Blister Management. Your Opinion?

May 23, 2015 by · Leave a Comment
Filed under: Foot Care, Sports 

When you enter a road or trail race, or start an adventure race, or plan a group or solo event, whether single day or multi-day, do you think about blister management?

There can be many responses to this question. Here are my guesses at the most common three responses.

For many, I’d guess the answer would be no. What happens, happens. They may have a simple first aid kit or blister kit. A bit of tape, maybe a pin and an alcohol wipe.

Others, if participating in an organized event, will count on aid station personnel to have the supplies and knowledge to fix whatever problems develop. They don’t understand that some aid stations do not have the right supplies or medical people, or if they do, they have little to no understanding of how best to treat blisters.

The third bunch takes a full hands-on approach. They have a fully stocked kit and either they or their crew know how to work on feet.

Then there’s the same question put to race directors and event organizers. When you put together the plans for your race, how much thought and planning goes into foot care for the participants?

Again, I think there are three typical responses.

The first is they don’t think about it. It’s either they simply don’t even think about it or they decide to let the runners deal with whatever problems develop.

The second group puts together simple kits of typical first aid equipment and puts them out on tables at the aid stations. Most likely, no one working the aid station knows what to do, or if they do, it’s hit or miss repair. Supplies often are minimal and sometimes not even helpful. I worked an event, a long multi-day race that fell in this category. Runners were hurting.

The third group is wiser. They have medical people and a well-thought out kit. Some, at larger events, have dedicated foot care people.

I need to say here that you don’t have to be a medical person to provide good foot care. I have worked at many events where non-medical people had excellent foot care skills.

You Can Help

So here are my questions for you.

  1. As a runner or adventure racer, what do you want to see at a race?
  2. What do you expect to see?
  3. If the race website and material does not specific what kind of aid or foot care is provide, do you assume it will be there?

Here’s my reason for asking.

A few days before Western States next month, I will be presenting a session about Blister Management at the 2nd Annual Medicine & Science in Ultra-Endurance Sports Conference in Squaw Valley. Plus two hands-on workshops teaching foot care skills.

I have my presentation pretty well planned. I’ve done this long enough and have learned a lot of material and skills. But sometimes I am puzzled at what I see from the race participants. Ill-prepared runners and crews and even some dumb decisions by runners (socks with holes, brand new shoes, serious athletes foot, bad toenails, and more).

My audience will be medical personnel and race directors from many ultras and adventure type races. The aim of my presentation will be to teach them about blister management during a race.

What I need to know is a bit about your expectations about blister management at races as a runner. Send me an email. You can copy in the three questions above and answer all three or as many as you want.

Thanks for your help.

How to Get Kinesiology Tape to Stick

May 2, 2015 by · 1 Comment
Filed under: blister care, Foot Care, Foot Care Products, Sports 

Most of you know how much I like kinesiology tape for taping feet. Over the years, I have used several brands and refined my taping skills. I can tape any part of the foot, and for any blisters or prevention desired.

As I have talked to others who tape, runners or crews, or medical people, I have heard stories of tape not sticking as well as needed. And I have seen first-hand tape coming off – generally because of a lack of skin preparation and taping skill levels.

So I was pleasantly surprised to see an article over at www.theratape.com about How to Get Kinesiology Tape to Stick – the 6 P’s of kinesiology Taping.

Kinesiology tape at the base of the big toe

Kinesiology tape at the base of the big toe

When properly applied, kinesiology tape will stick for days through all kinds of conditions. When improperly applied, it may last for less than a day, or in some cases, only a few hours.

The article at Theratape.com identifies three phases to taping: skin preparation, tape preparation and application, and wearing the tape.

Here is a summary of the three phases.

Phase 1: Skin Preparation

  • The skin must be completely dry before applying the tape
  • The skin needs to be clean

Phase 2: Tape Preparation and Application

  • Use good quality tape
  • Round the corners
  • Don’t touch the adhesive
  • Go easy on the stretch
  • All strips must end on skin, not on another piece of tape
  • Activate the adhesive

Phase 3: Wearing the Tape

  • Avoid contact at the ends

This is a very good article and you’ll learn a lot about taping with kinesiology tape. Click of the link to read How to Get Kinesiology Tape to Stick.

What you didn’t read is a few things we have learned when using the tape on feet. The typical use of kinesiology tape is for injuries to muscle and soft tissue, very different than taping feet. Once you put the tape on feet and go running through streams, dust, mud, swamps, and other adverse conditions, things change. There are more stressors on the tape and many times its applied just moments before resuming your adventure.

Here are my extra tips exclusive to taping feet:

  • Use a tape adherent on the skin
  • For extra tough cases, run a strip of tape adherent over the edges of the tape/skin
  • Apply the tape the day before your run if possible
  • Make sure you apply either a thin layer of powder or lubricant over any remaining exposed tape adherent
  • Always roll your socks on and off to avoid pulling the tape loose

While you are Threatape.com, check out their line of kinesiology tapes and supplies. Their website offers a lot of information about kinesiology tapes, information about different brands, application instructions, and videos by body part and brand. I have worked with the good folks at Theratape for several years and love their products and service. For medical professionals, they also offer a professional discount.

Looking for Minimalist Footwear?

April 22, 2015 by · Leave a Comment
Filed under: Uncategorized 

Today I received an email asking for help in finding a certain type of footwear. Here’s the email.

I’m looking for new shoes and thought you might have some expert counsel? I’ve loved my New Balance Vibram Minimus for three years and am ready for a true barefoot experience–I think. I keep hearing about the FiveFingers, but can’t find them locally and am reluctant to order a pair without trying them on. I walk and do some cardio at the gym. Got any suggestions?

I told her that I get an email from a minimalist shoe website called Birthday Shoes. They have a free online newsletter with almost 5,800 subscribers. Check them out. Five Fingers are not for everyone. There are other very minimal shoes out there. The birthdayshoes.com website has most of them – and shoe some reviews too. They have 17 shoes companies represented on their website. Each review has a full report and photos of the shoes. Each review has comments from readers, which adds value. Definitely worth reading before you buy.

If you are in the market for minimalist shoes for trail running or just kicking around the yard, check out Birthday Shoes.

BirthdayShoes.com website header

BirthdayShoes.com website header

Your Spring Shoe Check

April 12, 2015 by · Leave a Comment
Filed under: Footwear, Sports 

Spring is here. The weather is turning and the days are longer thanks to the earlier day light saving’s time change. I, for one, love the longer daylight.

As the weather gets better, we look forward to spending more time outdoors. This is a good time to take a few minutes and check out your footwear. Haul them out and go over them, one pair at a time.

Check your shoes and/or boots for excessive sole wear, frayed shoelaces, torn uppers, lint and debris inside the shoes, flattened out insoles, and squished down midsoles. Any of these can cause problems as you change your gait in response to the worn shoes. More than your feet are affected. Changes move upward, affecting your ankles, knees, hips, and back. Don’t risk an injury because of worn out shoes.

Keep your feet happy with good footwear.

If you follow the shoe companies and read any of the popular running, backpacking, and outdoors magazines, or follow their websites, you know many have released new models. Check them out at your local store. There are some great new shoes being introduced. I’d bet one of them has your name on it.

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.

Kinesiology Tapes

February 24, 2015 by · Leave a Comment
Filed under: blister care, Foot Care, Foot Care Products 

If you have followed my blog long enough, you’ll know I have a preference for kinesiology tapes for protective taping before a race and patching blisters during a race.

Over the years I have used many different types of tape – most of which I no longer use. The one tape that has stood the test of time is the kinesiology tape. There are several to choose from including Kinesio Tex, Rock Tape, StrengthTape, and others. Since Kinesio Tex is a trademarked name of a brand of kinesiology tape, we should not use the term Kinesio tape when talking about a different brand than Kinesio Tex. For example, Rock Tape is a kinesiology tape, not Kinesio Rock Tape.

Last year I provided foot care at the Jungle Marathon Amazon and took Leukotape, Rock Tape H20 and StrengthTape. In the end, I stopped using the Leukotape because of the tape residue it left on the skin.

Here’s how I judge tapes:

  • I don’t want tape residue on the skin when the tape is removed or comes off
  • I don’t want a tape that is coarse
  • I don’t want a tape that is thick
  • I want a tape with superior adhesive
  • I want a tape that will hold in wet conditions
  • I want a tape that will conform (at least somewhat) to the shape and curves of the foot and toes
  • I want a tape that does not lose it sticking ability or workability in cold or hot conditions
  • I want a tape that can be used on all parts of the foot
  • I want a tape that is as smooth as possible
StrengthTape in the Amazon

StrengthTape in the Amazon

The benefits of kinesiology tapes are their stretchiness in length, softness, and smoothness, which allows them to be molded to the shape and curves of the foot and toes. In the image here you can see how the tape has molded to the toes and space between the toes. Imagine trying to patch a blister at the base of the large toe. Most tapes will fail at this because of their inflexibility or thickness, meaning they cannot mold around the toe into the fold at the base of the toe and onto the toe and ball of the foot. Kinesiology tape can do this with no creases or overlaps in the tape.

My favorite kinesiology tapes are Rock Tape H20 and StrengthTape. Both have excellent adhesive stickiness, even in wet conditions. The best application tip for kinesiology tape is to apply it the evening or night before your race. Use a tape adherent and after applying the tape to the skin, rub it for 15-20 seconds to warm the adhesive so it will stick better. Then put on the socks you’ll wear the next day. I have used these tapes in the Amazon Jungle and they stick better than others. Certainly the grit of the sand and dirt in the jungle will compromise the long term stickiness of the tape, but I still think it’s the best tape for wet conditions when a tape adherent is used and the tape is applied correctly and ahead of time.

A helpful website that offers a lot of information about kinesiology tapes and their uses is TheraTape.com. It’s where I get my tapes. In addition to selling most brands of kinesiology tape, the site has information about the kinesiology tapes, brand information, application instructions, and videos. TheraTape provides tapes in single rolls and bulk rolls and in a variety of colors, as well as educational materials if you want to learn more about using the tape. StrengthTape is also sold by ZombieRunner.

Please understand that kinesiology tapes are designed to provide healing benefits to athletes when injured and with inflammatory conditions. The videos do not show patching feet or taping for blisters since that is not what the tape makers promote. Here is a link to learn about kinesiology tape.

TheraTape just released a comparison chart of kinesiology tapes. I have included the chart below, split into two images. Click on each image for a larger view. Here’s the link for the kinesiology tape comparison chart if you want to go directly to the website to see the chart.You can order StrengthTape or Rock Tape H20 or another other kinesiology tape from TheraTape.com or StrengthTape from the ZombieRunner link above.

Connect directly to StrengthTape and Rocktape

  • StrengthTape.com has a number of informational videos on their website and is a good way to connect with the company.
  • RockTape.com also has a website with lots of good information and videos.
Kinesiology Tape Comparison Chart 1

Kinesiology Tape Comparison Chart 1

 

Kinesiology Tape Comparison Chart 2

Kinesiology Tape Comparison Chart 2

 

 

 

 

 

 

Running in Crocs

February 7, 2015 by · 3 Comments
Filed under: Footwear, Footwear Products, Sports 

Efraim Manzano caught my eye a few weeks when I learned that he had run the HURT 100 in Hawaii in Crocs. I messaged in on Facebook and we chatted back and forth a few times. He lives in Honolulu, Hawaii and has been running all his life, but running races for the past 10 years, and ultras for five years. Efraim said he’d be happy to share some tips about running in Crocs and how he came to use them rather than trail shoes. Here are the questions I asked Efraim and his responses. I added content about Crocs in a couple of sections.

Question: How often do you run in Crocs?
I run with my Crocs all the time.

Question: Do you also run in road or trail shoes?
No road or trail shoes, I only run in Crocs.

Question: What style Crocs do you use?
I use the Classic Beach style for road running (Marathon, Ironman) and the Bistro style for trail running. The Classic model has vent holes both on top of the toebox and around the side of the toe and forefoot. These are good for road races and help ventilate the feet. Crocs on average weigh 11 ounces per pair.

Running the Honolulu Marathon

Running the Honolulu Marathon in Crocs Classics

Question: How did you get started in wearing Crocs?
Back in 2007 before the Honolulu Marathon a friend of mine dared me to run in a Bahag (Filipino G String) or loincloth, commonly used throughout the Philippines before the arrival of the European colonizers, and which is still used by the indigenous tribe of the Philippines today. Shoes looked awkward with the Bahag so that’s when the Crocs came about and been I’ve been running in them ever since then.

Question: Do you use them in training and in races?
Yes! I always train in Crocs and use them in all my races.

Question: What’s the longest run you have done in them?
My longest run in Crocs is 100 miles.

Question: How long will they last (miles/time)?
They last a long time, approximately 1000+ miles, I still have the Crocs that I’ve use back in 2007 Honolulu Marathon and still use that pair for training.

Question: Do you wear socks with them?
Yes I always wear socks with them. I use any socks – even use socks I buy from Costco.

Question: Because they fit loosely, how do you keep them on your feet? Do you use the strap around the heel?
My feet always swell up after running anything over a marathon distance so I like my Crocs to be loose and yes, I always use the strap around the heels for insurance. The swelling that I’m talking about is the normal swelling of the feet when you are running or cycling. With regular running shoes it would bother me a lot because my feet get squeezed in there – so I like the looseness of the Crocs specially on those long run like marathons and especially on those ultra runs.

The Crocs Bistro

The Crocs Bistro

Question: Because they are fairly smooth on the bottom, how are they on trails?
I use the Crocs Bistro style on the trail. Crocs Bistros are designed specifically for those in the food service, hospitality and health care industries and has the Crocs lock slip-resistant tread. It works pretty well on the trails, even muddy trails. The Bistro also has an enclosed toe and forefoot design without the holes common to other Crocs designs like the Classic. The Bistro also has a more cushioned metatarsal area in the forefoot. The Bistro Pro has even more cushioning, an adjustable heel strap, and beefed up toe and heel bumpers for protection. The Bistro sells for about $45 and the Bistro Pro for $60.

Running the Hurt 100 in Crocs Bistros

Running the Hurt 100 in Crocs Bistros

Question: Have you had problems with rocks, dirt and trail grit getting inside?
At the HURT 100 a couple weeks ago when I feel something inside my Crocs I don’t let it bother me. I just stop running and take my Crocs off and shake it out. It gives me three seconds rest and recovery! The enclosed toe design helps keep junk out of the toebox.

Question: Have you had any foot problems from wearing them?
By the grace of God I never had any foot problems from wearing them, I had more problems before when I use to wear those high-end shoes. About blisters, it all depends if the socks got wet, this past HURT 100 I didn’t got any blisters. I changed my socks every loop so I didn’t get any blisters, but in the previous races that I’ve done before I’ve had blisters from the Crocs – especially on the rainy day.

Note: Thank you John for giving me this privilege to share my experience using the best and the most comfy running/cycling shoes in the world!

There you have it. You can run in Crocs! Thanks Efriam for sharing your story with our readers. I’ve heard of people wearing Crocs before, but this had never made a connection to do an interview. I’ll continue to use the three pair I have at home. Maybe the next pair I get will be the Bistro Pro. If you want to leaner more about the entire Crocs line, check them out at Crocs.com.

Dodging roots in the HURT 100

Dodging roots in the HURT 100

Superfeet’s Wool Insoles

Superfeet’s Wool Insoles

I have liked Superfeet’s insoles for many years. Last year I was sent a pair of Superfeet’s Wool Insoles to try. Before talking about these insoles, a bit of information about the design of their insoles is in order.

Superfeet's Insole Profile

Superfeet’s Insole Profile

If you need good support in an insole, look at a Superfeet insole. They are designed to work with the volume and fit profile of your feet. The volume is the amount of room needed inside your shoe to accommodate your feet, the sock and the insole. The fit is the amount of support and the shape of the insole under the foot and heel. With these insoles, you don’t get a one-size-fits-all type of insole. This is important if you have feet that require heel or arch support, like an insole with a well-defined heel cup, or simply want a insole that will hold up for a long time.

Their volume and fit profile is based on three types of feet – low, medium, and high fit; and low, medium, and high volume. Low is the most common foot type, medium fits in most types of footwear, and high gives the most support. Fortunately, the Superfeet website shows how each insole is designed for volume and fit, which makes it easy to find the best insole for your feet.

SuperFeet's Grey Merino Wool Insoles

SuperFeet’s Grey Merino Wool Insoles

 

Their merino wool insole would be a good choice if you want a bit of added warmth in your shoes. The insole has the typical plastic support from the heel and mid-foot. Over that is the full-length foam that supports the top layer of merino wool. I measure these layers at about 1/8th inch each. That gives some added insulation from the cold coming up from the ground. The wool thickness is generous. They are very comfortable. You can get the merino wool insole in grey, which is thicker and made for high fit and volume, or white, which is made for medium fit and volume. All of the Superfeet insoles can be viewed on the Superfeet website. After that, you can purchase them from Superfeet, Zombierunner.com, your local running store, outdoors store, or other online stores.

They key with any insole is to try them in your shoes. Some are thicker and will reduce the amount of space in your shoes for your socks and feet. If that’s the case, you can either move to a thinner and lighter weight sock, or find an insole with less thickness.

So make sure you try an insole in your shoe before going out for your long run or hike. Wear them around the house for a while and see how they feel.

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