Foot Care – Whose Responsibility?
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.
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:
- What are the best shoes?
- Will you have additional shoes in a drop bag – the same kind, what size, and where?
- What are the best socks – one pair, two pair, double layer, Injinji toe socks, and what brand?
- Will you change socks – where and when, the same socks?
- Will you wear gaiters?
- Do you need lubricant – what kind, where on your feet, how much, and when to reapply?
- Have you trimmed your toenail and filed them short and smooth?
- Have you reduced your calluses?
- What is your plan for managing your feet during the race?
- If you get blisters, what will you do?
- How will you manage the inevitable water in your shoes and socks?
- Do you have a foot care kit?
- Do you and/or your crew know how to use the materials in the kit?
- If you go to medical for foot care, can you describe what you want them to do?
- 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.