A Thru-Hikers Story About Bad Feet

May 28, 2016 by · 4 Comments
Filed under: blister care, Foot Care, Footcare, Health 

Today’s post is a thru-hiker’s story about her experiences with her feet. It’s one that make you grimace when you hear the details and see the pictures. I share the story because there are lessons to be learned. Here’s her story.

“This past April, I started the Pacific Crest Trail intending to thru-hike northern-bound to the Oregon/Washington border. I’m an experienced long distance thru-hiker and frequently hike 20-25 miles without issue.

Taped feet with gauze and white athletic tape.

Taped feet with gauze and white athletic tape.

“Rarely do I get blisters, and I have no calluses. The day I started at Campo, California, I hiked a 20-mile day and was shocked to find my toe pads laden with deep blisters at the end of the day and a couple smaller surface blisters on my little toes. This is how the trip started! I did my best triage but wasn’t very familiar with how to treat such ailments, and so continued hiking.

“By the time I’d reached mile 350 on the trail, my feet were an absolute mess. Blisters had become wounds, wounds became infected, toenails were falling off and each foot was severely compromised. At one point I sat on the edge of the trail so frustrated I was in tears! What was wrong with my feet?

Healing left foot

Healing left foot

“Only after my feet got good and angry did I switch to a larger size shoe in hopes of accompanying the swelling. I think one of my mistakes early on was that I used gauze and Neosporin along with athletic tape and made mummies of the feet. Add to this 90-degree heat through the desert and my feet looked like big balloons, which barely fit in shoes. They were so painful that one day while walking, I took my socks off to give my feet more room. That caused heel blisters. But aside from cutting the sides out of my shoes, I had no other choice. I was in a remote area hardly able to walk despite taking NSAIDS.

Healing right foot

Healing right foot

“After I hit Big Bear Lake, I rested for 4.5 days in hopes of curing my issues. When I set back out on the trail I switched to Altra Olympus 2.0, in a half size larger than normal (for swelling issues) since they offered more cushion. I hiked for two days, but my feet were not healed all the way and I suffered terribly during that timeframe. Blisters popped up in places they’d never been, likely because my gait was compromised and I was still in pain. I was finally able to hobble down to a highway and hitchhike to a town where I put on flip-flops, rented a car and flew home.

“I’d never had these issues before in all my years of long treks. When I got home, I started researching foot care online and came across your book, which I downloaded. I read it cover to cover and feel it’s the part of the puzzle that I never knew I needed and also, the solution moving forward. I’m following your advice with the tapes and have been practicing with bandaging as you suggest, including the betadine prep and a dab of zinc oxide on the new recovering skin. I also purchased some powders and lubes and will take the whole shooting match with me when I get back out on the trail.

“I’m also trying Injinji liners to see if that helps, although my feet aren’t particularly sweaty. I believe that the deep blisters in my toe pads were due to the heavy water weight I had to carry through the desert, which was different than how I trained since I underestimated how much water I’d need in such a harsh environment. I did wear trail gaiters, but my shoes were Altra Lone Peak 2.5’s and they allowed dirt to come in. There was a lot of abrasive mica in the desert soils and it’s hard to keep feet clean with little water available. I used wet wipes but it was still hard to get the grit out. My pack’s base weight is very low at 14 pounds, so I’m doing everything I can to keep the pack as light as possible and have lots of experience with backpacking. Nothing else hurts – no hip, knee or ankle pain – just these silly feet.

“I did not make any changes to my shoe or sock choices before starting. I used the same combination I’ve used for years without problems. Things I did not do which I probably should have: take more breaks, start out slower and not push huge days, wipe my feet off several times a day with wet wipes, change socks more frequently, stop more for hot spots, listen to my body, and take preventative measures to not get blisters.”

I initially asked the thru-hiker my usual questions. Did you change footwear, socks, conditioning, etc? Were you wearing good socks? Was the weather a factor? Do you wear gaiters? Do your shoes/boots have a mesh upper that allows grit and dirt inside? It sounds like your feet rebelled at what you wanted them to do. We traded emails several time with her providing answers and my giving suggestions.

The lessons I mentioned at the start of the post? Here are a few that pertain to thru-hikers, hikers in general, runners, ultrarunners, and adventure racers.

  • Know your event. Carrying extra water, food, and other supplies in a weighted fannypack, hydration pack or backpack can put extra stresses on your feet.
  • Know any possible weather issues. Heat, rain, and humidity can all cause problems.
  • Know any possible trail/road issues: water, stream crossings, desert sand, grit, and rocks.
  • Know about any special accommodations necessary for like swelling feet, and grit or sand getting into your shoes’ mesh uppers.
  • Know what to do when you have problems with your feet and have the supplies to fix them. Practice ahead of time to refine your skills.
  • Know how to get your blistered feet back into hiking/running condition.

A Pep Talk on the 6P’s of Foot Care

May 20, 2016 by · Leave a Comment
Filed under: blister care, Foot Care, Footcare, Sports 

A month ago I wrote a blog post about two multi-day races in Europe that are implementing a triage system for medical care at aid station – the outcome of their being overwhelmed by the amount of treatment and time that their participant’s blistered feet were requiring. Here a link to that post about Providing Foot Care for Athletes.

In this post, I want to expand on a quote from their website that I included in the original post. It was about the 6Ps of foot care.

They stated that foot care is easily divided into several phases, what they call the 6Ps: “Proper Preparation Prevents Piss-Poor Performance” and provided a thorough list of preparation, prevention, assessment, and treatment suggestions. “Proper Prevention” means in the months before the event, “Prevents” means during the race, and “Piss-Poor Performance” is what happens if you fail to follow the first three Ps. Let’s talk about these one-by-one.

Proper Preparation – In the months leading up to your race, and even race to race, you, and you alone need to be responsible for learning proper preparation. You need to learn how your feet respond to being wet and maceration starts, to being in sweat soaked and dirty socks, and when your feet are caked with dirt and grime. You need to learn about the best lubricants and/or powders, and insoles. You need to learn what causes the hot spots and blisters and what steps you can take if or when they develop. You need to practice taping or whatever strategy you plan to use. This is your job – not your crew’s job – and not the medical or non-medical people at aid stations.

Doing Your Own Foot Care

Doing Your Own Foot Care at Raid the North Extreme in northern BC Canada 2007

Prevents – You need to know what to do when you develop hot spots and blisters, and have the materials and tools, and even more importantly, the skills, to fix your feet. This focus on “prevents’ needs to happen in the months before your race and during the race. It’s about proper toenail care, skin care, callus reduction, shoe and sock selection, whether to wear gaiters, preparation for a variety of weather conditions, and of course, putting the required and necessary training miles on your feet. This also is your job – not your crew’s job – and not the medical or non-medical people at aid stations.

Piss-Poor Performance – This is what can happen when you fail at any of the first three Ps. Your performance suffers. Your race may be over. In many races, medical volunteers will try and help patch your feet. Some races do not have the luxury of dedicated medical volunteers for all the aid stations, much less the finish line. You cannot and should not count on a race having medical personnel to help with your foot care needs. Just because there is a doctor, nurse, or EMT at an aid station, that doesn’t mean they know how to patch feet. You cannot and should not count on races to have the foot care supplies that you want for your feet. If you will have a crew, work with them so they know how to work on your feet with your supplies.

Some runners may feel I am being too harsh as I tell you these are your responsibilities. Let me share a story from years ago. In 1985 I ran Western States for the first time. After crossing the river at Rucky Chucky, I had blisters in the arch of one foot. Someone at the far side offered to help patch my feet. After lancing the blisters, I had a wad of gauze taped to my arch, which changed my gait. I finished the race, but learned a lesson. The treatment, while well intended, was not the best for my foot. I learned to take responsibility for my own foot care. For the next three years running Western States, I managed my feet – and I’m sure that experience helped fuel my interest in foot care.

So my point in expanding on the 6Ps in this blog post is to reinforce the notion that foot care of your feet is your responsibility. If there are medical volunteers at a race, and they know how to patch feet, and have the supplies – and the time, consider yourself fortunate – but don’t count on them being there.

Please feel free to agree or disagree with my position, and share by commenting below,

Exciting New Sock Technologies

May 7, 2016 by · 1 Comment
Filed under: Foot Care, Foot Care Products, Footwear Products 

I love how technology continues to push the limits in sock construction. The companies below offer unique sock design that shows how companies are making products that stand out in a crowded field. Here are four interesting sock companies worth check out.

Ellsworth V-Channel socks have vapor channels to carry sweat vapors through the channels and off the foot – keeping the foot drier. The channels run from the toes to the heels.

Farm to Feet has developed their Blackburg Water Sock with a combination of nylons and elastic yarns in a unique design that allows water to drain quickly, dries quickly, and provides UIV protection. PTFE-coated nylon fibers create a frictionless feel.

Sensoria Fitness smart Socks harness new technology by embedding electronic threads and textile sensors, and pairs these with thin anklets on the tops of the socks, These are paired with a Smartphone app to capture step count, cadence, and foot strike forces. The full system also has a heart rate monitor for full data capture and a virtual coach in your ear.

ArmaSkin anti-blister socks offer a layer of dermal protection with their socks, engineered for extreme endurance athletes. These are thin but tight fitting and are worn under your normal socks. The Si Fusion coating sticks to the skin and prevents any friction generation next to the skin while giving a dermal like layer of skin protection. In addition, the Si Fusion hydrophobic inner pushes moisture to the outer layer and is bacteria static so the socks can be worn for long periods of time. ArmaSkin’s smooth outer fabric reduces friction by allowing the outer sock and shoe to move harmlessly over the foot – preventing blisters. They recommend not using any lubricant inside their socks – other than a small dab between toes as needed. The socks are made in Australia, making them harder to find, but their positive features make the search worthwhile.

When you purchase socks, spend a moment reading the washing instructions. With most performance socks, you should not use bleach and fabric softeners as these may break down the fibers.

Check out the above socks and buy a pair or two. As always, don’t try them for the first time in a race.

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