Miles on Your Feet

May 25, 2014 by · Leave a Comment
Filed under: blister care, Foot Care, Footcare, Health, Sports 

Last weekend I worked the finish line at the Ohlone 50KM Trail Run in San Francisco’s East Bay hills. This is a tough trail, very exposed to the day’s sun, and every step is either up or down. Some people say, and I believe that if you finish Ohlone, you have a great chance of finishing Western States.

One runner who I admire and consider a close friend is Catra Corbet. She has proven herself as the “owner” of this trail. Many years she will run an Ohlone 100 or more just because she loves the trail so much. This year, Catra did 200 miles on the trail!

In talking to Catra after she completed the 200 miles, she mentioned that she had no blisters. I remember years ago taking a picture of her taping her toes. She used to tape every toe. I have a photo of her with a heel blister too. Now though, Catra runs blister free. What’s the difference?

I believe Catra’s success with blister free feet came through the miles of running she puts on her feet. She doesn’t run short runs, she doesn’t run a couple of times a week – she runs a lot. Many of you know Catra, or have heard of her – and know how much she runs. She also has found the right shoes for her feet – Hokas. She also wears Drymax socks – a favorite of mine.

But it’s not just Catra. I have worked medical and provided foot care at hundreds of ultramarathons, adventure races, walks, and multi-day races and have seen the same thing.

At the Western States 100 at 55.7 miles, for example, the top 20 to 30 runners come through Michigan Bluff without needing any type of foot care. There may be one of two that get some type of foot care from their crew down the road, but if so, is generally pretty minor. Most often, if anything, they just change socks or shoes.

As the race progresses and more runners come through, we begin to see runners needing help with foot care. The farther back the runners are, the more foot care they need. Not every runner, but many of them. And many of them have multiple issues. Not just one blister, but quite a few. The more problems that have, the more complex the repair, and the longer it takes to complete the fix. This becomes a huge issue if they are trying to stay ahead of the cutoffs at each aid station. I remember a runner several years ago that we patched up. At the next aid station, she need more care and wanted to get out of the aid station quickly to avoid the cutoff. That meant not doing a quality patch job –and she came back to the aid station after going a bit down the road. She knew her race was over.

So the point here is that you need to put lots of miles on your feet in order to train them for long conditions. You can run 10 miles a day, day after day, and then try and do a 50 miler, and odds are – you will have problems. You have 10-15 mile feet – not 50 mile feet.

This applies to walking, running, adventure racing, hiking, – any activity where you use your feet.

It all boils down to how many miles you are putting on your feet.

We all can’t be the top runners. Many runners don’t have unlimited time to train. So what can the rest of us do? Make sure you get some long runs, especially closer to your race. Make sure you have the best possible fit in your shoes. Make sure you wear quality socks. Reduce your calluses. Learn proper toenail care. Change your socks and shoes as necessary for the conditions of your run or race.

Over the years, I have talked to too many runners who think blisters are naturally a part of running and racing. They don’t have to be. Make smart choices and put miles on your feet, and your feet can be blister free.

Foot Care – Whose Responsibility?

May 10, 2014 by · 4 Comments
Filed under: blister care, Foot Care, Health, Sports 

The other day I was looking around the website for the Western States 100 and came across the picture below. It’s pretty brutal. The feet have been pounded to death and been wet – probably the majority of the race. I see torn blisters; blisters on the heels, bottom of the heel, ball of the foot, the crease by the toes, side of the big toes and the toes; and macerated skin. I have no idea if the runner finished the race or was helped off the trail, but my guess is that he gutted it out to the finish line. Click on the image for a larger picture.

Feet at the finish line of Western States

Feet at the finish line of Western States

My point in showing you this photo is to remind you, as strongly as possible, that there is only so much that I or any other medical person can do to repair your feet and get you to the finish line. You are the one person responsible for your feet, not your crew or anyone on the medical staff. Here are 15 questions you have to answer about your feet:

  1. What are the best shoes?
  2. Will you have additional shoes in a drop bag – the same kind, what size, and where?
  3. What are the best socks – one pair, two pair, double layer, Injinji toe socks, and what brand?
  4. Will you change socks – where and when, the same socks?
  5. Will you wear gaiters?
  6. Do you need lubricant – what kind, where on your feet, how much, and when to reapply?
  7. Have you trimmed your toenail and filed them short and smooth?
  8. Have you reduced your calluses?
  9. What is your plan for managing your feet during the race?
  10. If you get blisters, what will you do?
  11. How will you manage the inevitable water in your shoes and socks?
  12. Do you have a foot care kit?
  13. Do you and/or your crew know how to use the materials in the kit?
  14. If you go to medical for foot care, can you describe what you want them to do?
  15. Have you put the training miles on your feet necessary to run 100 miles?

These are not hard questions – but each is important – and together they make up your plan for your feet. The runner whose feet are pictured above made some wrong choices about his feet. As did many other runners. It happens every year and at races across the country. It’s not just a Western States issue.

The best time to ask these questions is in the months before the race. Then develop a plan. Just like you make up drop bags, find a crew, plan your food, a plan for night running – you need a plan for your feet. I emphasize “You.”

I cannot stress this enough. The medical staff at races cannot fix every big and little problem each runner has. At most races there are too many runners per medical or podiatrity people. And not enough supplies. And not enough time to get everyone patched up to continue on and make the cutoffs. Yes, we are there to help you and we do the best we can.

At Western States there are eight aid stations with medical staff. Each station usually has someone who is in charge of feet. These people have varying degrees of skill and supplies. Did the person above seek help at any of the eight aid stations? I wish I knew. If he did, what did they do?

Of course, looking at the feet above, you might be asking, “What could have prevented this?” or “How do we fix this?” Those are questions for a different post on a different day.

I’ll give you a hint though; the first question is answered in the pages of Fixing Your Feet. And if you have an old edition, you are shorting yourself because these are new information, new techniques, and new products in every edition.

The second question is harder. I have some ideas that other might not think of. This runner will struggle for many days as his feet heal. I pray that he’ll wonder what he did wrong and what he could have done better – and then seek out answers so his next race has a different outcome.

Note: I wish I could credit the photo to a photographer. If I find out, I’ll add a comment to this post.

Listen to me interviewed on Trail Runner Nation

A few weeks ago I was interviewed by Scott Warr and Don Freeman from Trail Runner Nation. I was honored they asked me and we had fun doing the interview. The subject? What else but feet!

Trail Runner Nation

Trail Runner Nation

You can listen to the interview on their website, download the MP3 file, or better yet, subscribe to their podcast series through iTunes. Here’s the link to their webpage: FEET – Injury Prevention and Treatment with John Vonhof.

Here’s what they wrote on their website:

One of your most important tools as a runner is your feet. You need to take care of them or your training/race may be foiled. John Vonhof literally wrote the book on how to take care of your feet: Fixing Your Feet.  This book is now in the FIFTH edition!  John joins The Nation to discuss the basic principles of foot care:

  • How you can have healthy & happy feet
  • Footwear
  • Insoles
  • Gaiters
  • Blister prevention and treatment
  • What to keep in a foot care kit
  • Taping your feet

The interview is 62 minutes in length, but my interview starts about five minutes in. Enjoy the interview and then subscribe to Trail Runner Nation’s podcast.

Thanks Scott and Don for giving me the opportunity to share a bit of my passion for feet on your podcast.

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