Today’s post is contributed by Gwen Lewis.
Athletes are prone to a number of injuries; torn or sprained ligaments and muscles, bruises, and broken bones. More common, irritating, unsightly and often embarrassing afflictions are situations such as athletes foot and toenail and toe-bed injuries. Athletes foot is a fungal infection that affects the areas between the toes leading them to become itchy, inflamed and painful. In extreme cases, especially for extreme athletes, infection can lead to ingrown toenails and in the worst cases, loss of toenails, which can make practice unbearably painful and slow or halt performance. Read on to discover ways to protect and repair damaged and irritated feet and toenails.
From the ground up
As an athlete, the right pair of shoes makes all the difference when it comes to preventing wear and tear on hard-working feet. A pair of running shoes that are too tight will pinch nerves and lead to ingrown toenails as well as painful bunions, blisters and calluses.
Look for shoes that allow your feet to breathe (mesh, canvas or leather). Shy away from rubber and plastic, which hold moisture in and cause feet to sweat, and infections to flourish. Allow time for your shoes to dry – forgo wearing the same pair of shoes two days in a row. Many people do not realize how important the insoles of a shoe are and what benefits they can give your feet with the right pair. Wear socks made of natural fibers that absorb moisture best, or invest in synthetics that are especially designed to draw moisture away from the foot.
This affliction affects quite a large number of athletes. It is a fungal infection known as tinea pedis, which targets the nails and skin, causing skin to become red, cracked, burnt, scaly and itchy. Sometimes the infection stays mainly between the toes, but in extreme cases it may also appear on the soles and side of feet and spreads to the toenails. It can also be accompanied by painful, oozing blisters. Athlete’s foot is easily spread and can be picked up in common areas such as showers, and can become exacerbated by moist, tight shoes and socks.
Prevent athletes foot by keeping feet clean and dry, and wearing the right shoes and socks as we mentioned above. Avoid walking around barefoot in public areas and wear flip-flops in locker room showers and bathrooms.
Athletes are often prone to extreme cases of damaged and injured toes and toenails. These types of injuries can lead to loss of toenails, and debilitating ingrown toenails. Prevent ingrown toenails by keeping nails clean and clipped short and trimmed straight across. The medical term for toenails that fall off due to a fungal infection or traumatic injury is called onychoptosis or onycholysis, which indicate a separation of the nail from nail bed. If there is trauma to the nail, damage will be characterized by pain, bruising under the nail bed, discoloration of the nail, and ultimately loosening of the nail. If damage is caused by an infection, look out for thickening of the nail, yellow, brown or green discoloration, swelling, pain, itching, flaking, redness, foul odor and possible discharge.
If you see any of these symptoms, there are ways to treat and prevent further injury or damage. Athlete’s foot can be eased by a number of natural solutions; baking soda used as a paste can ease the itch and burn between toes, and a foot soak made of baking soda and salt will soothe affected areas. Plain yogurt is also an instant remedy for athlete’s foot, simply dab on infected areas, let dry and then rinse off. Tea-tree oil is a powerful antiseptic, mixed with olive oil and rubbed on it will clean, heal and soothe dry patches. Calendula is also a powerful herbal healer that has antifungal and anti-inflammatory powers. If your toenails are ingrown or inflamed, clean them with antiseptic, gently pull up the nail and trim what part of the nail you can off. Seek treatment immediately if the area under the nail bed is extremely painful and oozing.
Gwen Lewis is a writer who lives in California. She has a passion for beauty and health and loves to write her articles from experience. She grew up playing soccer and knows the importance of taking care of your feet. She hopes you find these tips helpful to prevent any athletes from foot problems.
A while back I was sent a sample tube of Blue Steel Sports Anti-Chafe Cream. It’s another entry into the marketplace of blister and chafe prevention products – needed by many athletes.
Blue Steel Sports Anti-Chafe Cream is a white non-sticky and non-greasy cream that spreads evenly and leaves a protective smooth, almost silky feel to the skin. Unlike some creams or lubricants, I did not have to wash my fingers after applying it to my skin. It’s not oily. It will wash off with soap and water and will not stain your clothes.
This cream can be used by athletes, whatever their sport. It has a great following by cyclists, but is perfect for runners, walkers and hikers. Use it on your feet – between your toes and on your heels, anywhere you typically develop hot spots or blisters. If you are doing a long race or event, you might want to pack a small amount in a Ziploc bag for a second application if you feel it necessary. While it will not sweat off, if you are ding a day long race, a second application could be helpful. It can be used on underarms, inner thighs, and anywhere in your groin or backside areas. It works well on sensitive skin areas and will not burn or sting. Cyclists can also apply it directly to the chamois in their bike shorts.
Blue Steel Sports Anti-Chafe Cream is available in a 3.3 oz tube and smaller single use packs. A little bit of the cream goes a long ways.
The cream contains Tree Tea Oil, which has nice healing properties. It also contain silicone, which helps with moisture and perspiration control, an important part of foot care for many athletes.
Here’s a report from a friend I asked to try the cream. “I got a chance to use Blue Steel Sports Anti-Chafe Cream cycling 46 miles on Friday. Cycling was the first sport on it’s list of uses, and it says ‘Apply directly to skin on ANY areas prone to chafing’, and on cyclists that would be the whole crotch zone, which is embarrassingly where I have a problem on long rides with lots of hills. You can also apply it after an activity to calm irritated skin, so I assumed it must be for sensitive areas. It was not uncomfortable to apply, and has a pleasant herbal scent, and was effective at eliminating crotch chafe for me, even though I rode 46 miles. I had no need to apply it afterwards and it did not stain my clothing. I used it only once, but I give it a ‘Thumbs up’!”
Check out some of the testimonials on their website and you’ll find someone who is doing your sport and has had success with the cream.
I recommend trying Blue Steel Sports Anti-Chafe Cream for your activity. I am a strong believer in trying products to find the best for your feet (and in this case, other body parts). I think Blue Steel Sports Anti-Chafe Cream is a winner.
I have no financial interest in Blue Steel products.
Filed under: blister care, Foot Care, Foot Care Products, Health, Sports
Maceration is not limited to runners, adventure racers, and hikers. The other day Deb shared a link on an online forum, which featured some awful looking feet. Actually, truth be told, she called them “fun feet photos.”
I’ve seen feet like these many times over, at many races. Most recently, last October, most of the runners in the Jungle Marathon Amazon had feet like these.
You can read my post about the Amazon race here.
In the link shared by Deb, there are 14 photos of cyclist’s feet – featuring the bottoms of their feet, along with their face. The images were taken immediately after the race ended. The Norwegian photographer Espen Rasmussen says in the piece, “You start in Trondheim in the north, then you go up the mountains and you meet snow, rain, heavy wind, and then you finish in Oslo in the south.” He’s talking about the bicycle race in Norway, which is 336 miles long.
Rasmussen wanted to capture the pain and the hardness these people went through.
As you look at each of the 14 pairs of feet, you’ll see maceration is the common thread. Maybe one or two pair has blisters – but these are simply feet that have been wet for hours and hours, encased in wet socks and shoes.
I have captured two of the images on this page and hope you will check out the full story in the link below. It is worth looking at these images and realizing that the same thing can happen to you. You’ll also see the faces behind the feet. It’s a great visual story.
So the question is what could have been done to prevent or minimize the effects of the moisture. For this type of event, it’s hard to say how often the riders stopped, how often they changed their shoes and socks, or what they might have done to their feet. Unlike runners, who know their feet take a beating, cyclists may not realize the outcome of moisture on their feet and therefore may not take proper precautions.
In the past months, I have reviewed several products that could have helped, and in a week or so will review another new product. Here are the two links to the blog posts:
For a longer informative piece on maceration, check out my blog post in June 2011 called Maceration.
CNN World writer Kyle Almond wrote the story. To read the full story and photos click on this link, Extreme Races, These Feet Don’t Lie.
I also plan to write a blog post about many of these lubricants and how to chose the ones right for your feet. I’d look for that in late March.
Filed under: blister care, Foot Care, Foot Care Products, Health, Sports
Foot Kinetics recently introduced several new products designed to reduce blister formation. Carl and Rick, founders of Foot Kinetics, developed HikeGoo, RunGoo, WalkGoo, and SilkStep foot creams for preventing blisters and providing moisturization. The products help avoid foot problems by forming a friction-free layer between the skin and sock. This protective layer reduces rubbing and friction, working on a variety of foot problems including blisters, callus formation, soft tissue bruising, and sore feet. Each formulation is different and contains a balance of hard wax, lanolin, and natural vegetable waxes to moisturize and protect feet from abrasion and foot fatigue.
The protective foot creams are formulated for specific activities and footwear. The relative percentage of hard versus soft waxes in each product’s formulation enables it to perform optimally for that activity. The more hard wax in the formulation, the longer the product stays on the skin’s surface and the slower it absorbs. HikeGoo has the hardest wax and will last in the harsh environment of a boot on an all-day climb. RunGoo has the hard wax persistence of HikeGoo but also some added soft wax moisturization. The higher percentage of soft waxes in the foot cream, the greater the absorption and dry skin moisturization. SilkStep has the softest waxes and is optimized for moisturization.
Rather than repelling moisture or attempting to block sweat, the unique formulations actually absorb sweat and moisture to become even more effective in reducing friction between the skin and sock. This is why Foot Kinetics say they are highly effective in both dry and wet conditions to protect feet from blisters, callus formation, and skin damage.
Why it works
According to the folks at Foot Kinetics,“Our barrier creams stick around much longer than any other blister prevention or anti-chafe product on the market. They contain a high percentage of specialty hard waxes that are blended into the emulsion and make it persistent…. make it stick around all day to provide a protective layer that reduces rubbing, friction, calluses and blisters. Most other anti-chafe and blister prevention products are dimethicone-based. They are OK for thighs and chest but are too thin to stand up in the harsh environment of a shoe and you can’t apply enough to last all day.” Click on the image above for a larger view.
Foot Kinetics put a high concentration of hard wax in the HikeGoo, RunGoo, and WalkGoo emulsions and then figured out how to adjust the ‘rheology’ (deformation and flow) of the product so that it can flow out of a tube. They point out no one else has been able to do this.
They point out the other key to the success of their Goo products is their ability to last over an entire day because of the balance of lanolin alcohol in the emulsion. The balance allows it to absorb water or excess sweat and makes the emulsion ‘slipperier’. Moisture, usually present between the skin and sock, contributes to blister formation, and the lanolin alcohol balance make the skin slipperier to help keep blisters from forming.
RunGoo Protective Foot Cream prevents blisters by providing a friction barrier between the skin and sock. RunGoo contains lanolin and a balance of both soft and hard waxes to create a foot care cream that protects feet from skin damage. It is effective in eliminating blisters and calluses in traditional, barefoot style running shoes, and hiking boots. RunGoo is available in 5.5 and 3-ounce tubes.
HikeGoo Protective Foot Cream is very similar to RunGoo and provides a friction barrier between the skin and sock that protects feet from blisters, nerve abrasion and foot fatigue all day. High melting point waxes slow its skin absorption to create a protective layer that stays on the skin’s surface and is highly effective in helping prevent blisters. HikeGoo absorbs completely by days end and socks easily wash clean. HikeGoo is available in 5.5 and 3-ounce tubes.
WalkGoo Protective Foot Cream is a thinner compound and is good for feet because it protects and moisturizes during sport walks or while on the job. WalkGoo’s friction-free formulation reduces rubbing by including Jojoba, Mimosa, and Sunflower waxes which stay on the skins surface longer to help prevent blisters, calluses and nerve abrasion while softening and smoothing cracked heels and rejuvenating dry feet. A single application lasts all day and absorbs cleanly. WalkGoo is available in 8 and 3-ounce tubes.
SilkStep Protective Foot Cream has the highest percentage of Jojoba, Mimosa and Sunflower waxes of all their protective foot creams. It absorbs slowly providing a protective layer on the skin.
You can find all their products at the Foot Kinetics website.
The Goo products all have the same basic compound, but the amount of hard and soft waxes as well as hydration varies in each formula. Some are thicker than others and will stay on the foot for longer periods of time.
The Foot Kinetics Goo products are advertised as lasting, “…for the entire race, workout, run or game.” You need to determine if that works for your event. There’s a big difference between a 12-mile hike, a marathon, a 100-mile run and a 24-hour run. Try the Goo to see how it holds up on your skin during your events, reapplying it if necessary. If using it in events with sand and grit, cleaning the foot and then reapplication will probably be necessary.
Applying the Goo
To apply, with one or both hands, squeeze the tube firmly to get the cream started out the hole. You may have to squeeze hard, especially if in cold weather. After this initial squeeze the cream will come out more easily. Continue squeezing the tube while rubbing the applicator over your foot taking care to thickly cover problem areas such as heels, bunions, toes and the soles of your feet. Don’t worry if the coverage is uneven or lumpy. This is normal. Starting at your toes with your sock mostly inside-out, roll or pull your sock on and up over your heel. Don’t drag your sock on as this could wipe away some cream leaving exposed areas. If you are going to be engaged in your activity for a long time (i.e. hours), a thicker layer provides optimum protection.
Foot Kinetics protective foot creams are to be used only on closed healthy skin and not open wounds.
The Foot Kinetics website has a testimonials page describing how athletes have used the their products.
I used HikeGoo on several occasions. The compound is thick. Getting the initial squeeze out of the tube is challenging, as they describe. The design of the applicator gives you a generous amount of the Goo to spread on your feet. That’s how the Goo is meant to be used. If you are used to rubbing a small smear of BodyGlide or other lubricant on your skin, You’ll have to get used to the Goo. The hard waxes keep it thick and that’s how you should use it. Many lubricants go on and you have a hard time knowing they are there. When applied properly, you’ll feel the Goo, and know it’s working.
The Goo reminds me of Desitin Ointment – the stuff used on baby bottoms. The consistency in thickness is almost the same. It’s white so you see exactly where you have applied it and how much is on your skin. I like that aspect of the Goo.
I also like the two sizes of tubes; making it easy to carry a small tube in a pack, while keeping the larger tube in your foot care kit.
There’s always room on the shelves for more lubricants. This is one you’ll want to try. When I try products, I often use one on one foot and another (or nothing) on the other foot. I feel that gives me the best opportunity to fairly test the products. I’ve done that with shoes and socks too.
Give RunGoo or HikeGoo a test. See how the formula works for you. Use your regular lubricant on one foot and the Goo on the other. Then do a long run or hike, and see which your feet like the best. They can be ordered from the Foot Kinetics website and from Amazon.
Disclosure: I was supplied several samples of the Goo products to test. RunGoo, HikeGoo, WalkGoo and SilkStep are trademarked names of Foot Kinetics.
Filed under: blister care, Books, Foot Care, Foot Care Products, Footwear, Footwear Products, Health, Sports
I love reading the unsolicited email and testimonials from athletes who have discovered Fixing Your Feet. They help motivate me to keep going. Here are two. The first is a simple sentence. The second is a personal story I received last week. Thanks everyone who has passed along their story.
I’m pretty sure Fixing Your Feet has saved most of us at one point. ~ an email from Deb Bosilevac.
Then Billy Pearce (husband, father of 3 boys, nurse and ultrarunner) shared his story:
My many years of ultrarunning with a three shoe size difference in feet caused by a traumatic injury as a child has always been a challenge with shoes and blisters. So I choose ultrarunning as my passion! I have had two DNF’s in the Australian classic Coast to Kosci 240km beach to Australia’s highest peak. So this year my attempt to get a finish was one of real attention to where things had gone wrong before.
This year I had my podiatrist and friend on my crew, (Brad White, from Footcare Woden, Canberra ACT Australia). I attend his clinic monthly as routine and we have planned all year for this race. Brad is also a gifted runner.
Best footcare ever. In over 42 hours 26 minutes of running I needed two stops to attend to feet – totaling less than 15 minutes for both stops! I gave him a copy of Fixing Your Feet and I think we have created a new passion for him.
I found your work after a 48 hour race when my feet become so bad I was reduced to painful shuffle for last 24 hours then weeks of healing. I am now able to race 24 hours on a track without a scratch and as we say, “If you do not have a plan for your feet, you do not have a race plan.” Thanks heaps for the help and advice you give so freely.
Do you have the 5th edition of Fixing Your Feet? Last summer while working on feet at the Michigan Bluff aid station of Western States, a runner’s crew member came up to ask me if I’d sign his copy of Fixing Your Feet. While I signed it, I told him he had a very outdated book the 2nd edition! Every edition has gotten better and larger with a lot of new and updated information. Maybe I am biased, but the 5th edition is the best ever.
If you have older editions, you owe it to yourself to invest in the 5th edition. You can purchase it through my website, Zombierunner, and most online bookstores. At Amazon, it’s available in either print or Kindle formats.
I am looking for two or three athletes with a toe(s) that curls under the next toe. In most of the cases I have seen, it’s the pinky toe that curls and rests under the next inside toe.
These cases have the appearance of one toe that is usually straight, but overlaps the next toe, which curls underneath it. The toe that curls under is susceptible to blisters, maceration from moisture of skin-to-skin contact, and toenail issues as the toe curls downward.
I have an idea that might help with these overlapping toe problems and am looking for a few people to test my idea. No guarantees, but I think it could help.
If you are interested, please send me an email and tell me a bit about:
- Which toes are affected
- What problems this has caused
- What you have tried to resolve the problem
- A snail mail address
- Send a photo if possible
Filed under: blister care, Foot Care, Foot Care Products, Health, Sports, Travel
Several months ago I received an offer to test several products made by Sportique Brands. It took only a little investigation to learn that Sportique is a high-quality company that carries a wide array of athletic and multisport endurance products made from botanicals and all natural ingredients. Their tag line is “Body Care for Active Bodies.”
Over a few months I used the Hard Day’s Night Foot Cream, the Century Riding Cream, the Foot Gel, and the Foot Spray. I like that these products contain no petroleum or harsh chemicals. As I have used the products and researched their complete product line as well as the ingredients and commitment to all natural product, I have the highest regard for Sportique. Their products are all vegetarian and most are vegan.
Sportique’s product line covers foot care, skin care, joint and muscle care, lip care, active care, massage, and shaving and personal care.
It’s important to understand that the substances we put on our skin is absorbed into our system. While using products with less than stellar ingredients once or twice a month may seem innocent, athletes who use them on a consistent basis, or do ultra or multi-day events should be concerned. Ingredients like petrochemicals, sulfate based detergents, and even petroleums disrupt the oils your skin needs. Toxins are absorbed into the liver and can affect our metabolism. In fact, whatever you put on your skin hits your liver in about four hours.
As I set out to write this review of Sportique products, the list kept growing. As an added benefit, the combination of botanicals and oils make these products smell good too! You can click on each product name to go directly to the product page, or click here to see all product and kits on one page.
Hard Day’s Night Foot Cream – A formulation of botanical and oils that smoothes roughness and calluses. Also works to deodorize and revitalize your feet. Comes in a 6 oz. tube. The cream worked great on the rough skin and calluses on my heels. I used the cream after showering and after using a callus file. Over a period of a month, I noticed a definite reduction in the callus and smoother skin. The thing to remember on callus for most athletes; it’s a continuing job to control the rough skin.
Foot Gel – A cooling gel to apply to tired feet. Its botanical ingredients are antimicrobial, antifungal, and it limits the development of perspiration. Comes in a 6 oz. tube. Just like the Foot Spray, it leaves the skin feeling refreshed.
Foot Spray – A refreshing and cooling foot spray to eliminate odor and absorb moisture. It also has antimicrobial, antifungal botanical ingredients. Comes in a 4 oz. container. The spray really does have a refreshing feeling. It felt good on my toes and bottoms of my feet.
Century Riding Cream – A collection of botanical ingredients to help repair skin after chafing and damage from friction. Contains important plant based occlusive silicones for a long-lasting friction free barrier. Also includes antifungal, antimicrobial, and skin conditioning botanicals. This cream can be used on all friction points with all running, riding, kayak, scuba, surf gear, and to prevent chafing and blisters. Available in 3.5 and 6 oz. tubes. It can be used on toes, feet, seat, armpits, chest, and groin, under sports bras – anywhere you chafe. I tried this on my feet and in my bike shorts and was impressed. I can see this being my lube of choice.
I have several more products on my list to try. They include:
Elements Cream – This is a cream to use for protection from wet, cold, heat and dry weather. The combination of botanicals and oils works to keep four face and exposed skin from chapping and chafing. Elements Cream is infused with a substance, which prevents seaweed from freezing in the ocean – it has been tested to -40 degrees! It was used in November by the winner of the Antarctic Iceman Marathon who beat his competition by some five hours. It prevents windburn and chapping for runners, cyclists, skiers – anyone out in the Elements.Available in a 6 0z. tube. The recommended use is to apply a light layer of cream and then after a few moments, apply a second slightly heavier layer.
Get Going Cream and the Warming Up Cream for pre-and post-race muscle treatment – both work to loosen up, expand capillaries, bring blood to muscle to avoid injury and improve comfort in the cold. Your skin’s sensitivity level will dictate your results of each.
Joint & Muscle Gel – For relief of achy and stiff muscles; helping strained joints and improves flexibility. It’s ingredients work to maximize relaxation, reduce muscle tightening, and calms nerves. Packaged in a 6 oz. tube.
Foot Powder with Lavender – A deodorizing and antifungal powder combined with lavender. Its botanical ingredients help absorbs perspiration, control inflammation, and keep skin cool and dry. Comes in a 3.4 oz. shaker.
I’d suggest putting your choice of Sportique products into smaller container as necessary to carry them in a pack or to carry in your cycling jersey. Many outdoor stores and drug stores offer smaller containers that could hold enough for a day’s event or a multi-day event in a lighter weight package.
For my October trip to the Amazon, Kathleen, the CEO at Sportique Brands suggested, “… for an alternative to DEET in the Amazon use our Foot Spray and/or Deodorant to repel leeches if you are doing any hiking in the jungle. The leeches have a unique way of ending up in your socks and can be a nuisance. Each morning spray your legs before putting your socks on and you should be good to go. I did some extensive trekking in India, Nepal and Tibet in the 80’s during monsoon season. Leeches are the thing to watch for in a wet jungle setting. DEET is usually the recommendation but it is tough on your body…we offer chemical free alternatives.”
Customer reviews are a good indicator of what people think about products. Sportique has a page dedicated to customer reviews. Look them over and you’ll see positive reviews from happy customers.
Sportique products are free of petroleum, animal byproducts, synthetic colors & preservatives, petrochemicals like PEGs, polyethylene and polypropylene glycol, parabens, carbomers, diethanolamine (DEA), and synthetic fragrances – and none of the ingredients and final products are tested on animals. Their products are all vegetarian and most are vegan.
Save 10% on Your Order
My readers can get 10% off your total order when you use the coupon code “FixingYourFeet’” at checkout. Put the code in the box just before hitting the orange check out button. Sportique can ship anywhere in the U.S., Canada, Asia, Europe, Australia, and South America. On international orders the buyer will be charged duties and taxes in the sales checkout process. Sales to Brazil and Columbia are discouraged because products often disappear before getting to the buyer. Sales cannot be made to Africa.
Sportique Brands is the exclusive wholesale distributor of Sportique products in the Unites States and sells through their website retail outlet to those not within reach of a store selling Sportique Brand products.
Disclaimer: I was provided products to test and have no financial involvement in Sportique.
Susan Alcorn’s Backpacking & Hiking Tales & Tips is a monthly email newsletter from her website at Backpack45.com. Susan and her husband Ralph have done hikes on the Pacific Crest Trail, the John Muir Trail, the Camino de Santiago, and more. Every month I review her newsletter for tips and information that I can share with my readers. I encourage you to check out her website and subscribe to her newsletter.
Only once before in the 15 plus years of publishing an email newsletter and this blog have I shared information that has the potential to save a life. Please read on and take this information to heart.
In the December newsletter, Susan shared a story they experienced while hiking the John Muir Trail. They met a hiker with a sobering tale he shared with them. He and his wife had reached Palisades Lake when she was suddenly hit with nausea, fever, and weakness. Initially he thought it was exhaustion, but the next morning his wife was worse so they did a layover day. She was even worse the following day so they decided to exit at Bishop.
His wife became so weak that she could no longer walk – even without her pack and with help. She collapsed on the attempt to descend the Golden Staircase. Her vitals were a temperature of 105, blood pressure of 90/50, a resting pulse 135 – and she was unaware of her surroundings. He and two others tried to carry her out, but found it impossible because of the narrow trail. A helicopter was brought in and she was airlifted out in a basket to Deer Meadow, where she was put inside the helicopter and taken to the hospital.
The Alcorn’s met the husband as they were leaving the John Muir Trail over Bishop Pass. He was going out on the east side and then going to find a way over to the hospital in Fresno. We wondered for days how this had played out and were happy when they heard a subsequent report. After four days in the hospital on antibiotics, the lady was ready to be flown home – not entirely well, but no longer in danger. The hospital did not do tests to determine the cause, but only treated symptoms, so the cause of the problem was up for speculation. Her husband thought that an infection had probably entered her blood through blisters in her feet – most likely the source was open blisters and their soak in hot springs.
Susan says, This is a reminder of the importance of avoiding infection in any open sore – especially under trail conditions.
I agree. In 2007 I wrote an article about another hiker on the Pacific Crest Trail who had to be evacuated out and spend a long time recuperating from a serious infection. Her infection was also caused by an infection through an open blister. This first photo shows her infected foot after she reached the hospital.
Bacteria causing the infection can come from your skin, from the environment, or from anything that gets inside the blister. The web spaces between the toes have more skin bacteria and open blisters here present an increased risk of infection. The second photo shows the redness common to an infection.
The take-away here is that we need to understand how to properly clean and care for blisters, have the right materials to patch them, and know the signs of infection.
All open blisters should be watched for redness, streaks up the leg, pus, heat to the touch, pain and/or swelling around the area, and fever. When any of these are present, prompt medical care should be obtained.
In my 2007 Fixing Your Feet newsletter I wrote, I think this is the most serious and important issue yet. It has in-depth focus on infections as a result of blisters. First read my editorial, Blisters Can Lead to Serious Infection, and then the feature article, My Infected Blister – Almost My Life! where Cari Tucker “Sandals” tells her story. I think you’ll agree with Denise Jones, the Badwater Blister Queen, who told me, ‘This is indeed sobering and shocking (literally). I think people need to see this because I do not think they take blisters very seriously!’ I urge you to fully digest the articles, then read the articles on Blood Blisters and Infections, Staph Facts and Cellulitis Facts.
Here’s the link to the July 2007 Fixing Your Feet newsletter with the articles.
Back in May I posted an article about Training With Wet Feet. My being invited to work on the medical team at the Jungle Marathons in Vietnam and the Amazon prompted the article. While the Vietnam race had to be cancelled, the Amazon race is happening – in a bit over two weeks.
As I wrote in that article, it was long felt the best way to manage your feet was to keep them as dry as possible. This was more and more evident as Denise Jones and I worked the Badwater Ultramarathon in the heat of Death Valley each July. Runners who kept their feet dry typically finished better than those who had wet feet. This was also based on our experiences at Western States and other events.
Then came the invite to help at the Jungle Marathons.
The Jungle Marathons are run by Race Director Shirley Thompson and the Medical Team Manager is Vicky Kypta. They found their runners had a better race when they trained with wet feet. As part of their instructions to their race participants, they stress the importance of training with wet feet.
The reason for this is the Jungle Marathons are wet. Very wet is typical in the jungle. Whether through rivers or streams, the Amazon is full of water.
When I am helping runners at the race in early October, I will be closely monitoring the condition of their feet. I expect runners will use lubricants and other products to control the moisture, or powder, socks, well-draining shoes, and maybe a few home-grown tricks.
Over the past few months, I have shared some of the findings by Rebecca Rushton, a podiatrist from Australia. In her Blister Prevention Report, she talks about managing moisture control. She supports her report with studies from medical and other professional journals. What she found through the studies is that you could reduce the incidence of blisters by keeping the skin either very dry or very wet.
Rebecca writes that, “… the very high or very low skin moisture strategies aim to reduce the coefficient of friction value between the sock and the skin to below blister-causing levels.”
The Coefficient of Friction
The coefficient of friction (COF) is the number that represents the slipperiness or stickiness between two surfaces. According to studies, this number is generally below 1.0. Inside the shoe, the COF between the foot’s skin, and the sock and insole can range from 0.5 and 0.9. Compare this to the COF between a sock and a polished floor – about 0.2.
In Rushton’s report, she illustrates this with an example of a runner whose feet sweat a lot. His socks become damp, creating a moist condition. The COF in this case might be 0.7. By moving away from a moist condition to either very dry or very wet, the runner might reduce the COF to 0.5. If the runner’s blister-causing threshold is 0.6, getting to 0.5 will reduce his chances of blistering. Reducing the COF between your skin and socks/insole combination is important to having healthy feet.
Moist skin produces higher friction than very dry or very wet skin. Whether skin is dry and becomes moist through sweat or through a water moisture source, or is very wet and becomes moist through heat or simply drying out, when it hits this middle stage, it becomes more susceptible to blistering.
Very Dry Skin
Drying the skin can be done with powders, antiperspirants or other drying agents, used by themselves or in conjunction with moisture control socks. Keeping the skin very dry is tough because our feet sweat naturally. Humid or hot conditions can also make it hard to keep the skin dry. Dumping water over your head to cool yourself can result in water running down your legs into your shoes – defeating your efforts to keep your feet dry. Airing your feet with shoes and socks off can help. If you use powders, make sure it is high quality and does not cake, which can be an irritant. When counting on any of these methods to keep your skin dry, you mush also have shoes that allow moisture to escape. That may include shoes with mesh uppers and drain holes in the arches and heels.
Very Wet Skin
Increasing skin moisture leads to very wet, lubricated skin that reduces the skin’s coefficient of friction. This can be through the use of a lubricant and or by simply having wet feet. The thing to remember is that over time, 1-3 hours, friction will increase as the lubricant is absorbed into the socks – so ongoing application is required.
Remember too what happens to your skin when you spend too much time in the water. It becomes weaker and less able to resist trauma on wrinkly skin. In extreme cases, the skin can fold over on itself and split. Severe maceration can be painful and athletes say it feel like a giant blister on the bottom of their feet.
In the Amazon Jungle Marathon, the trick will be to dry the feet at the end of each day’s stage. Because the feet will be wet during much of each day’s stage, the runners will have to find the balance between very dry and very wet, avoiding moist as much as possible.
Here’s some advice from my previous post about training with wet feet.
As said earlier, stop and deal with any hot spots as soon as you feel them. Check for folds in your socks, friction from dirt or sand, pressure inside your shoes – and get rid of these irritants. Lube the area or apply a piece of tape or blister prevention patch to help. This may seem like common sense, but many people ignore this simple step.
At the end of each day’s stage, remove your wet shoes and socks, dry your feet and air them as much as possible. If your feet have tape on them, remove the tape to dry the skin underneath. Wear sandals or Crocs around camp to keep your feet away from the wet ground and dirt and sand. Walking around barefoot will often aggravate wet, cold, and soft macerated skin. Later in the day or the next morning, re-tape your feet and patch any blisters.
Rest assured that I will write about how everyone’s feet held up in the wet Amazon jungle.
Credit is due to Rebecca Rushton for her Blister Prevention Report. Her website is Blister Prevention. Check out her website and sign up for her newsletter and free reports.
Here is the link to the Jungle Marathon Amazon.
If you want to read more, check out this article I did in November 2012 about Stuart Crispin who completed the race in Vibram FiveFingers.
Last Saturday and Sunday I worked medical at the Western States 100 Mile Endurance Run. I spent Saturday at the Michigan Bluff aid station at mile 55. With the help of Tonya Olson, we patched a bunch of feet. Some had blisters, one needed shoe modification, one had severe heel blisters that had split, and lots of maceration. We saw more maceration than in many past years.
After we closed our aid station at 9:45 pm, I went to Foresthill and talked to George Miller, who was doing foot care there. He had a pretty calm afternoon with nothing unusual.
I found a nice parking space near the finish line at the Auburn High School and spent an uncomfortable few hours trying to get some needed sleep. About 5 am, I headed over to the podiatrity tent and set up my gear. By then, 24 hours into the race, even with about 100 runners in, the tent was quiet.
Around 7 am, things started to pick up. As runners finished, there was a large washtub for them to wash off the dirt. Then they could move to one of the kiddy pools with cold water and ice to soak their feet. Only after that did we see them. As they moved from place to place, Dave, assigned to work finish line podiatrity, and Tonya and I (from Michigan Bluff) looked over their feet and answered any questions. This went on until well after the race ended at 11 am.
This year’s Western States was hot. I’d guess hotter than normal. To my knowledge, there wasn’t that much water on the course. However we saw a large number of runners with severe maceration.
Here’s a photo of one runner’s foot. This was repeated over and over as we evaluated runners at the finish. Most were convinced that they had large blisters that we needed to lance. In fact, with one or two exceptions, there were no blisters. Just wet, macerated feet with lots of skin folds, creases, and waterlogged skin.
We told the runners that time would heal their feet and to go home or back to their hotel and start a regiment of Epson Salt soaks. The salts help to dry the skin. Powders and airing the feet help too.
Some of the runners had blister with blood inside – some were tinged with pink, indicating blood traces. The decision was made not to lance these blood blisters. When runners have dirty feet and have not showered, and will be walking around in dirty shoes or sandals for a few hours during the awards ceremony, we didn’t want to increase the possibility of infection. In these cases, we gave them the same instruction to do Epson Salt soaks and watch for signs of infection.
A good question is why there was so much maceration. In the heat of the course, often time runners take advantage of every opportunity to keep cool. This includes going through streams, using water soaked sponges at aid stations, pouring water over their heads, and whatever else they can think of. Sometimes well-meaning crew and volunteers squeezed soaked sponges over the heads of runners. The problem is that the water runs down the legs and into the shoes. This helps maceration.
I have seen some runners coat their feet with zinc oxide or SportSlick to help hold moisture at bay. Changing shoes and socks can help, and can be important when maceration has started. Drying the feet and using powder in fresh socks is also important.
Here are four blog posts about maceration and wet feet. Read them to know more about this condition and gain insights about how to manage your feet when wet.
Maceration - June 23, 2011
Training for Blisters in Wet Conditions - September 15, 2012
Training With Wet Feet - May 5, 2013
A New Kind of Foot Coating - September 25, 2011