Really Sore Feet and Fleecy Web

October 31, 2015 by · Leave a Comment
Filed under: blister care, Foot Care, Foot Care Products, Footcare, Health 

After years without an expedition length adventure race in northern California, the Primal Quest Adventure Race returned this past August. Even though there were openings for 20 four-person teams, only 11 teams toed the starting line in South Lake Tahoe.

For those unfamiliar with adventure racing, races generally consist of a mix of disciplines: trekking, mountain biking, orienteering, white waters, rafting, kayaking, and ascending and rappelling. Some events have caving and other exotic disciplines.

This year’s race stated with a downhill run to kayaks on the shore of Lake Tahoe, after which they paddled north, and then took off on mountain bikes for a long ride. Unfortunately, much of the 80+ miles turned into a hike-a-bike. Then at Kirkwood, they took off on foot for a long trek / orienteering section. For some teams, this section took hours longer then expected.

I was at TA3 (transition area) and we expected the first team early Friday morning, but in fact they arrived almost 24 hours behind schedule. The rest of the teams were spacer further and further apart as time progressed.

My point is that many of the racers had been on their feet for more than two and three days by the time they reached us. Then teams went back on their bikes, into kayaks, and into another long trek. Some teams were short-coursed – taken ahead on the course

Fast forward to TA6, a day and a half later and teams are still racing. Some of the racer who have done the full course to this point have had little time to rest and their feet are extremely sore to the point of being very painful. They may also have some degree of maceration going on too.

One such racer, Thomas, asked me to look at his feet. There were no blisters on the balls of his feet, just very soft and tender skin – very sore with some maceration. I told him I could help.

Hapla Fleecy Web

Hapla Fleecy Web on very sore feet

I cleaned his feet and allowed them to air dry. I applied Tincture of Benzoin Compound to the skin from mid-foot upwards to the base of the toes. Over this I place a piece of soft, 1/8 inch thick Hapla Fleecy Web (adhesive felt), cut to follow the shape of foot at the base of the toes, square at the bottom, and curving up a bit on each side of the foot. At the base of the felt, mid-foot, I placed a strip of Leukotape to help hold down the bottom edge of the felt. Benzoin was used under the tape and edges were rounded. The last touch was two figure 8’s, cut from HypaFix cotton tape, placed between the 1st and 2nd toes and the 3rd and 4th toes, with the bottom of the 8 under the foot and the top of the 8 on top of the foot. This anchors the forward edge of the felt against the skin and keeps it from rolling, especially on downhills. Each figure 8 is about three to four inches in length and the tape is two inches in width.

Fleecy Web on the foot

Fleecy Web showing application on the side of the foot

I received a report later in the race that the patch job had held. After the race ended, Thomas let me know the patch had helped his race.

The adhesive felt helps pad the forefoot and provide cushioning to the sensitive tissues, and can help relieve pain and discomfort from maceration. This is not moleskin, or a version of moleskin. It’s a thicker product and much softer. The felt can be found in 1/8 and 1/4 inch thicknesses. In the Amazon we used fleecy web that is 1/8 inches thick. In the Amazon Jungle Marathon I used the patch job many times on macerated feet – after drying the skin as much as possible.

Medco Athletics sells adhesive felt in a variety if thickness and lengths. You can search on “adhesive felt” or for a specific product I have used, “Fleecy Web.” To give you an estimate on pricing, four Hapla Fleecy Web 9” x 16”, x 1/8 thick sheets sells at Medco for about $26.00. The Hapla Feecy Web is 100% cotton and is latex free.

It also works well for padding around blisters, bunions, heel bumps, and more. Because it is thicker than tape, I would use Benzoin to help it stick better and consider adding extra tape as I described above.

Foot Care – Help Yourself and Study Up

October 16, 2015 by · Leave a Comment
Filed under: blister care, Foot Care, Footcare, Health 

My October issue of Backpacker magazine featured an article about Bil Vandergraff, a Search and Rescue (SAR) Ranger. He served as a ranger for 25 years in the Grand Canyon backcountry. In the article he shared tips on surviving in the backcountry – especially in the harsh and unforgiving Grand Canyon with its heat and extreme elevation changes.

His tips on dealing with the heat are right on: wear the right clothes, embrace the sweat, go slow, stick to mornings and evenings, and know when to stop.

He stresses the importance of helping yourself and to study up – studying the route and conditions.

The one line that struck me was this:

“I don’t take care of blisters. I refuse to. If you can’t take care of your own blisters then you don’t belong in the canyon.”

Wow. I like that.

That same philosophy could be applied to runners, adventure racers, hikers – in short, anyone venturing into the outdoors on their own. Badly blistered feet can stop you in your tracks, can make it hard to climb out of the Grand Canyon, or off a mountain or out of any trail.

Can we apply that to races too? That’s a hard question. A huge question!

If a race has crew access, should the crews be responsible for foot care? Some races don’t provide specific foot care. Others have it in limited form based on whatever foot care knowledge any aid station volunteers or medical personnel may have and based on whatever supplies they have.

I know that at some ultras and adventure races participants will move along the trail from aid station to aid station, and at each one, require some degree of foot care. What was patched at an earlier aid station didn’t work or didn’t hold up. And they want someone at the next aid station to redo their feet. That’s a lot of work and a lot of supplies.

What compounds this question is that many athletes fail to do what SAR ranger Vandergraff stressed, helping yourself and study up. Anyone who has worked an aid station knows full well that many of the participants fail to take care of their feet to start with, fail to trim toenails, fail to reduce calluses, fail to wear the right socks, fail to wear gaiters, fail to replace worn shoes, insoles and socks, fail to learn how to do self-care, fail to educate their crew on good foot care techniques, and fail to have adequate foot care supplies. So then, when they run into problems, they want help. Their failure to plan, and in many cases, take common sense action that could have prevented or reduced the problem, then creates work and expense by others.

I remember an old quote by Benjamin Franklin, “If you fail to plan, you are planning to fail.”

Many events would see their finishing rate drop dramatically if they eliminated foot care. There is a definite need for medical care to ensure that participants don’t get into trouble that could cause them serious injury or bodily system failure – but is foot care one of those?

I’ll repeat Vandergraff’s statement. “I don’t take care of blisters. I refuse to. If you can’t take care of your own blisters then you don’t belong in the canyon.”

Again, can we apply that to races too? That’s a hard question. A huge question!

When Your Shoes Fail You 

October 3, 2015 by · 1 Comment
Filed under: Footwear, Sports 

It’s not common but it can happen. At the worst opportune moment, your shoes fail you. Maybe it’s on a training run, or worse yet, it’s during a race or somewhere where you are miles from getting help or another pair of shoes.

I’ve seen it more than a few times.

Shoes that fell apart where the upper joins the midsole. Shoes where the upper material was so flimsy it came apart running in an adventure race. Shoes that partially melted when left too close to a fire in the desert in Chile (that was user error though!). Shoes with seams that did not hold, leaving gapping holes in the uppers. Shoes where the outersoles came apart. Shoes whose shoelaces won’t stay tied. Shoes that simple fell apart.

Then the other day a story on Facebook caught my attention. One of Nike’s elite runners was running the Berlin Marathon this past Sunday and had a major shoe failure.

Keya’s Eliud Kipchoge won the marathon, but the insoles of both shoes came up and out the back heel counter of the shoe. He had run in the shoes previously in Kenya without incident. Here’s a link to the story on The Wall Street Journal’s website.

Insole failure

Insole failure

In the marathon, the shoes failed around the first kilometer! It’s hard to be certain, but he missed the world record by just 63 seconds. Setting a new world record was his goal for the race. Nike said he was testing a new prototype.

I feel for Mr. Kipchoge.

Sometimes stuff just happens. Sometimes though it happens because of user error, as in one of my examples above.

Your job is to make sure that whenever you lace up your shoes, they are in good working condition. How often do you take a few minutes and check your shoes? Take out the insoles and clean out the shoes and wipe off the insoles. Check the insoles to make sure that aren’t flatter than a pancake or even worn through. Make sure the back edge of the insole around the heel hasn’t folded over or formed a hard, thick edge. Check your laces for worn spots that could break, Check the shoes top to bottom for seams coming apart or weak areas. Check the midsole to make sure it still has life left in it. Make sure the inside fabric of the heel counter doesn’t have holes in it.  Make sure the outersole hasn’t loosened at the edges and that it isn’t work through.

That’s your job. It really pretty simple. But you’d be surprised how many times I’ve seen runners in a race that they’ve paid a lot of money to enter, and trained hard for, only to wear shoes that should have been replaced.

Don’t let your shoes fail you, -and make sure you don’t fail your shoes.

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