Blister Repair – Your Way or Their Way?

July 29, 2012 by · Leave a Comment
Filed under: Uncategorized 

One of my goals is to educate athletes about good foot care techniques. You may recall blog posts where I stress the importance of knowing how to do foot care and importantly, to know what’s best for your feet.

I recently received an email from Rob, asking for some advice. Here’s Rob’s email:

I have been running a modest 30 miles a week for a few years. Last weekend we attended a tennis camp and during the first night of drills during ball pick up (not during a drill or competitive play) another player smacked a ball in to the arch of my foot from a shot distance away causing severe pain. I played through the pain and the next morning I asked the trainer to tape up my bruised arch, which she did. I played all day and at the end of the day there was a blister in the center of my foot between the taped and un-taped area. I went back to the trainer in the morning and she created a donut shaped pad about a 1/4-inch thick and taped it to my foot. I took out my shoe arch supports and played for another 1/2 day in a bit of pain. When I took off the shoe, sock, and bandage and pad I found that the blister had filled with liquid to the size of donut hole – now a huge blister about the size of a silver dollar and 1/4-inches thick. The camp staff took picture as the biggest tennis-related blister they had seen. I went back to the trainer at the college and she drained about half of the liquid out of the blister and we decided I was done playing tennis for the rest of the camp. I’m not sure going to the trainer really helped and I probably should have had your book along as reference and taped myself up. Now I am back home and have a huge blister on the bottom of my foot. 

This is a case where the trainer patched Rob’s blister the best way she knew how. It was an “old-school” patch job. A piece of moleskin cut in a donut shape with a hole in the middle for the blister. There may have been Vaseline on the center, and then tape or gauze over the top.

The problem with this old-school method is that it adds bulk to the foot – that can easily alter the person’s gait. This gait change can lead to further problems. At the same time, the patch can cause irritation, expanding the original blister or leading to new blisters.

Rob’s experience shows there is a long ways to go to get everyone up to speed about good blister care. I’d bet that if Rob had been prepared, he could have done a better job then the trained did. It’s hard to go everywhere with a blister patch kit in hand, but here’s my recommendation. Make up several simple kits and put them in Zip-Lock bags and stash one in your car and another in your gear bag. Fill the kits with your choices of blister tapes and patches. Then of course, make sure you know the best way to patch any blisters that may develop.

Here’s where to start – pages 228 to 256 in the 5th edition of Fixing Your Feet. If you don’t have a copy, or have an old edition, my suggestion is to get the new one. My home page has a link to Amazon if you need one. I was amazed at Badwater in Death Valley a few weeks ago. One of the runners had me autograph a copy of the 2nd edition. So much changes from edition to edition that it’s a small price to pay to help your feet.

Blood Blisters

July 22, 2012 by · 1 Comment
Filed under: blister care, Foot Care 

In reality, most blisters don’t have blood in them. Repeated heavy pressure (friction) or simply long periods of pressure can turn an ordinary blister into a blood blister.

The fluid will go from clear to light pink, and with continued pressure, to blood red.

The general rule of thumb is not to lance and drain any blood blister. You may have to pad the area to take the pressure off the blood-filled skin. You need to now how to manage a ruptured blood blister.

Here’s why. The problem with blood blisters is that by draining them, the athlete’s circulatory system is opened to possible infection. In a sterile environment or at your home, this may not be an issue. However out on a trail, or somewhere where the athlete may be unable to keep his feet clean, it’s a different story. Where the blister is on the foot can present more problems. A blood blister on the side of the heel is not as problematic as one on the bottom of the foot. The opened blister is exposed to dirt, grime and any bacteria on whatever is touching the skin. Blood blister must be treated as wounds.

Another issue is whether the athlete has he right supplies in his foot care kit to patch the blister. Opening it up and not applying antibiotic ointment and a covering it is a huge mistake.

I tell athletes that normally blood blisters are not lanced because that is the wise thing to say. If everyone thinks they can simply lance them, without fully understanding how to care for them, we’ll have a lot of people with infected feet.

At Badwater last year we had a runner with a very large heel blood blister. She was from Brazil and would be flying home – but she was also a diabetic. Because of her diabetic status, we declined to lance the blister. It would not have been safe.

Arch of the foot blood blister

Arch of the foot blood blister

The photo here is from last week’s Badwater Ultramarathon in Death Valley. The runner had completed the 135-mile race. I talked to him at the finish line and told him the pitfalls of lancing a blood blister. I told him to shower and be careful of popping it and to come see us in the medical room if it did pop. It popped when he was in the shower, the best of all places.

I cleaned the area with alcohol wipes and lanced the blister with a #11 scalpel. I made three cuts so any more fluid would be forced out as he walked. I expelled the blood and applied a generous layer of antibiotic ointment. A gauze 4×4 was placed over the top and then the foot was wrapped with Coban, a wrap material that sticks only to itself. I gave the runner a Zip-Lock bag with a small tube of ointment, several more 4x4s, a Popsicle stick to apply the ointment. I told him he could unwrap the Coban and reuse it multiple times. Then I asked him if his Tetanus was up to date after which I gave him the usual infection speech.

Recheck the blister three times a day for signs of the infection. Each time you check, apply a new coating of antibiotic ointment and change the dressing. Early treatment can keep the infection from becoming more serious.

An infected blister may be both seen and felt. An infection will be indicated by any of the following: redness, swelling, red streaks up the limb, pain, fever, and pus. Treat the blister as a wound. Clean it frequently and apply an antibiotic ointment. Frequent warm water or Epsom salt soaks can also help the healing process. Stay off the foot as much as possible and elevate it above the level of your heart. If the infection does not seem to subside over 24 to 48 hours, see a doctor.

It’s wise to keep a tube of antibiotic ointment in your foot care kit. You may never get a blood blister, but then again, you might. And if you get one, it may not rupture, but then again, it might.

It’s better to be prepared by knowing how to care for blood blisters.

 

Follow Badwater starting Monday 7/16

July 12, 2012 by · Leave a Comment
Filed under: Sports, Travel 

Next week is Badwater. I’ll be there along with Denise Jones, patching feet. I’ve captured the press released from Chris because if utilizes the best of social media and the web to keep followers in touch with the race. After the race, I’ll post pictures. Promise. Here’s the story and links.

 

Badwater

Badwater

AdventureCORPS, Inc., an event production firm specializing in ultra-endurance and extreme sports events, will host the 35th Anniversary Badwater Ultramarathon on July 16-18, 2012. Recognized globally as “the world’s toughest foot race,” this legendary event pits approximately 95 of the world’s toughest athletes – runners, triathletes, adventure racers, and mountaineers – against one another and the elements. Covering 135 miles (217km) non-stop from Death Valley to Mt. Whitney, CA in temperatures up to 130F (55c), it is the most demanding and extreme running race offered anywhere on the planet.


The start line is at Badwater, Death Valley, which marks the lowest elevation in North America at 280′ (85m) below sea level. The race finishes at Mt. Whitney Portal at 8360′ (2533m). The Badwater course covers three mountain ranges for a total of 13,000′ (3962m) of cumulative vertical ascent and 4,700′ (1433m) of cumulative descent. Whitney Portal is the trailhead to the Mt. Whitney summit, the highest point in the contiguous United States. Competitors travel through places and landmarks including Mushroom Rock, Furnace Creek, Salt Creek, Devil’s Cornfield, Devil’s Golf Course, Stovepipe Wells, Keeler, and Lone Pine.

A true “challenge of the champions,” the 2012 AdventureCORPS Badwater Ultramarathon features 49 Badwater veterans and 49 rookies: die hard “ultra-runners” of every speed and ability, as well a athletes who have the necessary running credentials, but are primarily known for their exploits as adventure racers, mountaineers, triathletes, or in other extreme pursuits. They represent twenty countries by citizenship or residence: Argentina, Australia, Brazil, China, Costa Rica, Czech Republic, Canada, France, Germany, Iran, Italy, Japan, Mexico, Poland, Serbia, Spain, Sweden, United Kingdom, United Arab Emirates, and United States of America (and nineteen America states).

There are 18 women and 80 men. The youngest runner is 23 (rookie entrant Claire Heid of Tacoma, WA) while the oldest is 70 (Arthur Webb of Santa Rosa, CA, a thirteen-time finisher), with an average age of 45. Full details are available on the race roster.

The men’s course record is held by Valmir Nunez of Brazil with a time of 22:51:29 set in 2007, while the women’s course record of 26:16:12 was set in 2010 by Jamie Donaldson of Littleton, CO. It is expected that the winner of the 2012 AdventureCORPS Badwater Ultramarathon will finish in 22 to 26 hours. The average finishing time is approximately 40 hours, while the overall time limit is 48 hours, as compared to the 60 hour limited used in the races held through 2010. For those who finish in less than forty-eight hours, their reward is the coveted Badwater belt buckle. There is no prize money.

The 2012 race field is particularly competitive. Veteran contenders include 2011 men’s champion Oswaldo Lopez, 40, of Madera, CA (also place 2nd in both 2009 and 2010; Mexico citizenship), 2010 men’s champion Zack Gingerich, 32, of Tigard, OR, 2009 men’s champion Marcos Farinazzo, 44, of Brazil and 2004 men’s champion Dean Karnazes, 49, or Ross, California. Also competing is Marshall Ulrich, 61, of Idaho Springs, CO, the 17-time finisher who placed first in 1991, 1992, 1993, and 1996.

The women’s field, with 18 entrants, includes 11 rookies and 7 veterans. Veteran contenders include the 2011 women’s champion, Sumie Inagaki, 46, of Aichi, Japan and Pam Reed, 51, of Jackson, WY, the 2002 and 2003 overall champion who also won the women’s field in 2005. Every year is a new year at the Badwater Ultramarathon, with rookies and “previously unknown” athletes surprising the contenders with top performances. New stars will shine as the race unfolds in July.

RACE MAGAZINE Download the 2012 edition (44 pages; 3.4MB).

RACE WEBCAST Follow the race live via the webcast.

BADWATER ON TWITTER
Follow the 2012 Badwater Ultramarathon via Twitter. We will post race updates and observations, photo links, and important news and announcements. NOTE: Please use hashtag #bw135 to join the Twitter conversation! Here’s the current conversation stream.

BADWATER ON FLICKR
Official race photos by the Badwater Race Staff will post to Flickr July 15-18. Race Director Chris Kostman’s race photos will post to Flickr July 15-18 in his photostream.

BADWATER ON INSTAGRAM
Badwater Race Director Chris Kostman will be posting photos “live” (whenever a cellular connection is available, which is in Furnace Creek and then the latter 1/3 of the course and the finish line) via his Instagram account. Follow his photo stream on your iPhone or Android with the Instagram app and his stream at “chriskostman.” Photos also automatically post to Chris’ Instagram stream for viewing online.

BADWATER ON YOUTUBE
We will be posting videos from the race on the AdventureCORPS YouTube channel. Most videos will appear on Tuesday and Wednesday, where the internet connection is far superior to that in Death Valley.

My Foot Massage

July 1, 2012 by · 2 Comments
Filed under: Uncategorized 

Have you ever had a foot massage?

I had never had one until late in June. A while back I bought a Groupon coupon for a “reflexology” foot massage.

Some of you are asking, what’s refexology? Here’s what Wikipedia says, Reflexology, or zone therapy, is an alternative medicine involving the physical act of applying pressure to the feet, hands, or ears with specific thumb, finger, and hand techniques without the use of oil or lotion. It is based on what reflexologists claim to be a system of zones and reflex areas that they say reflect an image of the body on the feet and hands, with the premise that such work effects a physical change to the body. A 2009 systematic review of randomised controlled trials concludes that, “The best evidence available to date does not demonstrate convincingly that reflexology is an effective treatment for any medical condition.”

I had heard of reflexology and read a bit about it. So I decided to spend a few bucks and get one for half off. So what did I find?

First, I’ll tell you that I did trim and file my toenails before going. It made sense. Why would anyone go for a foot massage with unclipped toenails?

Second, I made sure my feet were clean. Again, to me that’s just common sense.

Thirdly, here’s what I experienced. I was asked to complete a multi-page questionnaire that focused on my health. Because this was sold as a reflexology session, I expected that. The reflexologist had me remove my shoes and socks and sit in a recliner chair. It started with a warm towel wash of each foot. Then massage oil was applied to my left foot, after which she wrapped it in Saran Wrap – I assume to keep the oil from drying out. Oil was applied to my right foot can she started the massage.

Not ever having a foot massage, I had nothing to compare it to.

My Foot Massage

My Foot Massage

Honestly, it was good. She used her fingers to work the tissue on the top, sides and bottom of my feet. I could feel her working between the metatarsals, between the joints and toes, and the fascia at my heel. It was easy to relax. She worked a couple of stubborn hard areas and complemented me on the condition of my feet. Once she was done with the right foot, she moved to the left.

My overall impressions were good. There was little said about reflexology. That may have been because I did not identify any health issues she could have focused on. But that’s okay.

The massage was great. My feet felt wonderful. I can see the value in getting regular foot massages if I was running regularly. The massage would help my feet in the same way that a leg would help the legs.

If you have tight muscles in your feet, cramping, or stress your feet with long runs with little recovery time between, a regular foot massage could help condition them to be as healthy as possible.

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