Merry Christmas from Fixing Your Feet

December 24, 2015 by · 1 Comment
Filed under: Health 

John VonhofFeet are a big part of my life. For the past 19 years, Fixing Your Feet has introduced me to great people. I have enjoyed helping runners at events like Western States; Badwater in Death Valley; Primal Quest in Colorado, California and Washington; Raid the North Extreme in BC Canada; the TransRockies in Colorado; Racing the Planet Atacama in Chile; the Coastal Challenge in Costa Rica; the Avon Walk; the Susan G. Komen 3-Day Breast Cancer Walk; The Amazon Jungle Marathon, and others. In all these events, I’ve worked on thousands of feet. In addition, I’ve responded to an uncounted number of emails from folks asking for foot care advice.

The best part has been the people I have met. Runners, hikers, adventure racers, walkers, and their crews. Athletes walking a fine line between making a cutoff in a race, front runners, back of the pack runners, short and long distance hikers, solo and in groups – all ages. Athletes with a simple blister and others with blisters all over. Athletes in pain, and those wanting to quit.

I can recall many of these people. I remember their stories. Some of you are in my stories. I have learned a lot from each person whose feet I have patched. I don’t pretend to know everything about feet. Together we have learned a lot. I thank each of you for what you have contributed to the Fixing Your Feet story.

I wish all my readers a fun, bright, delicious, warm and cozy, and loving Merry Christmas. I hope you can spend time with family and friends – and maybe give your feet some nice soft socks.

The ICESPIKE Traction System

December 19, 2015 by · Leave a Comment
Filed under: Footwear, Footwear Products, Sports 

ICESPIKES have been around for a while and have proven themselves to be a reliable tool for those wanting to run, walk, and hike in winter conditions.

It doesn’t take much in bad conditions to take a nasty fall. Landing on hard ice, a rocky trail, or rocks hidden under snow can ruin your day. Protecting your tailbone, hands and wrists, knees, hips, and ankles, and your back is key to staying active. This is where ICESPIKES come in.

Icespike Traction System

Icespike Traction System

ICESPIKES are a traction system of 32 spikes that are applied directly into the sole of your shoes or boots. Their cold-rolled, tool quality steel will maintain hardness and grip 10 times longer than other systems. The spikes are self-cleaning, while their patented design provided great penetration and stability. They should last up to 500 miles.

ICESPIKES allow you to run, walk, and hike through the winter with the anti-slip spikes

ICESPIKES can also be used in water, mud and muck conditions, on slick rocks and gravel, uneven and root-bound terrain; and in mossy and slick leaf conditions.

For a limited time, use the coupon code “stockingstuffer” for 20% off your purchase.

ICESPIKES are packaged in a kit of 32 spikes and an installation tool and in packages of 32 spikes.

ENGO Blister Prevention Patches

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

ENGO in Footwear

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.

ENGO Applied

ENGO Applied

ENGO Applied

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 Patch in Shoe

ENGO Patch in Shoe

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.

ENGO in a Shoe's Heel

ENGO in a Shoe’s Heel

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.

Kinesiology Tape Sale

November 23, 2015 by · Leave a Comment
Filed under: blister care, Foot Care, Foot Care Products 

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.

TheraTape Black Friday & Cyber Monday Sale

TheraTape Black Friday & Cyber Monday Sale

New Blister Prevention Book

November 2, 2015 by · Leave a Comment
Filed under: blister care, Books, Foot Care, Foot Care Products 
Rebecca Rushton, a podiatrist in Australia

Rebecca Rushton, a podiatrist in Australia

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.

Rebecca's Blister Prevention book

Rebecca’s Blister Prevention book

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.

Really Sore Feet and Fleecy Web

October 31, 2015 by · Leave a Comment
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.

Hapla Fleecy Web

Hapla Fleecy Web on very sore feet

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.

Fleecy Web on the foot

Fleecy Web showing application on the side of the foot

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.

Foot Care – Help Yourself and Study Up

October 16, 2015 by · Leave a Comment
Filed under: blister care, Foot Care, Footcare, Health 

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!

When Your Shoes Fail You 

October 3, 2015 by · 1 Comment
Filed under: Footwear, Sports 

It’s not common but it can happen. At the worst opportune moment, your shoes fail you. Maybe it’s on a training run, or worse yet, it’s during a race or somewhere where you are miles from getting help or another pair of shoes.

I’ve seen it more than a few times.

Shoes that fell apart where the upper joins the midsole. Shoes where the upper material was so flimsy it came apart running in an adventure race. Shoes that partially melted when left too close to a fire in the desert in Chile (that was user error though!). Shoes with seams that did not hold, leaving gapping holes in the uppers. Shoes where the outersoles came apart. Shoes whose shoelaces won’t stay tied. Shoes that simple fell apart.

Then the other day a story on Facebook caught my attention. One of Nike’s elite runners was running the Berlin Marathon this past Sunday and had a major shoe failure.

Keya’s Eliud Kipchoge won the marathon, but the insoles of both shoes came up and out the back heel counter of the shoe. He had run in the shoes previously in Kenya without incident. Here’s a link to the story on The Wall Street Journal’s website.

Insole failure

Insole failure

In the marathon, the shoes failed around the first kilometer! It’s hard to be certain, but he missed the world record by just 63 seconds. Setting a new world record was his goal for the race. Nike said he was testing a new prototype.

I feel for Mr. Kipchoge.

Sometimes stuff just happens. Sometimes though it happens because of user error, as in one of my examples above.

Your job is to make sure that whenever you lace up your shoes, they are in good working condition. How often do you take a few minutes and check your shoes? Take out the insoles and clean out the shoes and wipe off the insoles. Check the insoles to make sure that aren’t flatter than a pancake or even worn through. Make sure the back edge of the insole around the heel hasn’t folded over or formed a hard, thick edge. Check your laces for worn spots that could break, Check the shoes top to bottom for seams coming apart or weak areas. Check the midsole to make sure it still has life left in it. Make sure the inside fabric of the heel counter doesn’t have holes in it.  Make sure the outersole hasn’t loosened at the edges and that it isn’t work through.

That’s your job. It really pretty simple. But you’d be surprised how many times I’ve seen runners in a race that they’ve paid a lot of money to enter, and trained hard for, only to wear shoes that should have been replaced.

Don’t let your shoes fail you, -and make sure you don’t fail your shoes.

8 Top Tips for Foot Care

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:

  1. Trim nails
  2. Get in shape
  3. Fix calluses
  4. Prep your shoes
  5. Pack camp sandals
  6. Two ways to treat blood under a nail
  7. Wash your socks
  8. Lance right
8 Top Tips for Foot Care

8 Top Tips for Foot Care

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.

Feet at Primal Quest

September 6, 2015 by · 2 Comments
Filed under: blister care, Foot Care, Sports 

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.

Checking Katie's feet

Checking Katie’s feet

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.

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