Finding the Right Combination

November 22, 2017 by
Filed under: blister care, Foot Care, Footcare, General, Health, Sports 

This is Part V in a series about blister formation and prevention. Below are links to the first four parts of the series.

Finding the Right Combination

Each athlete needs to find a blister prevention strategy that works for him or her. One may use a lubricant, another may use Zeasorb powder, and yet another may pretape his or her feet. Each may use one of many types and styles of socks. There are many combinations. Remember, the goal of all these components is to reduce shear stress by bone movement, pressure, friction, and moisture; increasing skin resiliency; and absorbing shear. A look at the image will show how the 5 Blister Formation Factors (the 2nd outermost circle) and the 13 Blister Prevention Components (the two inner circles) are related.

Five Circles 1

High-level views of the factors in blister formation and components in blister prevention
The legend for the inner circle: G=Gaiters T=Taping N=Nutrition and Hydration C=Shoe and Sock Changes I=Insoles and Orthotics L=Lacing A=Antiperspirants S=Skin Tougheners and Adherents

Five Circles 2

 

Try any of the suggestions and find those that work for you. Some will and some won’t. That’s OK, because it’s a process. You are gathering information that will help you now, and file away other information that may help you later.

At the 2017 Western States Endurance Run I treated many runners who had ignored my advice about Running a Wet 100 Mile Trail Run posted on my blog two weeks before the race.I gave advice based on my years of experience in working on feet in multi-day races around the world. Things like clean socks, powder and lubes made for wet conditions in drop bags. And carry the same in hydration packs. I gave proactive advice on caring for one’s feet. It seemed the majority of the runners I treated had not read my blog post. because more runners than usual had badly macerated feet. The did not take advantage of a few of the components mentioned above.

Here are two more examples of runners using blister prevention components in combination.

Ultrarunner Dave Scott claimed his feet are often “as soft as a baby’s bottom” after the 100-mile Western States Endurance Run. Dave found that he rarely had foot problems. He trimmed his toenails, used a small amount of petroleum jelly, and regularly changed his shoes and socks. That is what worked for him.

Ultrarunner Tim Twietmeyer has won the grueling 100-mile Western States Endurance Run five times while accumulating 25 silver belt buckles for finishes less than 24 hours. Over the years, in addition to running ultras, he has enjoyed fast packing in the California High Sierra. He has found the differences interesting.

A week before running a 100-mile trail ultra, Tim trimmed his toenails as short as possible. The morning of the run he coated his feet with lanolin to reduce friction, provide warmth if running in snow or through water, and make his skin more resilient to getting wrinkled. Then he pulled on a pair of Thorlos Ultrathin socks. His strategy is “that the more sock you wear, the more moisture close to the foot. The more moisture, the more blisters and skin problems.” He usually wore the same pair of shoes and socks the entire way. Tim acknowledges, “My feet don’t usually have problems, and when they do, I’m close enough to the end to gut it out.”

Tim found that fast packing affected his feet differently. When he hiked the John Muir Trail in 1992 (doing 210 miles in five days and 10 hours), his feet were trashed more than ever before. His group of five experienced ultrarunners averaged 14 hours per day on the rough trail. Tim remembers, “We covered the ground so fast that my feet swelled and I almost couldn’t get my shoes on the last day.” He used the same strategy of using lanolin and thin socks. Instead of running shoes, he chose lightweight hiking boots. Foot repair became the group’s daily ritual as the 40-mile days took their toll. They realized that “an important strategy for keeping our feet from getting any worse was to get that first piece of duct tape on in just the right spot and make it stick. If we did that, our feet held up pretty well.” By the end of the fifth day, the last piece of duct tape had been used on their feet. Tim’s

cardinal rule for fast packing is to “keep your feet dry.” That can be hard to do when fighting afternoon thunderstorms, but when your feet are wet too long, it’s only a matter of time before they blister. Whether running ultras or fast packing, Tim knows the importance of keeping his feet healthy, and he has experimented to find what works well for him.

Both Dave and Tim used a combination of components: skin care, socks, lubricants, taping, toenail care, and changes of shoes and socks in an effort to prevent blisters. Determine what foot problems you normally experience, study this book, and then begin the task of finding what works best for your feet.

We need to understand the importance of other elements that contribute to prevention. Proper strength training and conditioning will help make the foot and ankle stronger and more resistant to sprains and strains. Everything you put on or around your foot becomes related to how well your foot functions. Keep in mind that whatever you do, the aim should be to reduce shear, moisture,

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