Miles on Your Feet

April 17, 2017 by · Leave a Comment
Filed under: Foot Care, Footcare, Health, Sports 

I have worked medical and provided foot care at hundreds of ultramarathons, adventure races, walks, and multiday races and have seen the same thing over and over—runners who do not have a good training base.

Of course there is not a set number of miles you need to run to do well at a race. Conditions vary. Some may get by with minimal miles a week, others run over 100 miles or even over 150 miles a week as they ram up for a big event. By and large though, the runners with more miles on their feet do better that those that have fewer miles.

I’ll take this a step further and say that the more miles on your feet, the better your feet will be.

At the Western States 100 Michigan Bluff 55.7-mile aid station, for example, the top 20 to 30 runners come through 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 they 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’ll have problems. You have 10- to 15-mile feet—not 50-mile feet.

Doing Your Own Foot Care

Doing Your Own Foot Care

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. It’s about conditioning your skin, muscles, tendons, and finding what shoes and socks are the best, and finding the best fit—everything about 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.

Every sport has this. In the summer I ride a 24-hour road bike charity event where you ride as far as you can in 24 hours. How far I go hinges on several things. How well my legs are trained, how my stomach holds up, how my back feels. But the most important, for me anyway, is how many miles I have on my butt. That’s right. When I ride over 250 miles in 24 hours, every part of my body has to be conditioned. If you get saddle sores, they can be painful with every pedal stroke.

If you want to finish a race, your feet have to be in the best condition possible. That means knowing what they need for shoes and socks, skin and nail care, and having the right foot care kit—and how to use the stuff in it. It also means putting the miles on your feet. That’s what will carry you to the finish line.

Foot Care Expectations

June 17, 2012 by · Leave a Comment
Filed under: blister care, Foot Care, Sports 

Lets talk about expectations for foot care at races. I like this subject because being prepared is important. It can make my work easier and likewise that of everyone helping with medical and foot care at races. This coming weekend is Western States and there will be a lot of runners needing help with their feet.

Over the years I have seen everything at 100-mile races. Runners with holes in their socks or socks so worn you can see through the material, severe Athlete’s Foot, long and untrimmed toenails, huge calluses, no gaiters, the use of Vaseline as a lubricant, the use of Band-Aids on blisters, existing injuries that have not healed, shoes that should have been tossed out, huge blisters caused by not treating hot spots, and lots more.

I see runners with crews that manage everything for them – including foot care. These are typically runners who have experience in longer races. They also seem to have some degree of foot care expertise. They will come through an aid station and meet their crew and all is well. If they need foot care, they have the supplies and they or their crew knows how to use the materials. They are prepared.

Other runners are less prepared. They might have crews, but they don’t have the foot care supplies, much less the expertise in how to do what they needed. They count on someone being there to fix their feet.

Many of these runners expect a lot from the podiatrity staff – sometimes, they want a miracle. There are four issues to get past. First, many times there are no “official” podiatrity people at the aid station. No podiatrist anyway. Second, what they get is someone who is maybe a nurse, paramedic, EMT, or even a full-fledged MD, who is volunteering as the aid station’s medical person. Third, often this person(s) has limited skills in fixing feet. And finally, fourth, often they have limited supplies.

So what do you get? You get a person who really wants to help but may be hindered by their limited skills and resources. Don’t fault them if the patch doesn’t work or it feels wrong. You might try and give them directions on what to do – with limited success.

What’s wrong here? Your expectations are wrong. You cannot expect every race to have podiatrity people at every aid station, with supplies to fix hundreds of feet. Some races have medical staff while other races have none. A majority of races do not have podiatrist on hand. Is it their job to provide it? Only if they advertise such aid.

This means you should be prepared at any race you enter, to have the foot care supplies and knowledge to patch your own feet – or have crew that knows how. Does that sounds harsh? Maybe so, but you entered the race. You spent money on travel, a crew, food, new shoes, lodging, new shorts and a top, water bottles, and more. But did you spend a few bucks on preparing a good foot care kit?

Why take a chance that I or anyone else is there to fix your feet? I find lots of runners who have my book (Fixing Your Feet) but I am amazed at the large numbers who haven’t heard of it.

Many of us don’t mind fixing your feet. In fact I love to do it. But we can’t be everywhere – at all aid stations, at all hours, and at all races. Can you do me a favor? Tell some else about Fixing Your Feet and this blog. Make their life a bit easier and help them finish their race with happy feet.

I’ll be in the medical area at the Michigan Bluff aid station. In back of the scales and food tables. If you need me, I’ll be there.

Foot Care at Western States

June 27, 2010 by · 1 Comment
Filed under: Foot Care 

Yesterday I work medical at the mid-point Michigan Bluff aid station at the Western States 100 Mile Endurance Run. We had a team of about 12 people: doctors, RNs, LVNs, a chiropractor, a physical therapist, and paramedic. What happens when I work medical is that I spend my whole time working on feet. Of course, that’s what is expected of me. If there was a major medical that stretched the “pure’ medical folks, I would step over to that side of the aid station. So, what happened?

Runners kept us busy the whole day – from about 3:00 pm until we closed at 9:00 pm. We did not keep count. I had a good time because of Tonya, a physical therapist, who wanted to learn foot care. She was a quick learner.

In short, the day can be summed up with three words: maceration and toes. The snow in the high country had created a wet day for runner’s feet. Snowmelt ran down the trail and made for slushy conditions. Runners’ footwear ranged from regular trail shoes to lightweight minimalist shoes like the New Balance MT100s and Inov-8 models. I didn’t see anyone running in Five Fingers. Virtually everyone had wet shoes. And that, of course, led to macerated feet.

Michigan Bluff medical aid station

Michigan Bluff medical aid station

I set up with a pop-up and tarp and two reclining chaise lounge chairs. Tonya and I often worked side by side. She watched me for the first batch of runners and then, after a while, she took on feet alone. Her skills were good. Importantly, she asked questions.

How should blisters be lanced and when and why? What’s the best way to tape toes? How about heels? How about between toes? Wow, what’s that? What can we do for those toenails? How can you drain fluid from under a toenail? How can we modify footwear? What are the best supplies? What tools do you use?

Over the coming weeks I will address these questions.

Follow-up to Foot Care – Day after Day…

June 4, 2009 by · Leave a Comment
Filed under: Foot Care 

Last week I wrote a post about Foot Care – Day after Day after Day after Day. I told the story of, “Richard Donovan who ran seven marathons on seven continents in five days, 10 hours and eight minutes.” I added that, “I had received an email asking about how to manage feet in a multiday event. This is similar to what Richard Donovan must have been doing (hopefully).” I ended by saying, “I will have to investigate talking to Richard Donovan. He sounds like an interesting guy.”

Thanks to the beauty and amazing power of the Internet, I sent him an email and within two days he responded. Nice guy. I’d love to meet his some time. He wrote:

Ultrarunner Richard Donovan

Ultrarunner Richard Donovan

“Many thanks for the email. I haven’t even seen Men’s Journal – but the magazine had contacted me a few times all right. I had no issues whatsoever with my feet and actually didn’t pay any attention to them. I guess it would have been a different matter if I was preparing for a desert race or a jungle race. I had only put the general plan together a short time before I undertook the challenge. Most of my efforts went into logistical arrangements / making sure that appropriately qualified people could verify I was indeed running accurate marathon distances. And it was very much a work in progress even as I embarked on the first leg. As a result, I paid no attention to diet, potential injuries; anything else…. and just assumed the marathon runs themselves should happen without too much incident. But they were more difficult than I thought because of the hot temperatures in some places, snow drama in London and my generally feeling sick — probably due to airline food, sleep deprivation, jet lag and so on. But it was good fun and I was lucky.”

So, I was wrong. He spent little time and thought on his feet. From the information on his website, The World Marathon Challenge website, I found out that he really runs – a lot. I guess that he has his feet pretty well figured out. Some people are fortunate like that. Others aren’t.

On another note, I received a nice compliment about my Happy Feet Booklet. Thanks John M.

John M. wrote: John’s booklet Happy Feet! Foot Care Advice for Walkers and Travelers is a sort of Cliff Notes for feet — 36 pages of memory reminders that seem so simple when you read them again.

The Golden Rule for Your Feet

May 23, 2009 by · 2 Comments
Filed under: Foot Care, Health 

The signature line on Mike’s email caught my eye. “Treat your feet as you would have yourself be treated.” He called it, Running’s Golden Rule.”

Can you love your feet?

Can you love your feet?

Because feet have always interested me, I asked him to tell me more.

Mike says, “I think it means the same as The Golden Rule: Take care of your feet and they will take care of you; treat your feet with respect and kindness and they’ll support you in tough times; be your best friend to your feet and they’ll be your best friend when you need one most.

I like that. Too often we relegate our feet to the end of the line. Sure we buy good footwear and socks – but that’s it – we forget about the feet themselves. We forget quality toenail care and then wonder why we get black toenails. We forget about callus control and then wonder have to deal with blisters underneath them. We fail to deal with corns, Athlete’s foot, and other problems common to feet. We get blisters but don’t take time to figure out why we get then and learn measures to prevent and treat them.

To often we forget the Golden Rule: “Treat your feet as you would have yourself be treated.” Actually, it is pretty easy. A few minutes a day it all it takes.

Managing Athlete’s Foot

October 25, 2008 by · 1 Comment
Filed under: Footcare, Footwear, Health, Sports, Travel 

Many people have Athlete’s
foot at one time or another. Athlete’s foot, technically called tinea pedis
, is a skin disease caused by a fungus. The hot
weather and foot perspiration that athletes typically encounter can make
athlete’s foot a common problem. The combination of a warm and humid
environment in footwear, excessive foot perspiration, and changes in the
condition of the skin combine to create a setting for the fungi of athlete’s
foot to begin growing. Athlete’s foot usually occurs between the toes or under
the arch of the foot.

     Typical signs and symptoms of athlete’s
foot include itching, dry and cracking skin, inflammation with a burning
sensation, and pain. Blisters and swelling may develop if left untreated. When
these blisters break, small, red areas of raw tissue are exposed. As the
infection spreads, the burning and itching will increase.

     Preventive measures include washing your
feet daily with soap and water; drying them thoroughly, especially between the
toes; wearing moisture-wicking socks; regularly changing your shoes and socks
to control moisture; and the use of a good, moisture absorbing, foot powder.
Since athlete’s foot is contagious, if you use a communal shower or bathroom
after an event, or use a gym to train, avoid walking barefoot in these areas.
Use thongs, shower booties, or even your shoes or boots.

     Treatment includes keeping the feet clean
and dry, frequent socks changes, antifungal medications, and foot powders. An
antiperspirant may also help those with excessive foot moisture.

     Check your local drugstore or pharmacy for
a complete line of athlete’s foot antifungal ointments, creams, liquids,
powders, and sprays. See your doctor if your feet do not respond to treatment
with over-the-counter medications. If the fungus returns, alternate medications
since it can sometimes build up a resistance to a particular fungicide. Other
over-the-counter antifungal creams or solutions commonly available in your
local drugstore and pharmacy include Dr. Scholl’s Fungal Nail Revitalizer and
Fungi Solution, Clotrimazole, Lamisi. Lotrimin, Micatin, Swabplus, Tinactin,
and Tolnaftate are all common. Zeasorb-AF is available as a powder and a
lotion/powder combination. 

Socks that Work for You

July 29, 2008 by · 1 Comment
Filed under: Footcare, Footwear, Health, Sports, Travel 

Two weeks ago, I was in Death Valley to help as part of the medical team for the Badwater Ultramarathon, a 135-mile run from Badwater, the lowest point in the continental U.S. to the Mt. Whitney Portal, at about 8600 feet. This race is always held in July to challenge the runners with extreme heat. The route is entirely on roads, however the runners often favor the rocky sides rather then the hot asphalt. As you might guess, this usually takes a toll on the runner’s feet.




In addition to the foot work done by the runners’ crews, three of us patched a lot of tired and hurting feet. Denise Jones, called the “Blister Queen of Badwater,” Gillian Robinson of Zombierunner.com, and I were all busy up and down the course.  By the way, I am running an interview with Denise in the next issue of my Fixing Your Feet Ezine.

 


I was wearing socks from Drymax and had two extra pair. I like these socks because they do a superb job of elimination moisture against your feet. While other socks have Sock_trail_running_quarter_crew_black_gray wicking capabilities, Drymax socks are made with an inner thread that hates water, making it pass through to the outer surface of the sock. With wicking socks, water adheres to the fiber’s surface. Once wicking fibers get wet, they stay wet. The fibers hold the moisture next to the skin ensuring the skin stays wet. Conversely, with Drymax socks, water drops actually bend around the Drymax fiber, rather than sticking to its surface. This happens because Drymax fibers do not carry surface charges, so the negative & positive charges of water are not attracted to Drymax fibers. Because sweat clings to wicking fibers, the foot remains wet when wearing socks made of wicking fibers. Also the process of wicking must rely on evaporation for the fibers to dry out. Evaporation is a relatively slow process, especially in humid environments such as inside a shoe, where evaporation takes place at a much slower rate than sweating.


 


When sweat droplets move through the Drymax water-hating fibers they stay together and move instantly through the fibers. Drymax stays dry and therefore needs no drying time to keep the skin dry. I have noticed this when I wear the socks. Others have too.


 


So, back to the Badwater story. Jon, the runner from a year ago whose horrible feet I patched (click here to read his story in the August 2007 Fixing Your Feet Ezine), came into Panamint Springs needing some minor foot patching. Once I finished, I looked at his socks and offered him a pair of my Drymax socks.  Denise Jones gave away two pair of Drymax socks. The runners were appreciative and finished the race successfully. Jon told me he loved the socks.


 


Trust me, these socks work for you. I wrote a lengthy review of the socks in the June Fixing Your Feet newsletter. If you are in the market for new socks, or if you want to see how they will reduce your likelihood of blisters, check them out. The website is DrymaxSocks.com and they can also be found at Zombierunner.com. Just click on Store and then Socks.


 


After all, we need to keep our feet happy.

Pre-Summer Foot Care – Part 4 – Sandals and Flip-Flops

June 11, 2008 by · Leave a Comment
Filed under: Uncategorized 

Summer officially starts soon. With it, if you haven’t
already started, comes the wearing of sandals or flip-flops. There are also
possible hazards for your feet. A bit of care can help your feet survive in
spite of how we treat them.

Support – remember that generally speaking, sandals are better for your
feet than flip-flops. They offer better support and protection around the foot,
and a more stable base. If you look at most flip-flops, they Images
are very thin
soled, often thinner on one side as the wearer walks on the side. The heel is
often exposed to the sidewalk. There is nothing to really keep the foot in-line
with the footbed of the flip-flop. At least with sandals a strap goes over the
forefoot and another around the heel, keeping the foot on the footbed. Most
flip-flops offer no arch support and no heel support. The foot is not secure
and it can easily slip to one side leading to a fall or a turned ankle. Then,
to top it off, the feet are usually dirty, often with calluses and cracked
heels. Often it is not a pretty sight. I wear flip-flops around the house, but
not in public.

Protection – Feet on flip-flops are exposed to anything and everything.
You can easily stub toes, something may drop on your feet, they might scrap
against curbs or rocks, and they are easily pierced by anything sharp. Sandals
offer more protection over, around and under feet.

Function – Flip-flops are designed for casual wear, not for extended
walking, exercise, golf, running – and especially not mowing your lawn. Sport
sandals are a better choice.

Given a choice, I’d recommend sandals over flip-flops.

Need more convincing? A study on flip-flops was released
last week at the annual meeting of the American College of Sports Medicine in Indianapolis.
Researchers at Auburn University in Alabama recruited 39 college-age men and
women, and measured how the participants walked on a special platform wearing
thong flip-flops. Study author Justin Shroyer, a
graduate student in Auburn's Department of Kinesiology, reported, "What we
saw is that when people walk in flip-flops, they alter their gait, which may
explain why we see some lower leg and foot problems in people who wear these
shoes a lot."

If you choose to wear flip-flops, at least
buy new ones every four months. When the thin footbed flattens out, it’s time
to replace them.


After all, we want our feet to be happy.

Pre-Summer Foot Care – Part 3 – Athlete’s Foot

May 27, 2008 by · Leave a Comment
Filed under: Uncategorized 

The facts are startling: 70% of people will be affected by
athlete’s foot in their lifetime, 45% of people with athlete’s foot will suffer
from it in episodes for more then 10 years, and seven out of 10 people with
athlete’s foot are male.

Athlete’s foot, technically called tinea pedis, is a skin disease caused by a fungus. The hot
weather and foot perspiration that athletes typically encounter can make
athlete’s foot a common problem. The combination of a warm and humid
environment in your footwear, excessive foot perspiration, and changes in the
condition of the skin combine to create a setting for the fungi of athlete’s
foot to begin growing. Athlete’s foot usually occurs between the toes or under
the arch of the foot. Typical signs and symptoms of athlete’s foot include
itching, dry and cracking skin, inflammation with a burning sensation, and
pain. Blisters and swelling may develop if left untreated. When these blisters
break, small, red areas of raw tissue are exposed. As the infection spreads,
the burning and itching will increase.

Treatment includes keeping the feet clean and dry; frequent socks
changes, antifungal medications, and foot powders. An antiperspirant may also
help those with excessive foot moisture.

Check your local drugstore or pharmacy for a complete line of athlete’s
foot antifungal ointments, creams, liquids, powders, and sprays. See your
doctor if your feet do not respond to treatment with over-the-counter
medications. If the fungus returns, alternate medications since it can
sometimes build up a resistance to a particular fungicide.

Pre-Summer Foot Care – Part 1 Callus

May 9, 2008 by · 1 Comment
Filed under: Uncategorized 

Summer is right around the corner and with it comes more time spent outdoors. Activities like running, walking, hiking, adventure racing, backpacking or fastpacking – all stress our feet. Now is the time to start pre-summer foot care. We’ll talk about this in several parts. Part one will talk about calluses.

     Calluses are controversial. A callus is thickened skin caused by recurring pressure and friction—usually a sign of ill-fitting footwear. Many people feel calluses help protect their feet from blistering. Jan_herrmann_right_foot_17_days_aft They can – but they again, they might not. The problem is that when, not if, you blister underneath calluses – these deep blisters are almost impossible to drain and treat. The hard callus rubs against any pressure point in your shoe (side of the heel or forefoot, ball of the foot, bottom of the toes, etc.) and when the rubbing has continued long enough, and/or with enough pressure, the callus begins to move against the deep layers of skin – and you have a blister.

     My suggestion is to work at reducing your calluses with creams and file them as smooth as possible. Some small callus is okay, but I would keep them fairly soft and thin. The thicker and harder they are, and the longer it takes to reduce them.    

     Buy an inexpensive callus file at your local drug store, or a pumice stone, and file the callus after showering or bathing. You also should also purchase a callus cream to apply after using the file.

     A bit of foot care before summer will help your footwear fit better and your feet feel more comfortable.

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