Athletes who are out in cold and wet conditions need to be watchful for frostbite.
Frostbite occurs when tissue actually freezes. Toes are particularly susceptible to this serious condition. Factors that contribute to frostbite include exposure to wind, wet skin (even from sweat), and tight socks and shoes that constrict blood flow.
Early signs of frostbite include numbness, a waxy or pale discoloration of the skin, the tissue becoming firm to the touch, and pain in the area. As the frostbite progresses, the skin gets paler and the pain ceases. Often frostbite will thaw on its own as the person keeps moving or gets into a warm environment and out of the wind, wet, and cold. As the tissue warms, there can be redness, itching, and swelling.
In severe cases of frostbite, the skin becomes immobile as it freezes with underlying tissue. Blisters can form with clear or milky fluid. Blisters filled with blood indicate deeper damage. While the skin may change color, or even darken, do not assume you will lose the toes. It may take weeks or months to know if amputation is necessary. Check with your physician as soon as possible to determine what care is necessary.
Be aware of moisture inside your shoes and socks in extreme cold conditions. Sweat and outside moisture can change to ice inside your socks, leading to frostbite.
Tips for Managing Frostbite
- Do not rub your toes to warm them—that causes even more tissue damage.
- Do not rub the frostbitten area.
- Unless absolutely necessary, don’t walk on frostbitten feet or toes.
- Get into a warm environment as soon as possible.
- Immerse the affected area in lukewarm—not hot—water, or warm the affected area with the body heat from another person.
- Do not use a heating pad, heat lamp, or the heat of a stove, fireplace, or radiator for warming.
- Do not rewarm or thaw frostbite unless you are sure you can keep the area warm. It is important to remember that thawing the tissue and then allowing it to refreeze can be devastating. Get professional medical help if possible.
- Dehydration will make you more susceptible to frostbite.
This past weekend I had the
opportunity to help at the Gold Rush Adventure Race in Northern California. While
the weather was great to start, over the day and evening, and into the night,
rain and cold came in. Everyone was wet and certainly the racers were cold in
addition to being fully soaked.
is easy to think when we are cold to simply add layers, or thicker materials.
In many cases, this works. But we have to be careful when this thought is
applied to our feet.
need to understand that when we have our feet in socks and then inside shoes,
there has to be some space. Call it air space, extra space, wiggle room,
whatever you want – it’s necessary for good circulation.
another layer of sock, or going to a thicker sock, may make the fit of the foot
in the shoe too tight. Socks that are too tight in your shoes can cause vascular
constriction. The circulation of your blood is compromised. This can lead to
even colder feet, and in extreme conditions or for extended periods of time,
can cause cellular damage.
yourself a favor. As winter's cold draws closer, be careful not to compromise
the circulation of your feet with the wrong socks. Your feet will thank you.
As your skin becomes wet it softens and is more susceptible to blisters. If a blister forms, it is more likely to rupture. The skin then separates further. Maceration happens when skin becomes soft and wet for long periods of time. This is what has happened when you take off your socks and find your feet look like prunes. The skin is tender, and can fold over on itself, separating, and creating problems. As layers of skin separate, blisters spread and the skin can split open and bleed, and the skin becomes whitish in color It is very hard to patch feet when this happened. Feet become so tender that every step is painful.
Consider the following pointers when planning any event where moisture and cold can be an issue.
• Wear socks that are have moisture-wicking capabilities. Socks made of 100% cotton should be avoided. Choose synthetic fabrics like Coolmax or Olefin or a blend of materials. Smartwool socks, make from wool, are good in wet conditions. Whatever socks you wear, change them frequently and dry the old socks.
• Foot powders that absorb moisture can help keep your feet dry. Put small containers of powder into your drop bags and in your pack. Reapply powder when you change your socks. Zeasorb or Odor-Eaters both make a good moisture-absorbing powder that does not cake up into clumps. Wipe off the old powder and grit before applying new.
• Wearing shoes that do not have adequate draining capabilities will subject your feet to extended periods of moisture. Use a heated nail to make a few small holes where your upper attaches to the lower part of your shoe or boot. Make one on each side of the heel and one on each side of the forefoot.
• Consider wearing waterproof socks. SealSkinz Waterproof MVT socks from Dupont are made without irritating seams and have a vapor-permeable membrane sandwiched between an outer layer of nylon and an inner layer of Coolmax. Their weak point is their Lycra cuff that can let in water. Another option is the Seirus Neo-Sock or Stormsock made from four-way stretch neoprene with breathable macro-porous technology to prevent moisture buildup while sealing in body heat.
• When resting or sleeping, take off your wet shoes and socks to allow your feet to breathe.
Many times in the winter we go outside for a walk or run and end up with cold feet. Is it our shoes, socks, or something else? Let’s look at several causes and solutions.
Our shoes can easily be the culprit, or at least a contributing factor. If the shoes are made with mesh in the uppers, the top of the shoe surrounding the foot, cold air can easily go right through to your feet. Consider wearing other shoes in the winter or even choosing a pair with a Gore-Tex liner.
Socks are a huge factor in keeping your feet warm. Simply changing to a thicker sock will not necessarily make your feet warmer. The types of yarns are important. Wool is a good insulator. Many socks are made with a combination of components: wool, Lycra, spandex, Coolmax, to name a few. Be sure you don’t increase the thickness of your socks too much and make your feet too tight in your shoes, which inhibits circulation. This in turn makes your feet colder.
Remember what you may have learned as a child. When your head is cold, the rest of you will also be cold. So… warm your head with a hat or cap, knit cap, or some form of headgear. Keeping your head warm will help warm your feet.