Junk in Your Shoes

March 25, 2015 by · 1 Comment
Filed under: Foot Care, Footwear 

There is an old Chinese proverb; “Failure results not from the length of the journey or the height of the mountain but the pebble in one’s shoe.”

We have all had it at some point – the pebble that is.

We are running or walking or hiking and feel a small irritant. We think to ourselves that maybe our sock bunched up. But, after a bit, we realize its something else. So we move our foot around a bit or kick it up against a rock or log, or maybe sideways on the ground. The hope is that that kick will move the irritating thing to the side where we won’t feel it.

Sometimes it works for a while. But it always comes back. We are always better off to stop, take off your shoes, and clear whatever the problem is. Even the smallest pebble can cause problems. It can start with a hot spot and develop into a blister. It can cause a hole to develop in the sock. It can tear into the insole’s covering.

So stop and remove it.

I remember a few years back when I was at the Gold Rush Adventure Race and encountered a similar situation. One of the racers came into the transition area and in the process of changing socks, I told her I’d clean out her shoes. The race route had taken runners through muddy areas and some had gone down into her shoes.

As I used my hands to clean inside her shoes, I found very rough hard edges under both heels. I thought it was a defect or tear in the insole. Surprisingly, it was hardened mud that was so hard, it took a lot of pressure to remove it from the insole. This must have hurt through the socks – but the racer had not bothered to clear out her shoes.

In reality, it might be a pebble – or mud. In either case, you are always better off to take a moment and get rid of the irritant.

Of course, I have to recommend gaiters for trail running. They can keep the pebble out in the first place!

Common Toenail Question

March 17, 2015 by · Leave a Comment
Filed under: blister care, Footcare, Health, Sports, toenails 

I get questions by email all the time. Toenail questions are quite common, so I thought I’d post this one. Here’s the question.

“I am emailing you because I have a 50K trail race this Saturday and for some reason I am just starting to get pressure from under my large toenail. It is in its early stages and my nail has not turned black yet, but it is starting to be uncomfortable. At what point do I decide to puncture thru my nail and lance the fluid under the nail? Also, if I should be lancing the fluid, what are your thoughts of using a really thin and clean drill bit (turned by hand) to get thru the toenail? I lost a toe nail once before and tried using a really hot paper clip and needle, but I had a hard time getting all the way thru my toe nail. Any help and advice you can give me would be much appreciated… thank you!”

The answer is pretty straightforward.

Draining a blister under a toenail

Draining a blister under a toenail

Can you recall any nailbed trauma? Once fluid is underneath the nail, the pressure becomes painful You’ll know. If you can see the fluid from under the tip of the nail, lance it there. A drill bit works better than a paperclip. Be forewarned that as it goes through the nail, it can go into the soft tissue underneath, so go slowly. Then press on the nail to expel as much of the fluid as possible. Cover with a Band-Aid for now (tape on race day) but don’t plug the hole with ointment, as it will still need to drain for a few days.

Relieving fluid from underneath a toenail is a simple skill that every runner should know how to perform – just in case. It could be on one of your toes, or the toe of a friend. If you have ever experienced the intense pain of a black toenail with blood or fluid underneath, you’ll appreciate knowing how to fix it.

Blister Repair – Your Way or Their Way?

March 7, 2015 by · 1 Comment
Filed under: blister care, Foot Care, Health, Sports 

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 the donut hole – now a huge blister about the size of a silver dollar and 1/4-inch thick. The camp staff took pictures of 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.

This post is from July 2102, but is important for athletes to understand.

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