Foot Care Preparation for Primal Quest – or Your Next Event

The seven tips below are written for the Primal Quest Expedition Adventure Race starting next week. They are also applicable to any race you may have coming up.

Primal Quest is less than two weeks away and here are seven things you can do to improve your chances of finishing with healthy feet.

1.    Wear the best fitting shoes you can. Have a bit of space in front of your longest toe and enough height in the shoe’s toe box to avoid squishing the toes from the top.

2.    Bad toenail care can result in toe blisters and black toenails, where fluid or blood is under the nail. Trim your toenails short and then use a nail file to smooth the tip of the nail. File the nails from the top over the edge down toward the tip of the toe. The goal of the trimming and filing is to remove any rough or sharp edges. File the nails so when you run your fingertip up and over the tip of the toe no rough edges are felt. It’s even better to file the nail so that no tip of the nail is felt. If you have thick nails, file the top of the nail down to reduce its thickness.

3.    Any time you can, remove your shoes and socks to dry and air your feet. Your feet will be wet from water disciplines, stream crossings, cooling yourself off by pouring water over yourself, and simply sweaty feet. When stopping to eat or rest, remove your shoes and socks. Lay your socks in the sun to dry and switch to a clean dry pair if possible. Issues caused by wet feet will multiply over time and can end your race or at the least, result in extremely painful feet.

4.    Do everything in your power to prevent and reduce maceration. This means not letting water poured over your head get into your shoes by bending over before dousing yourself. If means following the tips outlined in # 2 above.  Use a moisture-controlling agent to help prevent the skin on the bottoms of your feet from macerating. Several include Desitin Maximum Strength Original Paste (available at drug stores, Walmart, etc), zinc oxide, Chafe X, SportsSlick, Trail Toes, and RunGoo. Apply liberally and before all water segments to help prevent damage to your skin. Once serious maceration happens, only drying your feet and letting them air, with the help of powder and warmth, will reverse the condition. If left unchecked, the skin can fold over on itself, split open, and tear layers of skin off the bottom of your feet.

5.    Use gaiters to prevent pebbles and rocks, trail dust, and other debris from getting inside your shoes and socks. These become irritants and can lead to hot spots and blisters.

6.    Take care of small issues before they become larger problems. Lance and drain small blisters whenever you feel them to keep them from becoming larger. Put a dab of ointment over the blister and then apply a strip of tape over the top to protect the skin.

7.    Finally, make sure you have the supplies to treat your feet out on the course. Waiting to get to a TA to repair a blister can make a small problem much larger.

How Important are Gaiters?

Many runners have a love-hate relationship with gaiters.

Some love them and swear by them when running trails. Others never wear them, and dislike them. Which camp do you fall in?

I have regularly promoted the value of gaiters since I made my first homemade set from a pair of old white cotton crew socks. I believe it was one of the first years I ran Western States, maybe in 1985 or 86. I cut the foot out of the socks, leaving the ankle part to pull on my foot and fold over to cover the top of my shoes. I used twist-ties to anchor the socks to the shoes. And – they worked – as primitive as they were.

Then as the years progressed, people with more business sense than I started to make and sell gaiters. Now days, you can get gaiters in a myriad of colors and types.

I still believe in gaiters for trail runners, and in one recent conversation, told a friend that should make them mandatory gear for multi-day trail events.

You have every right to ask why.

Today’s shoes have become increasingly lightweight and many shoes are made with mesh uppers. It’s this mesh that allows all kinds of sand, dust, grit, and dirt into the shoe. These bad things will work their way into your socks and onto your skin. Rubbing and abrasions can occur. If you use any type of lubricant on your feet, the bad stuff will be attracted to the stickiness. The bad stuff can be a contributing factor that can lead to blisters.

A good set of gaiters will cover the tops of the shoes and the toe box to keep bad stuff out.

I’ve included two images of special gaiters that are typically found at the Marathon des Sables (MdS).

Running in sand at the MdS

Running in sand at the MdS

 

 

 

 

 

Gaiters at the MdS

Gaiters at the MdS

 

 

 

 

 

 

 

Here is the link to the myRaceKit for the MdS page that shows two gaiters they support. And a page from their blog that describes the fit and application.

These are highly useful when doing races in the desert, but how about when running trails? I believe the weak point in some gaiters is how they fail to cover the top of the shoe’s upper, thus allowing bad stuff inside.

I have treated many runners’ feet that are filthy with dirt and grit that makes it hard to wash off in order to find, clean, drain, and patch blisters. Blister patches and tape usually does not stick to dirty skin. In addition to making it harder for medical personnel to clean one’s feet, it also means it takes longer, which can affect not only your race, but those behind you that also need their feet worked on.

Back when, I wore homemade gaiters because that’s all there was. Now there are many styles and fabrics to choose from.

If I was going to run a tail race of any length, but especially a 50M or 100M, or multi-day race, I would buy one of the gaiters that attached to the shoe with Velcro and cover the whole shoe.

Still unsure?

Here are two of my blog posts about gaiters.

Blisters and Gaiters – this is by Lisa de Speville and adventure racer and ultrarunner from Soith Africa and her homemade gaiters.

Rough Country Gaiters: a review – this is a review of gaiters and offers commentary by Jay Batchen, who has done the MdS. Here’s a new link to the Rough Country Gaiters mentioned in the post.

In two weeks I will be working foot care at the Michigan Bluff aid station of the Western States 100. Then three weeks later I’ll be doing a foot care study at the Tahoe Rim Trail 100-Mile Run. I’d love to see a few runners wearing a more substantial gaiter.

How to Get Kinesiology Tape to Stick

May 2, 2015 by · 2 Comments
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.

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

 

 

 

 

 

 

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.

Cold Feet?

January 19, 2015 by · Leave a Comment
Filed under: Foot Care Products, Footwear Products, Health, Sports, Travel 

Many athletes suffer from cold feet.

Athletes have several options to deal with cold feet. The first, most commonly tried, is different socks. Some simply try thicker socks or two pair. Others go straight to thermal type socks made with wool or some other blend of yarns.

Footwear is often a contributing factor to cold feet. Today’s running shoes typically have a part-mesh upper, which lets cold air inside the shoes. And since the mesh is over the forefoot and toes, they get cold first. Secondly, footwear that is too tight, because the wearer has thicker than normal or two pairs of socks, causes constriction and impedes circulation.

Something else often tried is disposable chemical warming packets. These seem inexpensive at first, but because they are single time use, the costs add up quickly. Packs of 10, using two at a time, go fast. And they often don’t generate enough heat to provide overall warmth.

Thermacell Heated Insoles

Thermacell Heated Insoles

Another option for cold feet is one of the new lines of heated insoles. One major heated insole companies is Thermacell. While not cheap, if you suffer from cold feet long enough, you’ll likely be willing to spend the money for warm feet. Their insoles are water resistant, and durable. Once they reach the desired temperature, they turn off and then turn back on when needed. The insole’s top is molded and cushioning while underneath the inner components, is an insulated layer to keep heat from escaping. The insoles can be trimmed to fit shoes or boots.

Thermacell has two types of insoles:

Heater Insole Foot Warmers with embedded batteries that can be recharged 500+ times. Operated by a wireless remote control, they operate with lithium-ion polymer batteries embedded in the insoles. The three options are no heat, medium (100 degrees F), and high (111 degrees F). Each charge will last up to five hours with a medium heat setting. The batteries can be recharged at least 500 times and recharges in four hours or less. Their website currently offers a free car charger with every pair purchased while supplies last. These Heated Insoles retail are selling for $129.99 and come in full and half sizes. Click here for Thermacell Insole Foot Warmers.

ProFLEX Heated Insoles with removable batteries for extended use. They have the same features as the above insoles, same heating options, same wireless remote control, and the same rechargeable batteries. The first main difference is that the batteries are removable and replacement batteries are available. The second difference is that these are charged with a USB port or the customary wall charger. These insoles retail for $184.99. Click here for Thermacell ProFLEX Heated Insoles.

Thermacell’s insoles have been tested by SATRA, the worldwide leader in footwear research development and testing. SATRA found the insoles resistant to moisture, verified the five hour run time, and that the insoles maintain foot comfort with their heating.

If you feet are always cold, I’d look at these Thermacell insoles to help keep them warm. These could work in running shoes, cycling shoes, and hiking boots, as well as your normal everyday shoes. Make sure to check the insole thickness inside your shoes to see if you need to wear a less bulky sock.

Reduce Friction to Reduce Shear

December 21, 2014 by · Leave a Comment
Filed under: blister care, Foot Care, Foot Care Products, Sports 

I have often mentioned the website BlisterPrevention.com.au as a great source of information on blister care. Rebecca Rushton, manages the website and is on top of developments in the prevention and care of blisters. She’s a podiatrist in Australia – and a friend.

Through research and looking at the mechanism of how blisters form, Rebecca has changed some old theories of what causes blisters. Heat, moisture, and friction were always considered the three contributors of blisters. Further consideration has found that shear is a major factor. Shear and friction combine to cause blister formation.

You must reduce friction to  blister-causing shear.

You must reduce friction to blister-causing shear.

I want to quote a blog post by Rebecca about Healing Foot Blisters Faster to help you understand more about friction and shear.

“You know friction is responsible for friction blisters. But I bet you think friction is rubbing. It isn’t. Friction is about grip. High friction means two surfaces grip together. Low friction means they don’t … they’re slippery.

“Here’s how friction is responsible for foot blisters … There is high friction in your shoe. There just is. This means your skin grips your sock; and your sock grips your shoe. All three surfaces grip together so your foot doesn’t slide around in your shoe.

But with every step you take, your bones are moving around under the skin. And while the skin is stuck and the bones are moving back and forth. Everything in between is pulled and stretched. This pulling and stretching is what causes blisters.

We call it shear. And it needs high friction to get anywhere near blister-causing.”

With this opening, Rebecca starts to explain the effect of shear and friction on blister formation. She talks about cutting friction levels, especially when a blister develops, and gives examples of six friction reducers. Some of these are better than others.

We have always tried to reduce friction in both preventing blisters and when treating blisters. As Rebecca says, and I support, “Otherwise all that stretching (shear) continues at the blister base while it’s trying to heal. Making it hurt more. And taking longer heal.”

So take a moment and click on the Blister Prevention link and read Rebecca’s full blog post. While you are there, I encourage you to subscribe to her email list.

All About Insoles

August 30, 2014 by · 1 Comment
Filed under: Foot Care, Foot Care Products, Footwear, Health, Sports 

 

Insoles and Beyond

Insoles and Beyond is a family-owned small business based in North Carolina. They want to help you be comfortable, avoid injury, and reduce any pain you are experiencing. Their insole line includes a wide variety of insoles from manufacturers including, Birkenstock, currexSole, New Balance, Powerstep, Sof Sole, and Sole. Whether you are looking for orthotics for plantar fasciitis pain, arch support inserts for comfort, or insoles for running shoes and other sports performance, you can find them at Insoles and Beyond. Within each company’s line are a variety of insoles and sizes. You can look for insoles by company name, foot type, activity, pain/condition, and shoe type. They also carry compression wear from CEP compression and Mediven, and offer ankle braces, knee braces and splints as well. 

Because many athletes don’t understand insoles, I asked Stacey some questions about insoles. I think the questions will help you when you need insoles, or if you are unsure why you should replace the standard “sock liner” that came with your shoes. For years, I have told people that generally speaking, the stock sock liners shipped in shoes offer little support and are of little help. Many are simply thin pieces of foam or cardboard. Read on to learn about insoles. Then check out Insoles and Beyond’s website.

I’ve run for years and always used the regular insoles that come with shoes. Why should I consider a replacement pair of insoles? Most running shoes (expensive and inexpensive alike) use very simple and cheap foam insoles despite the tons of science that goes into making the rest of the shoe.  Many runners will spend $100 to $200 on a pair of running shoes based on the materials and technology used to make them but then leave in the relatively generic insoles that come with the shoes.  It makes sense that shoe manufacturers don’t invest much in the insoles – everyone’s foot is different. Shoe manufactures leave it to the consumer to purchase the appropriate insoles for their specific foot needs – high arches, low arches, overpronation, etc. Additionally, some people want more cushioning than others. Some want more support than others. Personally, the first thing I do when I buy a pair of shoes is rip out the “sock liner” and put in a pair of my favorite insoles.

currexSole Insoles

currexSole Insoles

There’s a whole bunch of replacement insoles to choose from, how can I make an intelligent choice? Our website has some good information on the various types of insoles and categories (collections) to help you find the insole that is appropriate for you. So, that’s a good starting place. However, within the categories (insoles for plantar fasciitis, insoles for running, insoles for hiking, etc.) there may still be questions. At that point, I’d suggest calling us or sending us an email to discuss things further.

Are certain insoles better than others for minimalist shoes and zero-drop shoes? Absolutely. Lower profile/volume insoles are best for minimalist shoes. Sole’s ThinSport and currexSole’s RunPros are both low volume options. The ThinSport has the same arch support as Sole’s Response and Ultra, but with less cushioning. The currexSole RunPros pack a lot of cushioning and less arch support (allowing for a more natural feel). Most insoles are neutral in terms of drop – they can be worn in zero-drop shoes.

How long do these insoles last? That depends. Many manufacturers recommend that you replace the insoles as often as you replace your shoes. Generally most running shoes should be replaced at 500 miles. I find that the BirkoSport by Birkenstock last pretty long – I’ve used them through four or five shoe replacements. Sole, New Balance, and Powerstep insoles tend to last a while (3 or 4 changes). Birkenstock and Sole both mold to your feet the longer you wear them. SofSole tends to only last one or two changes, but they are also less expensive. Generally speaking the more cushioned the insoles and the more activity they are subjected to, the more frequently you’ll need to replace them.

What’s the difference between inexpensive insoles and the more expensive ones? I believe you can get a really good pair of insoles in the $25 to $65 range. Custom insoles can run hundreds of dollars and many customers who’ve had custom insoles have shared with us that the $40 insoles they got from us were just as effective as the $400 custom pair they got from their doctor. The cheap insoles ($10 to $20 insoles at the drugstore) tend to not be much better than the insoles that come in the shoes to begin with. Among the insoles we offer, the materials used and the overall durability of the insoles set inexpensive and expensive insoles apart.  I find that the more expensive the insoles, the longer they tend to last. Conversely, the less expensive insoles last a shorter period of time. Materials like carbon fiber, cork latex, tend to be more expensive and durable than gel insoles.

I cross-train and ride bikes too. Are there insoles made for biking shoes? There are definitely insoles specifically made for biking shoes. You can, however, use general purpose or running shoe insoles for biking shoes as well. The trick is to make sure that the insoles are low volume (since most biking shoes will not accommodate thick insoles) and that they have good cushioning in the ball of the foot (the part that is in contact with the bike pedal the most). Something like the currexSole RunPro can easily go from your cycling shoes to your running shoes if you are cross-training.

You may be asking why you would order insoles from Insoles and Beyond. Yes, you can find insoles in the foot care section of your local drugstore, sporting goods store, and running store. But will they be the right ones for your feet? Check out their lines of insoles and if you have questions, give them a call. On the right side of their page, is a 10% coupon and they offer free shipping in the U.S.

Disclosure: I have no financial involvement in Insoles and Beyond.

Maceration at Western States

Last weekend I worked foot care at the Western States 100 Mile Endurance Run.  We had a fairly dry winter with not much snow in the high country and I had heard runners talk of the dust on the trail. Based on that, I did not expect to see high number of runner’s having foot trouble because of maceration.

Working Michigan Bluff aid station, at 55.7 miles, I was surprised by the runners coming in with wet feet, and varying degrees of maceration. For some, it was minor skin softening and maybe a few surface creases. Others had more severe maceration, with creases that were deeper over widespread areas on the bottom of their feet.  A few were really bad – deep creases and skin folding over on itself.  In extreme cases, the folded skin can split open.

While maceration is commonly caused by stream and river crossings, it also happens when runners pour water over their heads and body and it runs down into their shoes. Feet also sweat a lot, some people’s more than others, and this also can lead to maceration.

I also worked the finish line. There I saw even worst cases of maceration.

Severe maceration can manifest itself as a burning sensation, and the feeling of large blisters all over the bottom of their feet. Taking off the runner’s shoes and socks, we found virtually all of these complaints to be degrees of maceration. Two facts are evident. First, as might be expected, the longer a runner is on the course, the worse the feet can become. Secondly, not changing one’s shoes and socks during the race can magnify the effects of maceration.

The photos here are of one runner. My recollection is this runner finished the 100 miles in about 29 hours. She came into the podiatrity area of the medical tent and could barely walk. This is not uncommon. Runners dig deep and finish on adrenalin and then once they stop, the extent of the injuries to their feet hits them.

Photo 1: Macerated Feet WS100

Photo 1: Macerated Feet WS100

Photo 1 shows the bottom of the right foot – it’s worst than the left. You can see the white of the skin, and the creases running over much of the foot. The creases extend down to the mid-foot. Notice the white skin flap on the tip of the little toe.

 

Photo 2: Macerated Feet WS100

Photo 2: Macerated Feet WS100

Photo 2 is a close up if the toes. You can see the large skin flap on the little toe. This flap of skin was very white and looked as if the skin on the tip of the toes had been pulled outward and pinched. It was about ¼ inch in length. It runs from the toenail to the bottom of the toe.

 

Photo 3: Macerated Feet WS100

Photo 3: Macerated Feet WS100

Photo 3 shows the side of the forefoot. You can see the large fold of skin of the inside of the ball of the foot. This can be very painful and can split open under pressure.

Unfortunately, there is no quick fix for maceration. Typical treatments include warming the feet, moisture-absorbing powder, dry socks, allowing the feet exposure to air to dry, and time. In talking to this runner, she did not change her shoes nor socks during the 100 miles. I don’t recall the type of shoe, but my guess is that it did not allow water to drain.

Athlete Applying Hipoglos

Athlete Applying Hipoglos

There are several ways to manage possible maceration. Several years ago I watched as an adventure racer coated the bottom of his feet with Hipoglos, a European version of zinc oxide. The compound helps control moisture on the skin, whether zinc oxide or Desitin or a similar product. RunGoo, Century Riding Cream, and Blue Steel Sports Anti-Chafe Cream are similar products. I may have another product to announce early next month.

Another helpful tip is to make sure your shoes drain well. Whether that means mesh uppers, mesh or a draining material down to the shoes upper sole, or making drain holes with a heated nail, draining water out of the shoe is important. Then of course, changing your shoes and socks is also important. Most 100’s have aid stations with drop bags and it’s easy to put a pair of shoes in one or two drop bags, or have your crew have them ready.

Maceration can be cruel. It ruins the race for some runners. It’s painful. It can take days to heal fully.  But there are ways to minimize its effects.  If you are running a 100 or a multi-day race, and there is a chance of water on the course, plan accordingly.

Listen to me interviewed on Trail Runner Nation

A few weeks ago I was interviewed by Scott Warr and Don Freeman from Trail Runner Nation. I was honored they asked me and we had fun doing the interview. The subject? What else but feet!

Trail Runner Nation

Trail Runner Nation

You can listen to the interview on their website, download the MP3 file, or better yet, subscribe to their podcast series through iTunes. Here’s the link to their webpage: FEET – Injury Prevention and Treatment with John Vonhof.

Here’s what they wrote on their website:

One of your most important tools as a runner is your feet. You need to take care of them or your training/race may be foiled. John Vonhof literally wrote the book on how to take care of your feet: Fixing Your Feet.  This book is now in the FIFTH edition!  John joins The Nation to discuss the basic principles of foot care:

  • How you can have healthy & happy feet
  • Footwear
  • Insoles
  • Gaiters
  • Blister prevention and treatment
  • What to keep in a foot care kit
  • Taping your feet

The interview is 62 minutes in length, but my interview starts about five minutes in. Enjoy the interview and then subscribe to Trail Runner Nation’s podcast.

Thanks Scott and Don for giving me the opportunity to share a bit of my passion for feet on your podcast.

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