Fixing Your Feet 6th Edition Available

After 14 months of revising and updating, editing and then editing again, and issues with the cover, the 6th edition of Fixing Your Feet is available.

While it has been available for pre-order in Amazon, they now have the print version in stock and ready to ship. Amazon currently has the 6th edition priced at $13.64, well below the retail price of $19.95 – a great buy. Here’s a link if you want to order a copy.

The Kindle ebook version will be released in about two weeks.

As I meet runners and crews at races, I find many have an older edition. I encourage you to bite the bullet and get the 6th edition. It’s well worth it.

Every new edition has all products and URLs verified. In addition, the text has been tightened up to eliminate redundancy of topics, and remove out-dated information. Many topics have expanded and new information. Every chapter has been reviewed and some degree of change made.

The chapter on Extreme Conditions and Multiday Events includes new information on the growing problem with maceration, as well as new information on trench foot, chilblains, and frostbite, all possible in the adventures we participate in.

A new chapter is Blister Prevention – The New Paradigm. The chapter revises the thinking that moisture, friction, and heat are the causes of blisters. After much study by experts in the field, I introduce the concept of shear as the underlying cause of blister formation. Several charts show the relationship of moisture, friction, and heat to shear, and how new things like bone movement, skin resilience, and pressure; along with the usual things like fit, socks, insoles, lubricants, and more, influence blister formation. The chapter also stresses the value of ENGO Blister Prevention Patches.

Fixing Your Feet, 6th Edition

Fixing Your Feet, 6th Edition

I would be remiss if I didn’t comment on the new cover. The first cover mock-up had an image of an athlete trying to patch her feet, but it did not capture my view of doing foot care and blister patching well. I arranged a photo shoot with a local photographer and Tonya Olson, a physical therapist and well-trained foot-patching expert as our model. Thanks Tonya. I’ll let you be the judge, but I like the cover and the design.

If you have an older edition, you will benefit from the new edition. Even if you have the 5th edition, you’ll find value in the new 6th edition. Order the 6th edition through Amazon.

Once you have the new edition, I’d be appreciative of a review in Amazon when you have time. Reviews are important and help other buyers make informed decisions.

Note: The links above are my Amazon affiliate link.

Don’t Do This to Your Feet!

July 17, 2016 by · Leave a Comment
Filed under: blister care, Foot Care, Footcare, Footwear, Health, Sports 

Over the next few days, over 90 ultra runners will test themselves at the Badwater Ultramarathon in California’s Death Vally. 135 miles. Extreme heat, scorching roads, sand, wind, hot winds, and then at the finish line – much colder temperatures. I’ll be there to help with runner’s foot care issues, working with Denise Jones.

I decided to rerun this blog post from 2010. It describes an issue that can harm a runner, and can happen when time is not taken to repair small blisters before they become large, and then huge.

Here’s the post from July 2010.

This was a good week. Badwater in Death Valley always is. Fit runners, great crews, fantastic scenery through the harsh reality of Death Valley – and for me, lots of feet needing care.

For the most part, things were pretty normal. Blisters and more blisters. A great case of severe capillaritis (heat rash) on one runner’s ankles. Ugly toenails. Stinky feet. And more. Lots to like for someone who does foot care.

At the closing ceremony, I noticed Monica, a runner from Brazil, was favoring her right heel. I had met her several years earlier at a previous Badwater when I patched her feet at the 40-mile mark. This year, she finished her 2nd Badwater and that was important. However, she had not come in for help.

She should have.

After the awards ceremony, Denise Jones came and told me I had to see this blister. She talked as if it was really a great find. Denise, as the Badwater Blister Queen, has seen everything and it takes quite a bit to faze her. This blister did. And yes, it was good.

What started as a small blister, one that could have been treated to prevent it from getting bigger, was now an enormous blood blister. The image shows you the size.

An enormous blood blister

An enormous blood blister

There were several issues we had to consider. First and foremost, Monica is a diabetic. This makes foot care a huge issue because any foot infection suddenly becomes a huge health issue. Secondly, the size of this blister, filled with blood, would make it difficult to patch. As always, blood-filled blisters must be managed with care.

We debated the issues and gave Monica advice on how to take care of the blister for her trip home. We advised frequent soaks in warm/hot water with Epson salts and sticking to sandals or other open heel footwear.

What I want to emphasize here is that this never should have reached the size it was and worse yet, filled with blood. For those wondering, a blood blister is bad because, once opened or torn, it can introduce infection into the circularity system if not kept clean.

I wish Monica had taken care of this earlier. She may have never mentioned it to her crew. At any rate, what could have been easily treated now became a huge issue.

It’s a good lesson on not allowing small problems to become large problems. In other words, “Don’t do this to your feet.”

Thru-Hikers Feet – an Update

July 13, 2016 by · Leave a Comment
Filed under: blister care, Foot Care, Footcare, Health 

This is an update to my blog post of May 28, A Thru-Hikers Story About Feet. The thru-hiker is Tami and she is still hiking the PCT.

When possible I love to share people’s before and after stories with their feet.

Her story was interesting because she was having huge issues with her feet. I shared three pictures that she sent me, which shows the damage to her skin. I’d suggest going back to read the first part of her story and seeing the pictures. It’s important because it put today’s blog post update in a real-life perspective.

Tami wrote:

“I just wanted to drop you a follow up line and let you know that my feet have never been better thanks to you! I just walked 600 miles (trudging over 20 miles per day in the High Sierra on rough rock during dehydrating heat spells carrying an extremely heavy pack complete with bear canister…yes this is a run-on sentence but I can’t help myself) using your preemptive taping methods and tincture of benzoin for toughening and I didn’t get one single blister! This is a huge breakthrough for me and I’m giving acknowledgements to your book and your suggestions everywhere I can- you truly are helping me hike the Pacific Crest Trail.

“Yes, I’m still hiking and super in tune with these feet. Every tiny hot spot or slight discomfort makes me stop and evaluate everything. Thanks for the reminder to not get complacent, it seems like my feet are tough, but it wasn’t too long ago that I was disabled to due horrible blisters.

“I thought my foot issues would be putting the cabosh on my plans, but here I am with happy feet! I met a girl on a bus who was limping around with blister pain and pulled out my foot kit for her to look at. She took notes, jotting everything down including your book title. These are hard lessons learned, but then again, I never seem to do anything the easy way. Thanks so much.”

So what do we learn here? We see that there is hope. It shows that athletes can survive and find help and solutions for their foot issues. Whether you are a thru-hiker, like Tami, an ultramarathoner, marathoner, walker, adventure racer, or anything else, you don’t have to quit because of your feet. Tami was smart and reached out for help – and was willing to put in the effort to learn what to do and what her feet needed.

You can do the same thing.

Consequences of Maceration

Macerated feet at the finish line of Western States

Macerated feet at the finish line of Western States

At Western States we saw a lot of negative results from wet feet. Even though we tried to spread the word, many runners did not protect their feet. Runners had poured water over their heads, which went into their shoes, and they sat in streams. Runners were complaining of blisters on the feet, mainly the balls of the feet but it was maceration. In reality, almost everyone had one or more skin folds common to their feet being wet for long periods of time. These might be in the center of the mid-foot or at the ball of the foot near the toes. Some did fine by warming their feet, applying powder, changing socks and shoe when possible, and maybe sitting a bit – and continued on and ran well. Others did not stop at aid stations or get crew help, and ran on with wet feet. Then they reach a pain point at which they cannot continue, or they reach the finish line – and they want help with their feet.

There is no quick fix to maceration. The more severe it is, the longer it takes to return to normal. Maceration can be painful – and yes, feel like one’s feet are burning. The skin is so soft and tender that every step is painful. Many times the skin has folded over on itself or has lifted to form deep creases, which can split open. I have seen maceration go through several stages:

  1. First, the skin begins to soften and becomes tender.
  2. Second, the pruning starts as the exposure continues. The skin wrinkles and softens even more.
  3. The third stage is when the skin can form creases and folds over onto itself. The creases may be shallow or deep, but are painful.
  4. The fourth stage is the most severe. The folds split open and/or the skin may tear.

If there are blisters, they must be drained and covered with a waterproof dressing to help keep tissue swelling under control. Tissue swelling leads to cold and damp skin, swollen and difficult to patch.

There are ways to deal with maceration, but it’s even more important to take steps upfront to prevent it. For instance, change into dry shoes and socks whenever possible, change socks as often as possible. When getting crew aid or at aid stations, remove your shoes and socks to allow your feet to dry, sprinkle with powder and rub it in, warm your feet with light massage, let them see some sunshine, and use one of the moisture control agents.

For moisture control, RunGoo from Foot Kinetics is one of the best. Its thick white paste works wonders on the skin and helps keep moisture at bay and it last a long time. FootKinetics.com has created a great product that works. Other excellent products include Trail Toes, ChafeX. SportsSlick, and Desitin Maximum Strength Original Paste. One thing to look for in these products is how long they last and do they come small packages or could they be packaged small enough to be carried in a hydration pack. My preference for applying any of these is to use them liberally. Then bunch your socks and roll them over your feet. Avoid just pulling your socks on, which can thin the product around your toes and forefoot.

Applying a coating of Hipoglos

Applying a coating of Hipoglos

Having severely macerated feet is not a badge of courage. It’s a sign that you could have made better earlier choices in foot care. Some of the worst feet I have seen have been because of severe maceration.

For 20% off your purchase of RunGoo from Foot Kinetics, use the coupon code “tfk20john.” I’m even using it as a chamois cream when road bike riding. It does last.

In a future post, I’ll talk about treating feet and maceration at a race finish line.

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