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.
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.
A month ago I provided foot care at the Western States 100. Then two weeks ago I worked the Tahoe Rim Trail 55KM, 50M, and 100M. And finally this week I worked Badwater in Death Valley. As much as I hate to say it, I saw a negative common denominator as I worked on or saw runner’s feet.
The common negative was runners’ toenails.
I wish I didn’t have to say the toenails were bad, but a lot of them were. While not every runner suffers with their bad toenails, many do. Enough to warrant this blog post.
The picture here is an example of nails that could be better – much better. I won’t identify the runner or the race because I saw these same toes at each of the three events.
Toenails that are thick can be smoothed with a nail file. In severe cases, a Dremel tool can be used to reduce the nails quicker, especially when the nails are really thick and tough.
Your nails don’t have to be thick. They don’t have to be rough. They don’t have to have an upward curl or edge. They don’t have to be wavy. They don’t have to stick over the end of your toes. In short, candidly, they don’t have to look like your toes are 90 years old and you live in a nursing home. If you think you might have toenail fungus, check with your doctor – and take care of it.
An inexpensive toenail clippers will set you back about $5. If you have tough nails, you may want to buy a stronger set of clippers that look something like wire cutters. Then get a file for another $1 or $2.
Toenails that are too long, too thick, have rough edges or corners, will catch on your socks, which will push the nail back into the nail bed and cause trauma, fluid or blood under the nail, or toe blisters. During a race, these nails become painful to touch – meaning you can’t trim or file them without pain.
So we see you at an aid station, and you are hoping we can fix your feet. If there is fluid or blood under the nail, we can drain them. We can run a strip of tape over the tip of the nail to provide a bit of protection to the nail. But we cannot fix the discomfort and pain.
I can patch most anything on your feet, but I cannot fix a thick toenail that sticks up way above normal. I cannot smooth the rough edges if you cannot tolerate the filing. I cannot trim the nails if you cannot tolerate the pressure.
Caring for one’s toenails isn’t that hard. Once a week, use a clippers and nail file to trim them. Clip them fairly short and then run the file over and down the tip of the nail, removing any rough edges. The goal is to have nails that you can’t feel when you run your finger over the front edge of your toes.
If you have lost a toenail, as the new one comes in, file the top of the nail thin. Wrap a Band-Aid around the toe to help train the nail to curve naturally to the shape of your toe.
Toenails are not complicated. But just as you care for other parts of your body, you need to care them them too.
Filed under: blister care, Footcare, Health, Sports, toenails
I get questions by email all the time. Toenail questions are quite common, so I thought I’d post this one. Here’s the question.
“I am emailing you because I have a 50K trail race this Saturday and for some reason I am just starting to get pressure from under my large toenail. It is in its early stages and my nail has not turned black yet, but it is starting to be uncomfortable. At what point do I decide to puncture thru my nail and lance the fluid under the nail? Also, if I should be lancing the fluid, what are your thoughts of using a really thin and clean drill bit (turned by hand) to get thru the toenail? I lost a toe nail once before and tried using a really hot paper clip and needle, but I had a hard time getting all the way thru my toe nail. Any help and advice you can give me would be much appreciated… thank you!”
The answer is pretty straightforward.
Can you recall any nailbed trauma? Once fluid is underneath the nail, the pressure becomes painful You’ll know. If you can see the fluid from under the tip of the nail, lance it there. A drill bit works better than a paperclip. Be forewarned that as it goes through the nail, it can go into the soft tissue underneath, so go slowly. Then press on the nail to expel as much of the fluid as possible. Cover with a Band-Aid for now (tape on race day) but don’t plug the hole with ointment, as it will still need to drain for a few days.
Relieving fluid from underneath a toenail is a simple skill that every runner should know how to perform – just in case. It could be on one of your toes, or the toe of a friend. If you have ever experienced the intense pain of a black toenail with blood or fluid underneath, you’ll appreciate knowing how to fix it.
Filed under: blister care, Foot Care, Footcare, Footwear, Health, toenails
Here are a few foot care tips I wrote to help runners at the Amazon Jungle Marathon. I’ll be there in a few weeks to help with foot care on the medical team. The tips are valuable for anyone doing a 24 hour race, a multi-day event, an adventure race, or a long backpack. Remember, your feet will carry you day to day only if you take care of them.
Start with good toenail care. Trim your nails short and then use a file over the front edge to remove any rough edges. File the tip of the nail so when you run your fingertip over the tip of the toe and over the nail, you don’t feel any rough edges. You can also file the top of the nail if it’s thick. Coming to the race with bad toenails will ensure toe blisters and black toenails.
Make sure your shoes fit well. Have enough room in the toe box for your toes to wiggle. Your feet may swell over the race and you don’t want shoes that are too tight. Some shoes, like Hokas, retain water and become heavy over the days, as they are wet so much of the time. Wet and waterlogged shoes are heavy.
Get good socks. Don’t show up with cotton socks. Socks made with Coolmax or wool are good choices. Injinji toe socks are great. Have several pair and wash then after each day’s stage or have one pair per day. Also don’t show up with old socks or ones with holes in them.
Do whatever you can to reduce any calluses. Getting a blister under a callus can be painful and it’s very hard to find the pocket of fluid for draining. After showering, use a callus file or pumice stone to shave the callused skin from your feet. Then apply some callus cream. This is something that should be done several times a week. Calluses are the result of friction and pressure between your shoes and feet. Make sure your shoes will drain water.
Shoes that hold water inside will increase the maceration effect of your feet being wet to long, leading to wrinkled and soften skin that can fold over, crease, and split open. Check this by filling your shoes with water and seeing whether it will drain out. You can heat a nail (at least 1/8 inch round) or an awl and make several holes at the inside and outside arch, and the heel of your shoes. Learn how your feet respond to being wet for long periods. Do some long walk or runs three to six hours long with wet feet. Try several products like Desitin or similar cream for baby bottoms that works to control moisture on the skin. Google “baby bottom cream” to see many options.
Do not skimp corners on your foot care kit you need to carry in your pack. Have several yards of a good quality tape, several needles to drain blisters, and learn how to drain and patch blisters. The medical team will try and help with your foot care needs, but we can become overwhelmed by the number of people wanting help. Part of your responsibility as a runner is to know how to do good foot care.
Carry a good pair of camp shoes to wear in the camp after each day’s stage. You don’t want to walk around barefoot and doing so will destroy the taping or blister patching done by you or the medical team. Lightweight Crocs, flip-flops, or sandals are easy to strap to your pack. Change into these after running to allow your skin time to heal from the moisture.
Several weeks ago I was interviewed by Gabriella Boston, a reporter for The Washington Post. She emailed me asking whether I was available and when could we talk. When she called we talked for about an hour. She asked all kinds of questions about foot care based on my experiences for runners.
The article came out on the 17th and is worth reading. The title is How Runners Can Keep Their Feet Happy. Sections include, run training, proper footwear, cross training, and foot care. Gabriella interviewed two podiatrists, a physical therapist, and me. Fixing Your Feet is also mentioned in the article. Click on the link in the paragraph above to read the full article. My bet is that you’ll learn something new.
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.
Filed under: blister care, Foot Care, Foot Care Products, Footwear, Footwear Products, Sports, toenails
Several months ago I had the good fortune to work on the medical team at the Jungle Marathon Amazon. My specific role was foot care of the 78 runners and to work with the others on the medical team to teach them good foot care techniques. I learned some things that I am calling, Your Event Homework…” By that I mean, your homework is to consider these five things that, if you learn them, can help you be more successful in the event.
Over seven days, I got to know most of the runners. The race offered a one-day, four-day, or seven-day event, and runners were required to carry all their gear and food in a backpack. Hammocks were mandatory and everyone had to carry a mandatory kit of emergency supplies. Because of all the gear and food, some runners limited their medical supplies to the most basic (read: as small as possible). Others had large plastic bins or bags of their mandatory gear. Most had planned well.
As runners came through the pre-race check-in to have the mandatory gear inspected, I talked to a lot of them about their shoes, socks, and – their feet. While doing this, I applied ENGO Blister Prevention Patches into many shoes. While I had a good supply of the patches, this would be the only time to get them into runner’s shoes. Once the race started, their shoes would be wet and the patches would not stick. I noticed that there was a good mix of shoes even though the runners were from around the world.
Then the race started.
Three miles into the race, there was a stream crossing. After that, their feet were almost always wet or full of sand or grit. Here are the five main things I saw.
- At the end of day one, one runner asked for help with his insoles. The sand and grit had worn holes in both heels. I could tell, however, that they were well worn even before he started. We dried out the insoles and I cut away any rough edges. Fortunately, the sun had dried the insoles enough to apply ENGO patches over the holes.
- Some runners had chosen shoes that were minimalist in design, and some did not hold up well in the rough trails in the jungle, where rocks, roots, and plants tore at the shoes’ uppers. Two runners’ shoes were shredded at their sides. The handiwork of one of the runners saved the shoes as he sewed the uppers back together with dental floss.
- Several runners had made bad choices in socks. All cotton socks have no place in any athletic event, much less anything over a 5km race. One runner in particular had low-rise cotton socks suitable for walking in the park, but not a seven-day race in the jungle. Another runner had only two pairs of socks, and the first pair had holes in both heels at the end of the first day.
- Some runners experienced problems with toenails that affected their race. Long nails, untrimmed nails, and nails with rough edges cause problems, which can lead to toe blisters, and black toenails.
- While some of the runners managed their feet by themselves, many came to the medical team day after day. While we were there to help, time and supplies were limited – especially time. Runners that can patch their own feet are ahead of the game. Some had the right supplies, while many others with small mandatory gear kits, did not have the necessary equipment. The medical team worked hard to patch feet as we could. Whenever we could, we made sure the runners saw what we were doing so they learned how to do it themselves. By the end of the race, I saw more that a few runners that were working on their feet and helping others.
Lessons to Learn:
- Make sure your insoles are in good shape. Many runners fail to remove their insoles and inspect they – to see if they need replacing. Most standard insoles are flimsy and should be replaced after several hundred miles. For a $25-$30 investment of new insoles, you’ll gain support and comfort. Investing in a marathon, ultramarathon, multi-day race, can be costly. Yes, there’s the money side, but there’s also the gear required, time spent in training, and travel. This is not the time to skimp on footwear. Chose good, high-quality shoes – preferably a design you have worn before and know works on your feet. And whatever you do, don’t wear old shoes that have seen better days.
- Invest in good, high-quality socks – new socks – not some dug out of your socks drawer that are threadbare. Find the right socks for your feet. Try Injinji socks if you have toe blister problems. Try a thin liner with a bit heavier outer sock. Try several types of socks to find the right amount of cushion and support.
- Learn how to care for your toenails. That means how to trim them and file them smooth so they don’t catch on socks or hit on the top or front of the shoe’s toe box.
- Runners can help themselves by learning how to manage their feet and treat any blisters that might develop. While some events have medical personnel and staff experienced in foot care, many don’t. Or they don’t have the best choices in supplies. Better to be prepared and know what your feet need – and how to manage your own feet. Then if there are people providing foot care, you can use them, and tell them if you need or want certain things done.
In the same way you train for an event, and invest in clothes and packs, and food, you must invest in your feet.
I have a large file of feet pictures on my computer. Pictures of toes, heels, balls of the feet, and arches. Pictures of blisters of all shapes and sizes. In addition, I see all kinds of feet when I work events. Over the years, I have worked races ranging from short distances to ultramarathons, to multi-day stage races.
I am probably one of a limited number of people in the world who gets excited at photos of bad feet. I like them because they tell stories.
The first full multi-day event I worked was Racing the Planet’s Atacama Desert six-day stage in the high desert of Chile in 2004. The stressors of being on your feet for long distances day-after-day for six to seven days often bring out the worst in feet.
A lady in that race wanted us to remove her toenails at the end of day two. Another runner had the worst case of trench foot I have ever seen. That was nine years ago and my techniques have changed for the better, but the feet remain the same – bad!
I believe that feet tell a story.
The photo here is from the Racing the Planet Iceland. I don’t know the owner of the feet. I don’t know the level of training and experience the person had prior to this race. I also don’t know what experience this person had with foot care planning before a race and during the race.
Here are my observations about the story behind these feet.
- Almost every toe has something going on.
- The photo was posted online for stage five, meaning the runner had to tolerate these toes for four plus days.
- These blisters don’t typically happen in one day. My guess is they started on day one, progressed to blisters on day two and then got worse.
- My bet is the shoes’ toebox was too short in length and/or too low in height.
- The runner may have worn two pairs of socks, which could have made the fit too tight.
- The toenails don’t look too long but it’s hard to see if they have any rough edges or are thick, both of which can lead to toe blisters.
- These toes scream pain – especially if they are encased inside shoes.
- It’s possible the toes received some degree of care, but it is hard to tell from their condition.
- Four of the toes have major trauma.
- We cannot see what is going on under the toes, but from the outside edges of the big toes, you can see blistered skin of the left one and maceration on the right one.
- The left big toe has blood showing in the blister on the outside edge.
That’s a lot of information pulled from a photo. I wish I knew the toes’ owner. It would be nice to learn more about his/her race. What shoes and socks they wore. How the trauma to the toes progressed day-to-day. What care they received. Whether they finished the race.
My guess is that with proper care, much of this could have been prevented. That care could have included lubricants, moisture control skin protect, tape, modified shoes, and nail care.
What story do your feet tell?
Here’s the link to the Racing the Planet’s Iceland race. Racing the Planet does four desert races every year called The 4 Deserts: the Gobi in China, the Atacama in Chile, the Sahara in Egypt, and Antarctic. Every year they add a new location for that year. Past sites have included Australia, Nepal, Namibia, Vietnam, and 2014 will be in Madagascar. You can check them out at Racing the Planet.
Filed under: blister care, Foot Care, Footwear, Health, Sports, toenails
Which is more important, blister prevention or blister treatment?
For more than 17 years, I’ve taught foot care techniques to anyone who will listen. I have taught classes at running stores, REI stores, events, and more. In addition, I have worked medical at many races, helping provide foot care to participants. These races have been in Death Valley, Chile, Costa Rica, BC Canada, Colorado and Washington, and many in California. This year I will be at Western States 100, Badwater, the Gold Rush Adventure Race, the Jungle Marathon in the Amazon, and hopefully at races in Colorado and Namibia.
I have never counted the feet I have worked on but I would put the number well over 3000. I remember one race in Colorado in 2010 when I saw the same lady 10 times. It was a six-day stage race and she’d come in every evening and morning! I’d patch her feet in the evening and she’d take it off when she went to bed in her tent. She had foot wear issues that gave her blisters on top of blisters. She was never into prevention mode – only treatments.
In this picture, taken from the cover of the 5th edition of Fixing Your Feet, we see treatment taking place. I love the picture. I even know whose foot it is. What I can’t tell you is what he did for prevention. I wish I knew.
My question in this blog post is what should we spend more time on, blister prevention or blister treatment?
Prevention can take many forms: good choices in footwear, the right socks, lubricants and powders, toenail care, skin care, taping, Engo patches, correct lacing, the right insoles, and training and conditioning.
Treatments likewise offers many options: blister draining, many different types of patches, taping, ointments and salves, a multitude of tapes, wraps and straps, silicone pads, Engo patches, toe caps, and lubricants and powders.
So here are a few questions:
- Does prevention last only until the race starts?
- What are your best prevention options?
- How much do you count on aid station personnel to manage treatments?
- Do you know how to treat your feet?
- Do you carry materials to treat your feet?
- What are your best treatment options?
- How well do you understand blister formation and prevention?
For 17 years, athletes have had Fixing Your Feet as a resource to learn important information about foot care. As I patch feet at races, I try to educate the athletes about what I am doing and why, and what could have helped in their feet. If crews come to me for advice, I try to help them too. I have watched athletes and crews work on feet with materials and using techniques I have long preached.
In general, foot care has advanced over the years. Shoes, socks and insoles have become light years better. Lubricants, powders, blister patches, and our tools are better. People interested in foot care are trying new blister patching techniques.
All this is good because every day there are new athletes coming into running, adventure racing, hiking and thru-hiking, walking, and other feet stressing sports. Let’s make sure they understand the importance of prevention before treatment.