Filed under: blister care, Foot Care, Foot Care Products, Footcare
Over my years of taping feet, I have seen techniques improve to where pre-taping is more helpful then ever before.
Often times, in the middle of a race, one cannot take the time necessary to do a high-quality tape job. Things may be rushed. The runner may be in a huge hurry to make a cut-off. The feet and skin may be wet. Conditions may be less than ideal – lightening, set-up, workable access/angle to the feet, supplies, etc.
However, before a race, a hike, or run, there is more time to do a high quality pre-tape job. It’s also the time to practice your skills and learn how to do a really good tape job. The first photo here shows a pretty poor tape job on toes. In this photo, the tape will probably peel off from sock changes and general wear. If any one of the pieces comes off, the now untapped toe will be subject to the roughness of the tape on the neighboring toe. It looks like Leukotape, which sticks well, but does not conform to the curves of toes and other places on the foot. It is possible to do a great tape job on toes with Leukotape – but it take time and practice. I must admit I like Leukotape for certain conditions and tape jobs.
A good, high-quality pre-tape job should hold up well, for several days if necessary, and cared for. In this next photo, you can see the right foot of Bogie Dumitrescu after finishing a solo, self-supported crossing of Death Valley followed by up and down to Mt Whitney. You can see how the tape has held for 157 miles in the extremes of Death Valley. It’s hot on the valley floor, but there are two long uphill’s climbs followed by long downhill’s over two passes. An 11-mile trail hike follows that up to and another 11 back down Whitney. The tape job held for 157 miles! In fact it looks perfect.
The tape is Kenesio-Tex on the heels, balls of the feet and big toes. Hypafix tape is used in a figure eight cut to anchor the tape at the forward edge of the ball of the foot, between the toes, and anchored again on top of the foot. This prevents the forward edge of the tape from rolling.
The next photo shows Bogie’s two feet after the tape was removed. No blisters. One of the reasons the tape held is that Bogie managed his feet well. He kept them as dry as possible. This is important in Death Valley where often Badwater runners get their feet wet when they are sprayed or doused with water in an effort to cool them.
Bogie was fortunate to have his feet taped by Denise Jones, the Badwater Blister Queen. Denise is a master at taping feet and does a precision tape job. This is not a 30-minute tape job. It takes as long as it takes to do it right. Denise and I tape almost identically. If we apply a piece of tape and it looks or feels wrong, we remove it and retape. Our aim is to get the runners on the course and able to finish with good feet.
The point of this blog post is to show a good tape job that can hold up over multiple days. The final photo shows Danny Westergaard’s feet that Denise taped for Badwater three weeks ago. Danny’s feet are taped perfectly. You can see the small strip of Hypafix that Denise wrapped around Danny’s big toes to further secure the tape edges.
I commend Bogie and Danny for their runs. Bogie completed his solo self-supported Badwater crossing the week before the official Badwater ultramarathon. Danny completed his 7th Badwater, went to the summit of Whitney and then reversed direction and went back to the start for his 7th Badwater Double.
And I commend Denise Jones for her care of runner’s feet. She’s a class act. Thanks Denise.
Kinesio, Leukotape and Hypafix tapes, as well as Compound Tincture of Benzoin and other foot care supplies are available at Zombierunner.com.
Disclosure: When you purchase through this link, I make an affiliate small amount of each sale.
Several years ago I met Gregg at Badwater in Death Valley. We were in line to check in at Furnace Creek and I heard the last name. It was the same as an aunt of mine. Turns out we are related.
At Badwater he ran well and finished near the top. Later that year, he and his wife moved to Asia and I had not heard from him – until the other day. He sent an email about running the Spartathlon in Greece. It’s a 246-kilometer (153 mile) race between Athens and Sparta. The Spartathlon aims to trace the footsteps of Pheidippides, an Athenian messenger sent to Sparta in 490 BC to seek help against the Persians in the Battle of Marathon. Here’s his email:
I just finished running Spartathlon. It was nearly as hot as Badwater (100.4), ok maybe not as hot as Badwater, but it was far to hot for this race, considering it is normally 86. The race by the way is fantastic; I would highly recommend that you make a trip out there if you get the chance.
So, I took a photo of my feet after the race and thought you might like the photo, being that you are the foot guy. Might make for a good example. The blister appeared to start from underneath the pad of my foot by my big toe. The pressure built up so much that it formed the blister on top of my foot as well – as you can see from the photo. Pretty cool if you ask me. I probably ran with it for 50 miles, since I didn’t change my shoes and didn’t feel like taking them off. They lanced it when I finished… as I was receiving two bags of IV fluid. Haven’t had any problems with it since, although it has taken a few days for the pressure under my foot to slowly recede.
As you can see in the photo, there is blood in the blister. Here’s where you have to be careful and take precautions to prevent infection. I don’t encourage people to lance these on their own, but in aid stations with the right equipment and knowledge, it can be done. When I do it, I always give the athlete the warning signs of infection: redness, warm to the touch, pain, fever, pus, and swelling. If you have a blood blister, be careful.
Really though, Gregg’s feet look pretty good for just having run 153 miles. Don’t you agree?
One of my goals is to educate athletes about good foot care techniques. You may recall blog posts where I stress the importance of knowing how to do foot care and importantly, to know what’s best for your feet.
I recently received an email from Rob, asking for some advice. Here’s Rob’s email:
I have been running a modest 30 miles a week for a few years. Last weekend we attended a tennis camp and during the first night of drills during ball pick up (not during a drill or competitive play) another player smacked a ball in to the arch of my foot from a shot distance away causing severe pain. I played through the pain and the next morning I asked the trainer to tape up my bruised arch, which she did. I played all day and at the end of the day there was a blister in the center of my foot between the taped and un-taped area. I went back to the trainer in the morning and she created a donut shaped pad about a 1/4-inch thick and taped it to my foot. I took out my shoe arch supports and played for another 1/2 day in a bit of pain. When I took off the shoe, sock, and bandage and pad I found that the blister had filled with liquid to the size of donut hole – now a huge blister about the size of a silver dollar and 1/4-inches thick. The camp staff took picture as the biggest tennis-related blister they had seen. I went back to the trainer at the college and she drained about half of the liquid out of the blister and we decided I was done playing tennis for the rest of the camp. I’m not sure going to the trainer really helped and I probably should have had your book along as reference and taped myself up. Now I am back home and have a huge blister on the bottom of my foot.
This is a case where the trainer patched Rob’s blister the best way she knew how. It was an “old-school” patch job. A piece of moleskin cut in a donut shape with a hole in the middle for the blister. There may have been Vaseline on the center, and then tape or gauze over the top.
The problem with this old-school method is that it adds bulk to the foot – that can easily alter the person’s gait. This gait change can lead to further problems. At the same time, the patch can cause irritation, expanding the original blister or leading to new blisters.
Rob’s experience shows there is a long ways to go to get everyone up to speed about good blister care. I’d bet that if Rob had been prepared, he could have done a better job then the trained did. It’s hard to go everywhere with a blister patch kit in hand, but here’s my recommendation. Make up several simple kits and put them in Zip-Lock bags and stash one in your car and another in your gear bag. Fill the kits with your choices of blister tapes and patches. Then of course, make sure you know the best way to patch any blisters that may develop.
Here’s where to start – pages 228 to 256 in the 5th edition of Fixing Your Feet. If you don’t have a copy, or have an old edition, my suggestion is to get the new one. My home page has a link to Amazon if you need one. I was amazed at Badwater in Death Valley a few weeks ago. One of the runners had me autograph a copy of the 2nd edition. So much changes from edition to edition that it’s a small price to pay to help your feet.
Those of you who are fans of Fixing Your Feet will probably agree that the 5th edition released in the Spring of 2011 is the best one yet. Of course I am biased, but I have seen each edition become better that the previous ones.
Yes, I think the 5th edition is the best one.
My publisher, Wilderness Press, released it as a trade paper version. So imagine my surprise when I received word that it would be released in a special edition hardcover edition for Rodale Press and Runner’s World. Several months ago, in a deal with my publisher, they did a test, offereing Fixing Your Feet to their subscribers. Because the test was successful and the interest was good, they decided to go with a hardcover edition.
If you are interested in Fixing Your Feet in hardcover, click on the link. As you can see from the ad below, they did a great job with the marketing.
Last month I was at my local REI store to conduct a clinic on foot care. At the same time, they held a footwear festival, which had eight footwear companies represented.
I noted something about some of the shoes that is valuable to know if you are shopping for shoes. Specifically, the materials of the shoe’s upper.
I have two photos to share with you. The shoes in these photos are made by Salomon. In fair disclosure, I have several pairs of Salomon shoes that I received as swag for working medical at races. I find they are well made and are easy to fit to my feet.
The first photo shows a shoe that is typical of many shoes today – by most of the companies. The shoe’s upper is made with a mesh material. Whether it is one or two, or even more layers is not important. It’s mesh.
Wearing shoes with a mesh upper will generally help keep your feet cooler. But the mesh allows minute particles of sand and dirt to get inside, onto and into your socks, and on your skin. Those particles can cause friction and over time can cause hot spots and then blisters to develop. Yes you can wear gaiters, but the usual gaiter design covers only part of the front of the shoe’s upper. Stuff still gets inside. The alternative gaiter is a design that covers the full shoes, from the outer sole up over the ankle. A few months ago, I did a review of a gaiter that covers the whole shoe. Here’s the link.
The second photo shoes a different shoe, also made by Salomon, that has an upper made with a non-mesh material. This upper will keep sand and dirt out of the shoe. A gaiter with this shoe will be useful if you are running in a sandy, dusty, or dirty course, where you would likely get stuff into your shoe through the top of the shoe.
To be truthful, I feel strongly that trail runners should wear gaiters regardless of what shoes they wear. Gaiters are good proven equipment.
If you have a race or event on your summer calendar that involves lots of sand and loose dirt, keep the material of your shoes in mind when planning. Something as simple as a non-mesh upper can save your feet.
Life has been busy this past month and I apologize for not posting more often.
As I read the my magazines, I find shoe reviews. As I open emails, I read people’s experiences with their shoes. As I check newsletters, websites and blogs, I read reports and reviews of shoes. And then, of course, there are the ads – everywhere.
The thing is, they all point out the features and benefits of their shoes. Is there one shoe for you? Yes, there is one – and many more that will also work. Some work better than others.
My feeling after all these years of providing foot care is that you could easily slip into a number of shoes and they would work. You read the ads, the emails on forums from other runners happy with their shoes, and you hear other runners in one-on-one conversations recommending certain shoes. Maybe you’re happy with your current shoes and simply want to try out another pair. Or maybe you find the shoes you like have been discontinued.
Everyone wants the perfect shoe – and some people find them. Others try on shoe after shoe, looking for the elusive “best” fit.
You could run a 5K or 10K or even a marathon in many shoes and not have a problem. But move up to an ultramarathon or a multi-day event and you could have problems. A small thing when training or running can be multiplied many times over with more miles and cause problems. When changing to a different shoe, pay attention to any changes in how your feet and ankles feel. Does anything feel funny or seem bothersome? Do you feel a twinge the next day – telling you that something is wrong? At some point, if this continues, you need to consider the shoes. Change back to your old shoes and see if the problem goes away.
Where this affects athletes the most is moving from regular shoes to minimalist shoes or even no shoes (barefoot). Changing to these takes time and a gradual slow process. Wearing minimalist shoes puts added stressors on the feet until they get used to the change. Give it time. Slowly. Recognize you should be changing the way you land on your feet and your overall stride.
There are lots of shoes that will work for you. Give them a try. I bet you’ll find several you really like.
Ball of the foot blisters are quite common. Often they are more common when runners change to walking. Let take a look at these blisters.
Challenges with Ball of the Foot Blisters
There are three problems with ball of the foot blisters that make them more problematic than blisters elsewhere on the foot. Look at the image and you’ll see the large amount of area it covers. And yes, there’s blood in the blister section between the big and first toe.
- They often extend up into the skin between one of more toes
- They can spread out to cover a large area side-to-side and further down to the mid-foot
- They can easily tear at the front most area at the base of the toes
Preventing Ball of the Foot Blisters
I have learned several things about preventing ball of the foot blisters
- Keep your feet as dry as possible.
- Pre-tape if you are prone to these blisters
- Check your insoles for rough surfaces and change to a smoother insole
- Make sure your shoes fit and you don’t have a lot of movement of the forefoot inside the shoe
Patching Ball of the Foot Blisters
- Drain any blister, with a slit cut where ongoing foot pressure during the foot strike will expel extra fluid out
- Patch the blister with your favorite product and tape
- Apply tape from up one side of the foot to up the other side – not too high but over the edge
- Use one or more strips to cover the problem area
- Cut a figure 8 out of a piece of tape and apply it first to the forward edge of the tape between two of the toes, and pull it between the toes, securing it on the top of the foot.
The larger these blisters, the harder they are to patch. Try to patch them before they grow into monster blisters.
Here’s a link to a page on FixingYourFeet.com about Taping for Blisters.
These photos are courtesy of Ron Jones and were taken as I patched a runner’s feet at Badwater.
I first wrote Fixing Your Feet back in 1996, self-publishing it in 1997. Then came the 2nd edition in 2000, a 3rd in 2004, 4th in 2006, and finally the 5th edition earlier this year. That alone makes it a very successful book.
Do you have a copy?
I have talked to some athletes who have an old edition. As much as I love every edition, I am especially proud of the 5th edition. It is the best of them all. Each edition has built on previous editions.
After all these years, the book remains popular. I was surprised when I saw the sales number for the first six months of the 5th edition. It sold more copies than any previous six months after the release of past editions. Also surprising was that close to 300 copies were sold of the Kindle version of the 5th edition.
This morning I received an email from Runner’s World. The email had been sent to their subscribers. It gave information about a book with “583 secrets for foot-savvy athletes – like you.” It went on to say, “In the pages of Fixing Your Feet, you get secrets…” I wondered if someone had published a book with the same title as mine. I scrolled down in the email and saw the picture of the cover – and it was for my Fixing Your Feet! My publisher and Runner’s World, with Rodale Books, had worked the deal to offer Fixing Your Feet to their readers. The link to their three page website for the book is below.
I am honored.
This 5th edition has received accolades from lots of folks. This promotion by my publisher through Runner’s World and Rodale Books, is an honor. It shows how respected the book is. I hope you have a copy. If you don’t have a copy of the 5th edition of Fixing Your Feet, here is where you can get it:
ZombieRunner – click through to the website and then Books & Magazines
While you’re there, please consider a copy for a friend. Drop me an email and give me your feedback. I value your comments.
You, the athletes, are the ones who keep me going. I wrote Fixing Your Feet for you. Enjoy it.
What you put around your feet is one of the most important factors in blister prevention. The wrong type of socks or footwear that fits wrong can create pressure points and blisters. This is an area where trying different ideas can really pay off.
- Use an ENGO patch inside your shoe or on your insole to reduce friction.
- Wear two pairs of thin socks, a liner sock under a heavier sock, or double layer socks.
- Always use moisture-wicking socks – no cotton.
- Wear SealSkinz WaterBlocker socks for really wet conditions.
- Wear Injinji toe socks if you have frequent toe blisters.
- For bottom of the feet and heel blisters, try another insole.
- The heel is the first part of the sock to wear thin. Get new socks before they get too threadbare.
- Be sure to smooth the heels of your socks, and check the heels of your insoles and the inside of your heel counters for folds and worn or torn material.
- Replace worn-out shoes.
- Use shoes that are tested for the event, distance and the elements: cold versus hot, roads versus trails, and wet conditions.
- Try another pair of shoes-many shoes breathe better than others and are easier on your feet.
- To drain water, use a red hot nail to burn drain holes on the sides of your shoes right at the sock liner height where the shoe bends.
- Well-made and well-fit orthotics will help prevent blisters.
- Wear gaiters to keep rocks, dust, and dirt out of your shoes.
Most athletes hold a common misconception about blisters-that blisters are simply a fact of life that one must learn to live with. Most athletes try tips that they have learned from others. If those don’t work, they move on to another idea. Most try for a while, then give up and spend the rest of their life fixing their inevitable blisters. The fact is there are many ways to prevent blisters.
There are many things you can apply to your feet to help prevent blisters. Lubricants and tape are two of the most popular. Powders are a distant third. Remember that whatever you apply to your feet will react to what you put around your feet. When you apply a lubricant, your socks will pick up some of it, and more applications will be necessary. Tape works well, but tape applied poorly can be pulled loose as you pull on your socks.
In the 3rd and 4th editions of Fixing Your Feet, I had a chapter about 175 Ways to Prevent Blisters. Occasionally, I heard from people about how many of the ideas were confusing and seemed to contradict themselves. So for the 5th edition, I changed the chapter to reflect the best ideas in the different categories. The ideas below are the best in the Things You Apply to Your Feet section.
- Use a callus cream to soften calluses and prevent friction and resulting blisters.
- Use one of the popular lubricants to reduce friction. Body Glide, Hydropel Sports Ointment, Bag Balm, BlisterShield Roll-On, Brave Soldier’s Friction Zone, and Sports Slick are the most popular. Reapply each time you change your socks.
- Use powder to reduce friction. BlisterShield, Zeasorb, Odor-Eater’s, or Gold Bond foot powder
- Use one of the popular blister patching products: Spenco 2nd Skin. Blist-O-Ban, Bunhead’s Gel Toe Caps
- Use one of the popular tapes to pre-tape known hot sports or problem areas before your event: Kinesio-Tex. Leukotape, Elastikon, duct tape
- Use Certain Dri Anti-perspirant or Ban Roll-On on your feet to control perspiration.
- Use a slick energy gel wrapper between your sock and shoe to reduce friction.
- Avoid Vaseline – it’s too sticky, attracts grit and hardens on socks.
- For wet conditions, coat your feet with Hydropel Sports Ointment, Desetin Maximum Strength, or Sudocrem twice a day during a big race. Primarily designed to prevent diaper rash, this antiseptic healing cream leaves an oily trace on your feet and lasts for ages.
- Put a patch of lamb’s wool on a bruised, sore, or blistered area, and secure it to the foot with tape.
Try one or two. Give them a chance and maybe try a few more.