The  Good and the Bad. The second was Socks – Good, Bad and Ugly.

Then earlier this week, I was in Death Valley for the Badwater Ultramarathon – a grueling 135-mile run through extreme heat and fatigue. Because feet are what I do and what I see I came home with more observations – 10 in fact. So over the next couple of months, I will share what I saw and how it affects you as an athlete.

First though, I want to take a moment and acknowledge Denise Jones, the Blister Queen of Badwater. Denise is a close friend and I value her expertise in taping feet and patching blisters. She pretaped several runners at Badwater and is dedicated to the runners. When we talk, it’s always about feet and we bounce ideas off each other. Denise is a true class act. One of the fun aspects of Badwater is working with Denise. Thanks Denise. [Death Valley Ultras: The Complete Crewing Guide by Denise Jones and Theresa Daus-Weber is available at Lulu.com].

So, let’s start with a biggie, aftercare. This means the care that your feet need after an event like Western States, Badwater, or any extreme event. I have seen runners at both events that have not planned to manage their feet after the race. Healing the trauma starts at the finish line.

This is a two-part tip. First, whether you are traveling to an event or it’s close to home, I want you to add an item to your foot care bag. Epson Salts. They can be found in drug stores and pharmacies for about $3.00 for 48 ounces.

Epson Salts

Epson Salts

Epson Salts are great for soaking your feet to dry blisters and relieve the pain of bruises and sprains. Simply add a cup of the salts to a basin of warm/hot water and soak your tired feet for 15 to 20 minutes. Repeat this at least twice a day. As the skin of lanced blisters dries, trim it off.

The soaking will also speed up the process of re-absorption of fluids in intact blisters and help to reduce any swelling in your feet and toes. This means your feet will feel better and pain will be reduced.

If you have another race or event within a week or two, the use of Epson salts will speed up your healing process. Every time I patch someone’s feet after an event, I tell them about Epson salts.

Secondly, make sure you have a pair of sandals, flip-flops, or Crocs to wear home. It’s no fun having to wear the stinky dirty shoes you ran in. Plus you can’t air your feet in shoes. You don’t need socks and shoes after a race. Find a comfortable pair of lightweight sandals or Crocs, or even flip-flops and pack them in your bag. We cut the toes out of a good pair of shoes for one runner at Badwater because he forgot this simple tip.

That’s my two simple tips for today. Add Epson salts and sandals to your foot care bag for after the race.

Socks, Lubricants, and Powders

July 11, 2009 by · 4 Comments
Filed under: blister care, Foot Care, Foot Care Products, Footwear 

Socks. They seem so simple but have become very complex. Socks in their most common form are a tube (of sorts) that is knit from fabric and pulled on your feet while wearing shoes. They sound simple. It is the types of fabrics and how they are made that has become complex.

There has recently been a lot of discussion on the use of lubricants and powders with socks, and more specifically, Drymax socks. I posed the question to Bob MacGillivray of Drymax Socks. Here is his response. I will have additional comments at the end. I have taken the liberty to underline what I feel are the highlights of what he says.

About your question regarding lubes and powders and Drymax; It is our belief, which science backs up, wicking socks made of Polyester (this includes CoolMax), Wool, Bamboo, Acrylic, etc., rely on capillary action which is highly inefficient inside a shoe because where would the water go other than to be held against the skin?  It can’t evaporate. So many people try to overcome this failure by slathering their feet with lubricants and/or powder.

Drymax socks work in an entirely different manner. The inner layer of our socks is made from Drymax which has zero molecular charge and are Super Hydrophobic (water hating). This allows the Drymax fibers to act like a squeegee mechanically lifting moisture from the skin transporting it to the polyester outer layer that is hydrophilic (a water loving wicking material that most of our competitors use against the skin) which is used as a reservoir to hold moisture away from direct contact with the skin.

Using powders or lubricants can have a tendency to clog the Drymax fibers inhibiting their ability to properly move moisture away from the skin. This doesn’t matter with wicking socks because once you’re wet, you’re wet and lubricants are your only relief to the frictional heat created by wet feet, the socks have failed at that point.

By wearing Drymax socks runner’s feet stay drier. Skin doesn’t soften up nearly as quickly and frictional forces don’t have such a negative effect on the feet therefore lubricants aren’t needed.

(editor’s note: Here is the link to the Drymax web page that describes the blister cycle).

At a run like a 135 miler through Death Valley we would strongly suggest using our Drymax Maximum Protection socks. These are very special and unfortunately very expensive socks. They are knit with both Drymax and PTFE Profilen (aka Teflon) fibers 360 degrees around and against the foot with polyester to the outside. The reason why we use PTFE fibers is because they are the only other fiber that also doesn’t carry a molecular charge and has similar hydrophic characteristics as Drymax. This PTFE fiber also has the lowest coefficiency of friction of any fiber on the market reducing frictional heat; this combined with the lack of moisture negates the need for lubricants.

The Drymax Maximum Protection sock is incredibly expensive to knit since PTFE is about 16 times more expensive per pound than Drymax fibers and about 30 times more expensive than polyester. It is also very difficult to knit since it is so very slippery. Make no mistake, this is 100% PTFE not some silicone coated fiber like some other manufacturers use. The wear characteristics on these socks have proven to be impressive and last longer than many of our competitors making the replacement of these socks far less common than competing cheaper socks. In addition, we have a 100% money back guarantee. If for any reason a runner doesn’t like them or any of our Drymax socks they can return them to us and we will issue a full refund, no questions asked, however we love input so any constructive insight given is always appreciated.

Drymax Maximum Protection Socks

Drymax Maximum Protection Socks

On all of our most recent packaging we have added the statement about not lubricating and not using powders.

Now, my comments. The ultra list on the Internet has had comments from runners asking about the use of lubes with socks. Above is the recommendation when using Drymax socks. If you use other, wicking type socks, the use of lubes or powders is almost mandatory since you don’t have the combined action of water-hating inner fabric and reduced friction from the PTFE fibers as you do with Drymax.

Over the years I have worn a lot of different companies socks. Many are very good and work well for day-to-day use – whatever your sport. Every so often along comes a great product that set itself apart form the rest of the pack. I believe Drymax socks are one such product.

The comments from runners, many of whom are world-class front-of-the-pack runners, have shown the value of Drymax socks. Are they worth the approximately $23.00 cost? It depends on how much value you place on finishing well. For runners, adventure racers, fastpackers, and other athletes, spending a bundle of money on your adventure, I advise not to skimp on socks.

Still unsure of their value? Here is a link to the Drymax Sports blog. You can read about who is wearing Drymax socks. Karl Meltzer just won the Hardrock 100 with Drymax socks. Scroll down the blog and see how the socks fare in races this summer.

Zombierunner.com carries the Drymax line of socks, including the maximum Protection sock described in this post. Zombierunner is a good source of things for your feet and most other aspects of your sport.

Socks – Good, Bad, and Ugly

July 10, 2009 by · 2 Comments
Filed under: Foot Care, Footwear 

Let’s talk socks. In this part two of what I learned at this year’s Western States 100 Mile Endurance Run, I want to share a few observations I made while watching runners and helping them with foot care.

First – the good. Many runners are using good, high quality socks. Drymax, Injinji, Smartwool, Wrightsocks, Wigwam, and a few others were seen in large numbers. Of course, many were beyond recognition because of dirt and mud, or were covered with gaiters. But, at any rate, I am happy to see runners wearing good socks.

Now – the bad. Watching runners pull on their socks can be a bit bothersome. Many take the sock and simply insert their foot – and push. This is problematic as the sock is generally pulled on too tight, putting pressure on the toes and toenails, and stretching the sock, especially over the heels. It is better and easier to bunch up the sock and roll it over your feet. Let the shape of the sock fit the foot. Besides, pulling on socks can disturb any taped areas of your feet.

And finally – the ugly. I saw two runners whose socks made me cringe. One was lying on a cot getting an I.V. He was out of the race and had his shoes off. The socks on both feet had at least one hole over a toe! Stupid. After I patched the feet of the second runner he grabbed a pair of clean socks out of his drop bag and put them on. The socks were thread bare on the sides of the heels! I asked him why he would compromise a race and all the money it cost, for a pair of socks. When you pack for a race, make sure your socks are still worth wearing. Why make the race harder then it already is?

So that’s what I noticed about socks at Western States. In two days I leave for Death Valley to patch feet at Badwater. That’s always a great testing ground for foot care.

Trail Shoes – The Good and the Bad

July 3, 2009 by · 6 Comments
Filed under: Footwear 

Lightweight, breathable, flexible, gripping, durable, and stable are a few words that describe today’s trail shoes. By far, today’s shoes are better then shoes of years ago. Technology has made great strides in how shoes are designed and made. I love all the above features. They’re good. Trail runners have it made. Almost.

Last weekend I patched feet at the Western and I quickly realized many trail shoes have a huge flaw. Let me qualify my statement. When I look at footwear, my view is that of someone who repairs damage done by the shoe, socks, the trail, and other factors. Sure, I look at stability, fit, comfort, mid and outer sole design, the lacing system, and more. But put me out on the trail where I have runners coming to me for aid, and I look at the shoe a bit differently.

A Montrail shoe with mesh panels on the top and on the sides

A Montrail shoe with mesh panels on the top and on the sides

What I saw at Western States is the amount of dirt that gets inside the shoe. Even the runners who wore gaiters had dirt inside their shoes. Where did the dirt come from? It was easy to see. It came through the shoe’s mesh. On some shoes this was concentrated in the forefoot. Other shoes also have mesh around the midfoot and heel. All that mesh creates the flaw.

I understand that the mesh is designed to make the shoes breathable. This helps keep the feet cooler and weight down. It makes sense. But, Western States is a dusty trail. All that dust has to go somewhere. And it does – inside the shoe – through the mesh. Then the dust and grit goes through the sock and onto the foot. Sweaty feet and feet coated with lubricant attracts the dust. This leads to dirty feet and an increase in friction, hot spots, and blisters.

I still believe in gaiters for trail runners – but even with them, the mesh in the shoes give the dust and grit an entry point.

When you buy your next pair of trail shoes, look at them in this perspective. Some brands have more mesh than others. Maybe go for a pair that has a few mesh panels on the side, rather than over the whole forefoot.

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