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.
I’ve been on vacation much of the past two weeks and given my time away, have turned to a good friend, Alene Nitzky, an experienced and well qualified ultra runner who wrote an article published at the Coloradoan website. You have heard me go on and on about the importance of god foot care. Here’s another slant, from an ultra runner who has run Badwater and many other ultras.
Runners spend all kinds of money on entry fees, clothing, travel to races, nutritional supplements and race foods. They spend all kinds of time on training, body work, stretching, weight training or cross training.
They worry about their weight, hydration, nutrition, sleep, and preparing for race-day conditions. And most of all, they obsess about finding the right shoe.
But in all this obsession, the two things they forget are the most essential tools they have to carry them from start to finish and go into those expensive running shoes.
Your feet are your base of support. They are the vehicle that carries you forward and through the distance. You can’t run without them. So why do so many runners neglect them?
You can do all the right training and preparation, wear the right shoes and gear, but if your feet fail you, it can ruin months of hard work.
The problem is lack of foot care. Blisters are just a symptom of the problem. Friction and moisture are the two culprits in creating blisters. Improper hydration plays an important role, too.
Blisters are caused by layers of skin and fabric or debris trapped inside the shoe or sock, combined with friction from running motion. Creases in socks, rough edges inside shoes, and dirt contribute to these rough spots. Calluses that are allowed to develop on feet and are not removed can lead to deep, painful blisters. Rough or jagged toenails can catch on socks, causing the fabric to bunch and rub against the toes.
The role of hydration, especially too little sodium relative to fluid intake, also contributes to blistering. Fluid travels out of the blood vessels into the tissues and separates layers of skin, making shoes tight and contributing to more friction. Check your hands while running. If your hands are swollen, your feet are swollen, too. Popular sports drinks often don’t have enough sodium to replace what is lost during long, hot weather events.
Regular pedicures are helpful. If you don’t want nail polish and all the extras, you can do much of it yourself. Softening and removing calluses over time reduces the likelihood of blisters under these trouble spots. Soften rough, dry spots with lotion when you’re not out running. Keep your toenails trimmed and filed. Underneath the ball of the foot, most people don’t realize they have callouses, and these are a common trouble spot.
Moisture is another problem, even in our dry climate. If you are running trails with stream crossings or crossing snow banks at high altitude, you are also at risk for developing blisters. But even without water crossings, your feet sweat, and moisture in socks and shoes can become a problem.
Keeping your feet as dry as possible helps. If you have a dry pair of shoes and socks to change into after the stream crossings are behind you, that will help.
Use a good sock that wicks moisture away. There are many different brands at specialty running stores. Keep your shoes and socks clean. If you’re running a road marathon, don’t race in shoes or socks you wore on trails. The dirt will stay inside and cause friction.
A foot kit should be part of every runner’s supplies. You can learn how to give yourself a pedicure, how to stock a foot kit and tips for avoiding blisters and other foot problems by doing some research.
Band-Aids are fine for knees and hands, or even on feet that aren’t being used, but they are not meant for use on feet while running. They don’t hold up to friction, moisture and shearing. The Band-Aid will soon bunch up and crease, and any dirt in your shoes and socks will stick to them, causing more friction.
Two excellent resources for learning how to take care of your feet are John Vonhof’s book, Fixing Your Feet, 5th Edition, Wilderness Press, 2011, and website fixingyourfeet.com. You can also get a free subscription to his fixing your feet blog with helpful tips.
I encourage you to check out Alene’s websites. She’s a great person with a big heart.
Filed under: blister care, Foot Care, Footcare, Health, Sports
Last weekend I worked the finish line at the Ohlone 50KM Trail Run in San Francisco’s East Bay hills. This is a tough trail, very exposed to the day’s sun, and every step is either up or down. Some people say, and I believe that if you finish Ohlone, you have a great chance of finishing Western States.
One runner who I admire and consider a close friend is Catra Corbet. She has proven herself as the “owner” of this trail. Many years she will run an Ohlone 100 or more just because she loves the trail so much. This year, Catra did 200 miles on the trail!
In talking to Catra after she completed the 200 miles, she mentioned that she had no blisters. I remember years ago taking a picture of her taping her toes. She used to tape every toe. I have a photo of her with a heel blister too. Now though, Catra runs blister free. What’s the difference?
I believe Catra’s success with blister free feet came through the miles of running she puts on her feet. She doesn’t run short runs, she doesn’t run a couple of times a week – she runs a lot. Many of you know Catra, or have heard of her – and know how much she runs. She also has found the right shoes for her feet – Hokas. She also wears Drymax socks – a favorite of mine.
But it’s not just Catra. I have worked medical and provided foot care at hundreds of ultramarathons, adventure races, walks, and multi-day races and have seen the same thing.
At the Western States 100 at 55.7 miles, for example, the top 20 to 30 runners come through Michigan Bluff without needing any type of foot care. There may be one of two that get some type of foot care from their crew down the road, but if so, is generally pretty minor. Most often, if anything, they just change socks or shoes.
As the race progresses and more runners come through, we begin to see runners needing help with foot care. The farther back the runners are, the more foot care they need. Not every runner, but many of them. And many of them have multiple issues. Not just one blister, but quite a few. The more problems that have, the more complex the repair, and the longer it takes to complete the fix. This becomes a huge issue if they are trying to stay ahead of the cutoffs at each aid station. I remember a runner several years ago that we patched up. At the next aid station, she need more care and wanted to get out of the aid station quickly to avoid the cutoff. That meant not doing a quality patch job –and she came back to the aid station after going a bit down the road. She knew her race was over.
So the point here is that you need to put lots of miles on your feet in order to train them for long conditions. You can run 10 miles a day, day after day, and then try and do a 50 miler, and odds are – you will have problems. You have 10-15 mile feet – not 50 mile feet.
This applies to walking, running, adventure racing, hiking, – any activity where you use your feet.
It all boils down to how many miles you are putting on your feet.
We all can’t be the top runners. Many runners don’t have unlimited time to train. So what can the rest of us do? Make sure you get some long runs, especially closer to your race. Make sure you have the best possible fit in your shoes. Make sure you wear quality socks. Reduce your calluses. Learn proper toenail care. Change your socks and shoes as necessary for the conditions of your run or race.
Over the years, I have talked to too many runners who think blisters are naturally a part of running and racing. They don’t have to be. Make smart choices and put miles on your feet, and your feet can be blister free.
The other day I was looking around the website for the Western States 100 and came across the picture below. It’s pretty brutal. The feet have been pounded to death and been wet – probably the majority of the race. I see torn blisters; blisters on the heels, bottom of the heel, ball of the foot, the crease by the toes, side of the big toes and the toes; and macerated skin. I have no idea if the runner finished the race or was helped off the trail, but my guess is that he gutted it out to the finish line. Click on the image for a larger picture.
My point in showing you this photo is to remind you, as strongly as possible, that there is only so much that I or any other medical person can do to repair your feet and get you to the finish line. You are the one person responsible for your feet, not your crew or anyone on the medical staff. Here are 15 questions you have to answer about your feet:
- What are the best shoes?
- Will you have additional shoes in a drop bag – the same kind, what size, and where?
- What are the best socks – one pair, two pair, double layer, Injinji toe socks, and what brand?
- Will you change socks – where and when, the same socks?
- Will you wear gaiters?
- Do you need lubricant – what kind, where on your feet, how much, and when to reapply?
- Have you trimmed your toenail and filed them short and smooth?
- Have you reduced your calluses?
- What is your plan for managing your feet during the race?
- If you get blisters, what will you do?
- How will you manage the inevitable water in your shoes and socks?
- Do you have a foot care kit?
- Do you and/or your crew know how to use the materials in the kit?
- If you go to medical for foot care, can you describe what you want them to do?
- Have you put the training miles on your feet necessary to run 100 miles?
These are not hard questions – but each is important – and together they make up your plan for your feet. The runner whose feet are pictured above made some wrong choices about his feet. As did many other runners. It happens every year and at races across the country. It’s not just a Western States issue.
The best time to ask these questions is in the months before the race. Then develop a plan. Just like you make up drop bags, find a crew, plan your food, a plan for night running – you need a plan for your feet. I emphasize “You.”
I cannot stress this enough. The medical staff at races cannot fix every big and little problem each runner has. At most races there are too many runners per medical or podiatrity people. And not enough supplies. And not enough time to get everyone patched up to continue on and make the cutoffs. Yes, we are there to help you and we do the best we can.
At Western States there are eight aid stations with medical staff. Each station usually has someone who is in charge of feet. These people have varying degrees of skill and supplies. Did the person above seek help at any of the eight aid stations? I wish I knew. If he did, what did they do?
Of course, looking at the feet above, you might be asking, “What could have prevented this?” or “How do we fix this?” Those are questions for a different post on a different day.
I’ll give you a hint though; the first question is answered in the pages of Fixing Your Feet. And if you have an old edition, you are shorting yourself because these are new information, new techniques, and new products in every edition.
The second question is harder. I have some ideas that other might not think of. This runner will struggle for many days as his feet heal. I pray that he’ll wonder what he did wrong and what he could have done better – and then seek out answers so his next race has a different outcome.
Note: I wish I could credit the photo to a photographer. If I find out, I’ll add a comment to this post.
Filed under: blister care, Books, Foot Care, Foot Care Products, Footwear, Health, Sports
A few weeks ago I was interviewed by Scott Warr and Don Freeman from Trail Runner Nation. I was honored they asked me and we had fun doing the interview. The subject? What else but feet!
You can listen to the interview on their website, download the MP3 file, or better yet, subscribe to their podcast series through iTunes. Here’s the link to their webpage: FEET – Injury Prevention and Treatment with John Vonhof.
Here’s what they wrote on their website:
One of your most important tools as a runner is your feet. You need to take care of them or your training/race may be foiled. John Vonhof literally wrote the book on how to take care of your feet: Fixing Your Feet. This book is now in the FIFTH edition! John joins The Nation to discuss the basic principles of foot care:
- How you can have healthy & happy feet
- Blister prevention and treatment
- What to keep in a foot care kit
- Taping your feet
The interview is 62 minutes in length, but my interview starts about five minutes in. Enjoy the interview and then subscribe to Trail Runner Nation’s podcast.
Thanks Scott and Don for giving me the opportunity to share a bit of my passion for feet on your podcast.
How specialized can shoes become? Last year I watched many runners at the Jungle Marathon Amazon struggle with waterlogged shoes. The race went through rivers and swamps, dirt roads, sand on beaches and in the jungle, and through all kinds of rocks, roots, and other jungle junk. I remember one racer whose waterlogged Hoka’s seemed to each weigh three pounds after a day going through water, sand, and jungle. I saw shoes after shoes that were filled with sand and dirt, and were also waterlogged. This makes one’s race harder as you have to lift that weight with every step.
I have run races where my shoes were wet from stream or river crossings, or rain, or from puddles. Now Reebok has introduced their All-Terrain Series shoe as a solution to the problem with water. The shoes were designed to help runners in the Spartan Race Series of obstacle courses.
The Rebook All-Terrain Series Shoe
The Reebok All-Terrain Series shoe is a new shoe made for the popular obstacle races popping up worldwide – but I think they’ll be valuable in any race or event where water is a problem and traction is important. It’s named after the ever-popular Spartan Race Series and was designed and engineered in cooperation with the Reebok Spartan Race community. An important feature is the mesh H2O Drain ports that drain water quickly through the upper and midsole. The Super model has four drain holes on each side. The Sprint model has small drain holes all over the mesh upper.
The shoe has an outsole with square indented lugs and mid-foot teeth offering superior traction to shed mud. There are even lugs on the front toe of the shoe. The shoe is lightweight and breathable, with a rubberized tongue that will not absorb water and has holes to help expel water. Under the foot is a RockGuard plate to provide protection from rocks and other hard or sharp objects. The upper is made of DuraGrip for durability and ION Mask-fabric to repel mud and water. The shoe’s colors are vivid and bright.
There are two models, an All-Terrain Super and an All-Terrain Sprint. The Super is made for longer distance races and is engineered with more cushioning and stability. The Sprint is made for shorter distance races with a light-weight midsole and a low drop.
This is a serious shoe for obstacle course racers or events were water is a problem. It’s a shoe that can handle any abuse a Spartan Race can give it so you are unstoppable on any course – provided your legs and body don’t quit. I read reviews of Spartan racers who had tested the shoe and all swore by the H2O Drain ports. Having spent a week last October in the Amazon, I saw what wet shoes do to a runner’s feet. I think these would be great in the Amazon or any event with lots of water.
The Reebok All-Terrain Super retails for $119.98 while the Sprint is $109.98. Reebok says they should be in stores the end of April. They are also available through the Reebok website. I’m told they run a bit small so it is recommended to go up a half size. Reebok also offers the option to design your own shoe with a variety of colors for the upper, midsole, laces, tongue, and more. Here’s the link to check out the Reebok All-Terrain Series shoes.
Of course, remember to try any shoe for a while before committing to wear it in a race or long distance run/hike. Make sure the fit works on your feet. Make sure any shoes you buy for a specific event will hold up through whatever it throws at your feet.
The Spartan Race Series
The Spartan Race Series is an international obstacle racing series with three levels of courses: a 3-mile Sprint, an 8-mile Super and a 10-12 mile Beast. You will run, jump and crawl your way over a dozen or more obstacles. Courses are uniquely designed to test your mental and emotional fitness and push you past your limits. Race as an individual, as a part of a team or both!
Choose your Spartan Race here. There are races in many states, as well as Canada, England, France, and 11 other countries. Spartan has offered a discount to my readers interested in trying a Spartan Race. You can get 15% off any Spartan Race in the continental U.S.
If the idea of an obstacle race interests you, Spartan offers a free eBook, You’ll Know at the Finish Line: The Spartan Guide to the Sport of Obstacle Racing.
A FREE SPARTAN RACE ENTRY: If you are interested in a free entry into a 2014 Spartan Race in the continental U.S., write a comment to this blog post and tell me your thoughts on the All-Terrain shoe and why you deserve a free entry. The deadline is midnight Saturday, April 26, 2014. I will pick randomly pick one response on Sunday, April 27 and send that person the code for a free race.
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, Footwear, Footwear Products
Occasionally I see runner’s shoes that have wear holes in the material in the heel counter. This picture from Dan shows his shoes with holes to the outside of center on both heels. I emailed the following suggestion.
I’d try an ENGO Back of Heel Patch. They are made to shape to the curve of the back of the heel counter. Put them in when the shoe is dry. Rub them a bit in a curving motion to help them form to the shape of the shoe. Then peel off the paper backing and apply from the center outwards to the sides. Rub well so they adhere to the shoe’s material. You could also try the large ovals if the hole is small. The blue ENGO patches are very slick and can take a lot of wear. Once the blue wears down to expose white, replace the patch. Sometimes the holes are on the sides of the heel.
Last summer at Western States, I had a runner whose shoe was rubbing her heel raw. You can see from the image that she has a prominent heel bump. This, of course, contributed to her problem. This is the kind of problem one needs to plan for before it becomes a major issue – especially at the event the magnitude of Western States.
We decided to cut a notch out of the outside of her shoe’s heel. This allowed the back of the shoe to spread apart for her large heel bump. Then I applied an ENGO Back of the Heel Patch to the inside of the shoe’s heel counter. This provided some protection to her heel bump.
The large ENGO ovals can also be used when there is a small area to be covered.
I have been a fan of ENGO Blister Prevention Patches since I first discovered them years ago. The ovals are perfect for the common areas at the side of the heel where blisters form at the junction of insole and heel counter. The large rectangles are great to put on insoles underneath the ball of the foot, another common problem area.
Check out the ENGO website for more information. ENGO products are available through Zombierunner. If you are in Australia or New Zealand, ENGO products are available through Rebecca Rushton’s Blister Prevention website.
Disclosure: Tamarack Habilitation Technologies supplies me with ENGO Patches as I need them for races.