Runners Should Pay Attention to Foot Care

June 16, 2014 by · 2 Comments
Filed under: blister care, Foot Care, Footcare, Health, Sports 

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.

Alene Nitzky

Alene Nitzky

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.

Their feet.

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.

Alene Nitzky, Ph.D.,RN is a health coach and cancer exercise trainer. Her website is Sunspirit Wellness Services.  She has been running ultramarathons since 1991. Her blog is Journey to Badwater

I encourage you to check out Alene’s websites. She’s a great person with a big heart.

Learning Foot Care from the Heat

July 31, 2011 by · Leave a Comment
Filed under: blister care, Foot Care, Health 
Alene at Badwater 2011

Alene at Badwater 2011

This guest post comes courtesy of Alene Nitzky, Ph.D., RN

I ran Badwater as a rookie in 2008 with two years of crewing and pacing experience and several training runs across the valley. I’d never had foot or stomach problems before, but in the race, I suffered from an array of the usual problems runners have there: blisters, swollen ankles, not peeing enough, vomiting, nothing tasting good, and not getting enough calories.

While working on the medical team at Badwater in 2009 and 2010 and watching runners in some of the hot weather races I’ve run, I noticed the difference between runners who took cool down breaks and those who didn’t. Some dunked themselves in a cooler of ice water; others stopped and sat down in the shade of the van or sat in the air conditioning of the vehicle, while others seemed to reject the idea of stopping at any cost, as if it were a 5K road race.

What I also noticed were the number of runners who came to us in Stovepipe Wells, in various stages of dehydration and heat exhaustion, and the amazing turnaround they’d experience by spending an hour inside the air-conditioned medical room. They’d come in unable to urinate, nauseated or vomiting, unable to keep down any food or fluids. They’d lie there on a cot while their crews watched them anxiously.

We didn’t have to do too much for most of them. They’d cool off, sip fluids, and soon they’d be jumping up to urinate, the nausea was gone, they kept food and fluids down, and were on their way with their relieved crewmembers. Most of the time we wouldn’t see them again until they were at the post-race party being recognized for their finish.

What was happening?

Most of your blood flow goes to your skin and major muscles while you’re running in the heat. That means little blood is available to the GI tract, kidneys, and other organs. Low blood flow can rob these organs of oxygen and nutrient-carrying blood and make it hard to digest food and process fluids. This can lead to the puffy hands, bloating, sloshy stomach, nausea, and vomiting, and blistering, especially if you’re not getting enough sodium.

By taking a break, you allow some of the blood to be returned to the organs that allow your normal functions to resume. The blood flow that was going to your skin to keep you cool can go to the kidneys and GI tract again, so you process the fluids and start urinating again.

Here’s how I avoided a downward spiral?

Hydration and electrolyte replacement

Managing hydration and swelling

Managing hydration and swelling

I experimented with different products for electrolyte replacement. The one I used in 2008 didn’t have enough sodium for the extreme heat of Badwater. In 2011 I used S caps. I had tried them in the heat and humidity of Florida and South Dakota and they worked. I watched my hands for swelling routinely, made it a habit to look at my hands every time I got a new water bottle. If I was puffy, I had to think about what was happening. Usually it happened in the evening as the temperatures cooled down, when I needed less sodium. Then I’d back off. I also noticed that when my hands were puffy, my feet hurt more because they were swelling too.

Cool down breaks

I thought, it makes a lot more sense to take cool downs BEFORE you get overheated. I began trying this in my training. I’d sit for 10 minutes, put my feet up, put a little ice on my neck and legs, and soon, food started to taste better. When I got up to run again, I felt fresh.

I planned 10 minute cool down breaks every 60 to 90 minutes in the stretch between Furnace Creek and Stovepipe Wells. This year it was a lot cooler than previous years, and I often felt like I didn’t need it, so I’d go 90 minutes, but then I made myself stick to my plan. I used these breaks to my advantage to elevate my feet, check my tape, shoes and socks for moisture, get some calories in, and drink more. I had ice wrapped around me in a towel, on my neck, armpits, and thighs.

When I’d get up I usually needed to urinate. Then I’d get moving and I felt fantastic. I ran a lot more of this stretch than I anticipated, and even got into Stovepipe well ahead of my predicted time. The time I spent cooling down paid off.

Learned to work on my own feet

In 2009 and 2010 I watched Denise and John working on runners’ feet as they came in. Ugly, painful blisters, big chunks of skin peeling off their toes and heels. So many of the runners’ feet looked wet, like they’d been taking a bath.

I got a copy of John’s Fixing Your Feet book as soon as the 5th edition came out. I began doing my own weekly pedicure sessions, soaking my feet, working on reducing the calluses. I practiced the taping techniques John shows and found one that works for me. I built a well-stocked foot and first aid kit so I’d have everything I needed. And I kept my feet dry on the run.

Despite over a dozen “foot checks”, cool down breaks, and a few naps, I still managed to better my time from 2008 by over an hour and a half. I was extra cautious with my feet this time because I knew that in order to turn around and run back to Badwater, I was going to have to have my feet intact. On the way back, I followed the same strategy.

When I arrived at Badwater, after 270 miles, the only blister I had left was the one I had at 80 miles. Other than the general soreness that comes from 5 days of running on asphalt, the blister wasn’t really an issue. I used only two pairs of shoes, one for the race and one for the return trip. I never had to go to a larger size because my feet stayed dry and my feet didn’t swell much.

I thoroughly enjoyed my double and ran comfortably the whole way. When you take care of the basics like feet and hydration, everything else tends to fall into place.

Alene Nitzky, Ph.D., RN lives in Fort Collins, Colorado. She has been running ultramarathons since 1991. Check out her blog Journey to Badwater.

Alene Nitzky’s Foot Care Lessons From Badwater

July 24, 2011 by · Leave a Comment
Filed under: blister care, Foot Care 

Alene Nitzky is a veteran ultrarunner from Colorado who two weeks ago completed Badwater, and then turned around and made it a “Badwater Double” – going back on the course to the start. She had successfully run Badwater before and spent several years working on the medical team. Her Double this year was a success in many ways. Her stomach held up well and her feet cooperated. Here is a report from Alene’s blog about what worked for her feet.

You have to remember that whatever is going on in your hands is also going on in your feet. Avoiding the swelling that comes with fluid/electrolyte imbalance means your feet are not going to swell causing friction against your shoes, the layers of skin and tissue in your feet are not going to swell and separate, which means you avoid blistering.

My biggest problem in 08 was the blister under my left foot. I had a blister in the same spot but over the past year I read John Vonhof’s book Fixing Your Feet and learned how to tape properly, and how to reduce the callus in my problem areas. In 08 the blister was so deep John was unable to drain it with a scalpel, he taped it the best he could to prevent further blistering, and the blister finally popped from repetitive trauma on it’s own at mile 127, which hurt like hell.

Alene's boot w blister at the base of the big toe

Alene's boot w blister at the base of the big toe

This year, it was easy to access the blister pocket and drain it, which was much less painful and much easier to manage. Other than that blister, I developed only a few small, minor blisters, which I was able to easily drain as soon as they developed, and they never became a repetitive problem. At the end of 270 miles, I only had one blister left, the big one under my foot, which didn’t get any worse after 80 miles.

Keeping your feet dry is another requirement. Checking your feet for moisture is critical. I use Drymax socks exclusively and they do very well, but no sock is blister-proof. There are seams, movement in the shoe, and moisture builds up eventually no matter what sock you wear.

My tape job on Alene's blister

My tape job on Alene's blister

Changing your socks frequently is important, and you have to be very careful not to disturb your tape job. Don’t let your crew mess with the lacing on your shoes or pull your socks and shoes off unless they know exactly how to do it right. The runner is better off doing this is they can.

Speaking of shoes, I run in Brooks Addictions and I used only two pairs of shoes, one during the race and the other on the return. I never needed to change shoes or go to a bigger size because my feet never got very swollen and they stayed dry.

We can learn from Alene did. She gets five starts for a well planned and executed race. She ran a good race and with her insights from running it in 08, and years of working on the medical team, she put what she learned into effect. Her Lessons Learned blog post contains great information on hydration, food choices, stomach, and more. I encourage you to check it out. Congratulations Alene on a successful Double.

If you don’t have a copy of Fixing Your Feet, check it out at ZombieRunner.

Disclosure: I have an affiliate relationship with Zombierunner.com and earn a few pennies when you buy though this link.

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