Filed under: blister care, Foot Care, Foot Care Products, Footwear, Footwear Products, Health
This second version of a toe separator is a more complicated to make and apply. It uses a large or small ENGO oval, depending on the size of the toes. The idea is to pinch the patch into an upside down T where the base of the T goes between the two problem toes. The patch is stuck to your insole in a position where it keeps the two toes apart. The slippery surface of the ENGO patch will prevent rubbing and the upward base of the upside down T will keep one toe from going under the other toe.
How to Make Your Own Toe Separator # 2
Using a utility knife, score two cuts, about one inch apart on the backside of the patch. Make them only deep enough to cut through the paper backing – do not cut through the patch itself. Try to have the one-inch wide space in the middle of the patch. Make the width of the cuts wide enough so the folded separator will be tall enough to match the height of the toes it will go between. This is important – a separator used between middle toes will have to be taller than ones used for pinky toes. Men’s toes may also require taller separators. Using the tip of the knife, remove the one-inch strip. Fold the patch in half so the sticky sides match to each other. The two end of the cut backing should meet in the middle. You can now open the two ends and cut the patch into the needed shape based on where the patch will go on the insole and the length of your toes.
Separator # 2 Height and Length
Separators for pinky toes need to be shorter in height and length than ones for the middle toes. You may have to make more than one separator based on the size you need to find the right fit.
How to Use the Separator # 2
To use the separator in your shoe, remove the insole for the foot with the overlapping toes. The smoother the insole the better the patch will stick. Clean the surface of the insole of all lint, dust or other things that could interfere with the patch adhering. Make sure the insoles are dry. Put the insole on the floor and stand on it so your foot falls into any indentations. Usually, an insole will have indentations under the heel, ball of the foot, and some of the toes. Using a pen, make a mark between the two affected toes. Put on a pair of Injinji socks and make sure the marking is still in the right place.
Once the placement has been confirmed, with sock on, place the separator between the two toes to make sure it fits. The best way to do this is with your foot on the insole. The height should come up to the top of the toes with sock on. If the height is too high, trim it with a scissors. If it’s too low, make another separator where the pinched section is higher.
The length needs to be long enough to cover the body of the toe – without hitting the crease between the toes. If the separator touches the crease, it could rub and cause problems, especially if the foot moves forward in the shoe. If it’s too long, trim it with a scissors.
Once the fit has been checked, you can place the separator on the insole. Line it up so the upward part is in the correct place. Then remove the protective backing to expose the adhesive and place the patch on the insole with the upward part over the line on the insole. Rub the separator to make sure it is firmly secured to the insole. Use a scissors to trim any part that extends over the sides of the insole. Use a blow dryer for a few
If the patch does not stick, you probably have an insole with a surface that is not smooth enough or too soft with too much fabric that does not allow the adhesive to hold. In this case, you may want to try another insole with a better surface. They can be peeled off the insole if they are placed wrong, but will probably not stick as well if you try to reattach them. The patches will not stick to a wet insole. For easier removal, use a blow dryer or heat gun to heat the patch.
If the Separator # 2 is Too Weak
It’s possible that the pinched section of the ENGO patch will be too weak or thin to keep the toe from going under the next toe. If you can tell the toe is going under, here’s an idea to make it stronger. Take another ENGO Patch and cut a strip the width of the top of the separator, remove the adhesive backing, and pinch it over the existing separator so it reinforces the upward part of the separator and extends onto the base. This will strengthen the part between the toes and make it stiffer and better able to keep one toe from going under the other.
Filed under: blister care, Foot Care, Foot Care Products, Footwear, Health
This is part one of a two-part blog post.
Over the past few years, I have seen many athletes with a common toe problem – overlapping toes. Some people may call then underlapping toes or call them some other name. When a pinky toe goes under the 4th toe, both toes can be negatively affected. Skin is pinched. Hot spots and then blisters form. Often callus develops as the skin is constantly under pressure from the overlapping toe.
While most common to the 4th toe and pinky toe, overlapping toes can affect any two toes. This is not necessarily a problem limited to running shoes or hiking footwear. It can happen in everyday footwear too. The cause of over-lapping is unknown. Many experts suspect that they are caused by an imbalance in the small muscles of the foot.
There are some easy solutions, which may or may not help, because toes are different. You can switch to Injinji toe socks, giving each toe it’s own little sock and some degree of protection. You can cut out a portion of the insole under the toe that goes under the other toe, giving the toe some extra space. Another option is to tape around the toe or toes to give some protection too.
This is an idea to help runners, adventure racers, and hikers with the problem of overlapping toes. You will need Injinji toe socks, ENGO Blister Prevention Patches (large ovals), and removable insoles. There are two types of separators you can make. This post will cover the first of the two.
Toe Separator Number 1
I use an ENGO Blister Prevention Patch as the toe separators. They make a small and large oval, but I like the large because of its size.
The first toe separator is easy to make and use – and it uses one large ENGO patch. Take a scissors and cut a long oval into a strip, about ¾ inch wide and 1¾ inches long. If you are cutting this for a middle toe or for large toes, it may have to be 1 to 1 ¼ inches wide and a bit longer. Round all corners. Cut one of the remaining sections into a small strip, ¼ inch wide and 1¼ inch long. Take the large oval and remove half the backing from one end. Wearing Injinji socks, put the large oval between the two affected toes. Put the end of the large oval with the exposed adhesive over the toe next to the toe that goes under it. The blue side will go from the top of one toe, run between the toes, and under the toe that normally goes under the other one. What you have is an S shaped patch from the top of one toe, between them, and then under the next toe. Take the small strip and remove the backing, and put one end of the adhesive on the white backing that is underneath the toe at the bottom of the S. The other end of the strip can be stuck onto the top of that toes sock. The small strip is needed to hold the bottom of the S under the toe when you put your foot in your shoe. The S shaped patch will keep the toes apart. Obviously, these are single use. If the patch seems too weak, use two strips to make the S patch stronger.
Filed under: blister care, Foot Care, Foot Care Products, Footwear, Footwear Products
Today’s post will cover a great way to prevent blisters using ENGO Blister Prevention Patches. It’s a repeat of a post from mid-2013.
Tamarack Habilitation Technologies is well known for providing healthcare professionals and clients with innovative, value-added orthotic-prosthetic componentry and materials. Their ShearBan product is similar to the ENGO Blister Prevention Patches reviewed in this article. ShearBan is used in the orthopaedic and prosthetic industry on prostheses at amputation stump sites to reduce the incidence of skin breakdown.
ENGO in Footwear
Introduced in 2004, ENGO Blister Prevention Patches have radically redefined the way hot spots, blisters and calluses are treated. As a preventative measure, ENGO patches provide peace-of-mind that blisters won’t become a painful, debilitating problem. If a blister has already formed, applying patches to footwear, corresponding to the blistered area eliminates painful irritation and further skin damage, allowing continued activity. Friction forces are reduced by more than 50% when you apply an ENGO Patch to your footwear.
The patches are made from an ultra-thin Polytetrafluoroethylene (PTFE) film and are 0.015 inches total thickness – a very slippery surface. They are very durable, lasting four to six weeks in most applications. The aggressively sticky patch peels away from the backing and is applied to dry shoes or boots. The PTFE ENGO Patch reduces the ‘stickiness’ between the shoe and sock so they can glide over one another. The foot, inside the sock, glides over the patch shear distortion and friction are reduced, and blisters can be averted, in spite of pressure.
Avid runners, hikers and sports players rely on their feet to reach performance goals; from day hikes to ultra marathons. But quality footwear and socks alone don’t eliminate the skin trauma your feet can experience from repetitive rubbing — building friction forces to levels that cause hot spots, blisters and calluses. While I use these patches in runners’ footwear at races, they can also be used in ordinary every day shoes to reduce calluses.
Similar to Tamarack’s ShearBan material, ENGO patches are applied directly to footwear and equipment, not to the skin. Outcomes of this unique application include ease of use, long-lasting and guaranteed friction relief.
ENGO Patches are made in several sizes and types:
- A large oval – 2 ¾ x 1 ¾
- A small oval – 2 x 1 ½
- A rectangle – 3 ¾ x 2 ¾
- Back of the heel patch – 3 ¾ x 1 ¾
- A cushion heel wrap – 3 ¾ x 1 ½
When I work a race I always have a bag with different sizes of ENGO patches. I have applied the ovals and rectangles and the back of the heel patches. The patches are applied to the shoes and insoles – not to your skin. This means wherever you are going to apply a patch has to be dry. My advice is to apply patches before your race when your shoes are dry. I have used them inside the shoes in the sides, in the heels, and on the insoles.
Typical problem areas in footwear are under the heel and forefoot, and at the side of the heel. An oval patch can be applied to overlap the side of the heel counter and the insole as seen is the photo. I often use a rectangle or large oval under the ball of the foot or an oval under the heel – applied directly to the insole. The patches are useful over stitching or seams in footwear that are rubbing the wearer. If necessary, a patch can be cut to shape for where it will be applied.
The patches will reduce shear and friction; provide relief from hot spot and blister pain, and can be used in any type of insole or orthotic and footwear, from sandals to running shoes, and any type of hiking or ski boot.
I like ENGO patches because they work. The patch is thin and does not alter the fit of the shoe. When properly applied to dry footwear, they stick.
Rebecca Rushton, a podiatrist in Australia, strongly recommends ENGO Patches. She discovered the patches after getting blisters herself and now represents ENGO in Australia. She has written several free reports on blister prevention available on her website, Blister Prevention.
If you are unclear about shear and blister formation, here’s a link to my article An Introduction to Shear and Blister Formation.
The Technical Stuff
JM Carlson, in a 2009 report wrote, “The measurement of friction is the ‘coefficient of friction’. The coefficient of friction (COF) is a number that represents this slipperiness or stickiness between two surfaces and is generally below 1.0. Within the shoe, the COF between the foot, socks and insole can range from 0.5 – 0.9. In contrast the COF between a sock and a polished floor is around 0.2.” Tests have shown PTFE patches to reduce the coefficient of friction (COF) in the shoe by up to 80%. The COF is in approximately 0.16, which is significantly lower than all other in-shoe materials. Importantly, the low COF is maintained even in most and wet conditions inside the shoe.
Check out GoEngo.com for more information about ENGO Blister Prevention Patches. They also offer a money-back guarantee.
Many of you use kinesiology tape in either patching feet or for pain relief after injury. This week TheraTape.com is having a kinesiology tape Black Friday & Cyber Monday sale – all week. The sale goes through Sunday November 30.
Kinesiology tape is my tape of choice for all types of foot taping. whether preventative or as treatment. TheraTape is offering deals on rolls of RockTape and GO kinesiology tape, and several manufactures precut strips. For example, buy two rolls of RockTape and get three more free. Here’s the link to the TheraTape sale.
Be sure to check out their blog for articles about using kinesiology tape, how to apply it without touching the tape’s adhesive, using it to prevent injuries, and the what, when, why and how of using kinesiology tape.
Joanne and her staff at TheraTape are helpful if you have questions – order online or give them a call.
Filed under: blister care, Books, Foot Care, Foot Care Products
Rebecca Rushton is a podiatrist from down-under in Australia. She has championed the important of blister prevention and I have shared about her in past blog posts. Her website, BlisterPrevention.com.au is a wealth of information on the subject.
In an effort to resolver her own blister problems, Rebecca has investigated podiatry and sport publications, diabetic foot disease and prosthetic limb skin management, the field of tribology (the study of friction and wear), and military research. These have led her to write a number of publications about blister management, and continually address it in her blog.
Her latest work is a book and ebook, The Blister Prone Athlete’s Guide to Preventing Foot Blisters: Insider Tips to Take You From Blister Victim to Champion. These are available through Amazon – and for a limited time, the ebook version is available for FREE through Amazon’s Kindle. Here’s the link for the free ebook. Get it soon because after five days, it reverts back to normal prices. You can also get a print copy of the book to have in your foot care kit and share with your crews.
The 75-page book discusses blister formation and then tackles the causes and prevention of blisters on the most common areas of the foot: heels, the arch, the ball of the foot, and toes. The content is easy to understand and follow.
Rebecca is a friend and I highly recommend her book. I’d also suggest visiting her BlisterPrevention.com.au website and subscribing to her email updates.
Filed under: blister care, Foot Care, Foot Care Products, Footcare, Health
After years without an expedition length adventure race in northern California, the Primal Quest Adventure Race returned this past August. Even though there were openings for 20 four-person teams, only 11 teams toed the starting line in South Lake Tahoe.
For those unfamiliar with adventure racing, races generally consist of a mix of disciplines: trekking, mountain biking, orienteering, white waters, rafting, kayaking, and ascending and rappelling. Some events have caving and other exotic disciplines.
This year’s race stated with a downhill run to kayaks on the shore of Lake Tahoe, after which they paddled north, and then took off on mountain bikes for a long ride. Unfortunately, much of the 80+ miles turned into a hike-a-bike. Then at Kirkwood, they took off on foot for a long trek / orienteering section. For some teams, this section took hours longer then expected.
I was at TA3 (transition area) and we expected the first team early Friday morning, but in fact they arrived almost 24 hours behind schedule. The rest of the teams were spacer further and further apart as time progressed.
My point is that many of the racers had been on their feet for more than two and three days by the time they reached us. Then teams went back on their bikes, into kayaks, and into another long trek. Some teams were short-coursed – taken ahead on the course
Fast forward to TA6, a day and a half later and teams are still racing. Some of the racer who have done the full course to this point have had little time to rest and their feet are extremely sore to the point of being very painful. They may also have some degree of maceration going on too.
One such racer, Thomas, asked me to look at his feet. There were no blisters on the balls of his feet, just very soft and tender skin – very sore with some maceration. I told him I could help.
I cleaned his feet and allowed them to air dry. I applied Tincture of Benzoin Compound to the skin from mid-foot upwards to the base of the toes. Over this I place a piece of soft, 1/8 inch thick Hapla Fleecy Web (adhesive felt), cut to follow the shape of foot at the base of the toes, square at the bottom, and curving up a bit on each side of the foot. At the base of the felt, mid-foot, I placed a strip of Leukotape to help hold down the bottom edge of the felt. Benzoin was used under the tape and edges were rounded. The last touch was two figure 8’s, cut from HypaFix cotton tape, placed between the 1st and 2nd toes and the 3rd and 4th toes, with the bottom of the 8 under the foot and the top of the 8 on top of the foot. This anchors the forward edge of the felt against the skin and keeps it from rolling, especially on downhills. Each figure 8 is about three to four inches in length and the tape is two inches in width.
I received a report later in the race that the patch job had held. After the race ended, Thomas let me know the patch had helped his race.
The adhesive felt helps pad the forefoot and provide cushioning to the sensitive tissues, and can help relieve pain and discomfort from maceration. This is not moleskin, or a version of moleskin. It’s a thicker product and much softer. The felt can be found in 1/8 and 1/4 inch thicknesses. In the Amazon we used fleecy web that is 1/8 inches thick. In the Amazon Jungle Marathon I used the patch job many times on macerated feet – after drying the skin as much as possible.
Medco Athletics sells adhesive felt in a variety if thickness and lengths. You can search on “adhesive felt” or for a specific product I have used, “Fleecy Web.” To give you an estimate on pricing, four Hapla Fleecy Web 9” x 16”, x 1/8 thick sheets sells at Medco for about $26.00. The Hapla Feecy Web is 100% cotton and is latex free.
It also works well for padding around blisters, bunions, heel bumps, and more. Because it is thicker than tape, I would use Benzoin to help it stick better and consider adding extra tape as I described above.
My October issue of Backpacker magazine featured an article about Bil Vandergraff, a Search and Rescue (SAR) Ranger. He served as a ranger for 25 years in the Grand Canyon backcountry. In the article he shared tips on surviving in the backcountry – especially in the harsh and unforgiving Grand Canyon with its heat and extreme elevation changes.
His tips on dealing with the heat are right on: wear the right clothes, embrace the sweat, go slow, stick to mornings and evenings, and know when to stop.
He stresses the importance of helping yourself and to study up – studying the route and conditions.
The one line that struck me was this:
“I don’t take care of blisters. I refuse to. If you can’t take care of your own blisters then you don’t belong in the canyon.”
Wow. I like that.
That same philosophy could be applied to runners, adventure racers, hikers – in short, anyone venturing into the outdoors on their own. Badly blistered feet can stop you in your tracks, can make it hard to climb out of the Grand Canyon, or off a mountain or out of any trail.
Can we apply that to races too? That’s a hard question. A huge question!
If a race has crew access, should the crews be responsible for foot care? Some races don’t provide specific foot care. Others have it in limited form based on whatever foot care knowledge any aid station volunteers or medical personnel may have and based on whatever supplies they have.
I know that at some ultras and adventure races participants will move along the trail from aid station to aid station, and at each one, require some degree of foot care. What was patched at an earlier aid station didn’t work or didn’t hold up. And they want someone at the next aid station to redo their feet. That’s a lot of work and a lot of supplies.
What compounds this question is that many athletes fail to do what SAR ranger Vandergraff stressed, helping yourself and study up. Anyone who has worked an aid station knows full well that many of the participants fail to take care of their feet to start with, fail to trim toenails, fail to reduce calluses, fail to wear the right socks, fail to wear gaiters, fail to replace worn shoes, insoles and socks, fail to learn how to do self-care, fail to educate their crew on good foot care techniques, and fail to have adequate foot care supplies. So then, when they run into problems, they want help. Their failure to plan, and in many cases, take common sense action that could have prevented or reduced the problem, then creates work and expense by others.
I remember an old quote by Benjamin Franklin, “If you fail to plan, you are planning to fail.”
Many events would see their finishing rate drop dramatically if they eliminated foot care. There is a definite need for medical care to ensure that participants don’t get into trouble that could cause them serious injury or bodily system failure – but is foot care one of those?
I’ll repeat Vandergraff’s statement. “I don’t take care of blisters. I refuse to. If you can’t take care of your own blisters then you don’t belong in the canyon.”
Again, can we apply that to races too? That’s a hard question. A huge question!
Filed under: blister care, Foot Care, Foot Care Products, Footcare, Footwear, Footwear Products, Sports, toenails
8 Top Tips for Foot Care
If you are a subscriber to Backpacker magazine, check out the October issue, page 34 for a full page of eight top tips to care for your feet. I have included an image of the page in this post. If you click on the image, you’ll get a larger view.
I was contacted by Backpacker several months ago and did a phone interview. Here are the eight tips:
- Trim nails
- Get in shape
- Fix calluses
- Prep your shoes
- Pack camp sandals
- Two ways to treat blood under a nail
- Wash your socks
- Lance right
The tips are good whether you are a backpacker, runner, walker, adventure racer, or just plain person who loves the outdoors.
I like Backpacker magazine. It’s one of my favorites. I encourage you to pick up a copy and check it out.
The 2015 Primal Quest Expedition Adventure Race concluded a few days ago, after nine days of challenges to the 11 four person teams. This was an unsupported race, meaning there was no crew support. Race organizers, medical staff, and general volunteers all worked together to provide levels of support that were awe-inspiring. People worked together to help the racers get through over 400 miles of a variety of disciplines: trekking, orienteering, white water kayaking and rafting, mountain biking (sometimes referred to as hike-a-bike), ascending and rappelling, sleep deprivation, extreme heat and more. Through all this I am fairly certain that everyone had fun.
At the eight TAs (transitions areas), where racers changed from one discipline to another, were a number of volunteers. Medical staff included doctors, podiatrists, nurses, paramedics, physical therapists, athletic trainers, and more. Our job was to care for whatever medical needs the racers had, including anything and everything. Even though the teams carried mandatory medical gear, most relied on the medical staff for their advanced foot care skills and materials. Khristy Gavigan, an RN and the medical volunteer coordinator, had done an amazing job of assembling extensive medical kits for each TA.
I worked two TAs – TA3 and TA6. At each TA, we set up and area where the teams checked in, arranged their gear so they could get to their gear and bike boxes, and decided on an area for medical and foot care. Generally we went through all the medical bags to see what supplies we had.
Because the four person teams were seen at each TA, there was a lot of foot care required. Many times we worked on all four team members in assembly line fashion. There was a mix of problems, but it seemed we saw more toe blisters and toenail care required than usual. Many toes had the skin torn off the top of blisters. While there was a lot of heel blisters, there didn’t seem to be many ball-of-the-foot blisters. Treatment was with kinesiology RockTape and in some instances, Leukotape.
Teams might receive some foot care at one TA, and the next, and the next, and so on. That’s the nature of an adventure race with multiple disciplines.
Some of the teams were short coursed – meaning they bypassed one or more discipline due to overall time cutoffs. This reduced the number of racers with maceration from one of the kayak sections, and reduced more foot issues from the following 50-mile trek. All in all, I think feet were pretty much what I expected. The majority of teams were prepared with supplies to repair their feet, which is always nice to see.
Filed under: blister care, Foot Care, Foot Care Products, Footcare, Footwear, Footwear Products, Health, Sports, toenails
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.