Filed under: blister care, Foot Care, Footwear, Health, Sports, toenails
I believe strongly in prevention as a proactive measure in foot care.
Tim Noakes’ sixth law of running injuries must be heeded—any running injury can be cured only after the cause is found and eliminated. All of us who run, hike, or adventure race at some point have problems with our feet or sustain foot injuries. The prevention chapters are numerous and lengthy because many factors contribute to foot problems and injuries, and for every factor, there is a preventive measure that can reduce or eliminate it. Prevention is the key to saving your feet. Dave Scott, a good friend and ultrarunner, put the foot problem in proper perspective: “When you don’t take care of your feet during a long run or race, each step becomes a reminder of your ignorance.”
It’s very easy to relinquish our responsibility for preparedness and let someone else dictate what we should do. We tend to listen to those whom we look up to and to those who are more experienced. In many ways this is OK, and it is often the way it should be. However, only you can determine what works for your feet.
Knowing your prevention options is important. That’s being proactive. I get emails every week from athletes who are looking for answers for their feet issues.
Some have my book but others don’t. Some have the book and have gone through the chapters to find possible treatment options. Others have the book and haven’t read it – and want me to answer their questions.
I try. Sometimes it works and sometimes not. While I answer from my experience and knowledge, I don’t have your feet. And that’s important.
Your feet have your abnormalities (hammer toes, bunions, thick toenails, skin that calluses, a tendency to athlete’s foot, a tendency to blisters, etc.), your ankles, your shoes and socks, your fit (good or bad), your training base, your stride and gait, and more.
You are the best person to find what works for your feet. Others may give suggestions. Fixing Your Feet can give suggestions and I may offer a few via email or in this blog, but you need to try them on your feet to find the one that works best.
You are the key to prevention.
Please, don’t show up at a race with a bad case of athlete’s foot, holes in your socks, shoes that have outlived their support, insoles that are flat as paper, toenails that are long and untrimmed, shoes that don’t fit, huge thick calluses, blisters that are unhealed, thick nails from untreated toenail fungus.
Yes, I have seen all of these.
Again, you are the key to prevention.
When Geoff Baker sent me a few photos of feet, which he took at this year’s Barkley, I found two jewels. The composition of Brett Maune’s feet in the two photos after winning the race is great.
The first photo shows Brett removing tape from his feet. The condition of his feet and legs is rough. Note the light skin on the heel where he’s removing tape. Another light strip of skin is shown on the bottom of the big toe. A strip of tape is still evident on the inside of the right foot.
The second photo is a great example that Brett knows his feet well. All the light spots on the bottom and sides of the feet are places where he applied Leukotape. He knew where his feet were vulnerable and he applied just enough tape to protect the skin and tissue in those areas. From all appearances, it worked.
Years ago, a good friend and renown ultrarunner, Dick Collins, told me to never put anything on or around your feet that was un-necessary. His theory, that I support, is that anything that adds bulk can be bad.
That’s why I frown on using moleskin, gauze and soft foam with cutouts over blisters. They all add bulk. When the runner takes off after the patching, his feet feel tight in his shoes because of the added “stuff” in the shoe. This often adds even more pressure on the blistered area, making it more uncomfortable that before. This can easily change the runners gait and this affect continues up the leg to the knee, the hip and the spine.
I commend Brett for winning the Barkley and for knowing how to care for his feet. We can learn from Brett. In short, pre-tape where you need it.
To view a photo montage of images from Barkley, check out The Barkley: Bad Things Happen.
Here is Geoff’s contact information: Geoffrey Baker Photography.
As long as you have good form, whether walking, running, hiking—or any activity where you are using your feet for movement, you stand a better than average chance of not injuring yourself due to a biomechanical problem. But have a pack that rides wrong on your back so you lean to the side, weak abs that make you lean forward, tired arms causing your shoulders to drop, or spent quads cramping up, and your body is tossed out of alignment. This will ultimately work its way down to your feet. As they compensate for your biomechanical problems, your gait and stride change, and your feet develop their own problems. So what is “gait?” We’ll take our definitions from Wikipedia, the free encyclopedia. Its definition is, “Gait is the way locomotion is achieved using human limbs.”
“Walking is the most common human gait. It involves one foot placed forward with the second placed the same distance beyond the first. It can provide good move speeds with relatively little energy input and low (typically minimal) strain on the body.”
“Running is nearly identical to walk except that the person is actually airborne once each beat. This is the chief high-speed gait of humans. The beats happen faster and the distance-traveled per-beat is also much higher. This requires a lot more energy than walking. Jogging is a sub-gait of run where the pace is much less and the legs nearly never go out of the body’s centerline.”
In an article, Gait Biomechanics by Stephen M. Pribut, DPM, he describes, “The gait cycle of each leg is divided into the stance phase and the swing phase. The stance phase is the period of time during which the foot is in contact with the ground. The swing phase is the period of time in which the foot is off the ground and swinging forward. In walking, the stance phase comprises approximately 60% of the gait cycle and the swing phase about 40%. The proportion of swing to stance phase changes as the speed of walking or running increases.”
Again from Dr. Pribut, “In the gait examination, we will observe for symmetry. We will look for clues regarding leg length inequality. Arm swing asymmetry, uneven head bounce, unilateral pelvic drop, uneven stride length are all indicators that there is a leg length inequality. Other factors to note are: the heel contact point, an apparent bouncy gait, excessive pronation of the foot, early heel off and the angle of gait.”
If you have problems or pain that won’t go away, a gait analysis may be in order. Look for a podiatrist, preferably one who treats athletes and inquire about a gait analysis. It could be money well spent and will help keep your feet happy.
For more in-depth information on gait, read Dr. Pribut’s article Gait Biomechanics .
Biomechanics is the study of the mechanics of a living body, especially of the forces exerted by muscles and gravity on the skeletal structure. We often forget how the body aligns itself over the foot and the importance of correct alignment.
The foot, which includes everything below the ankle, is a complicated but amazing engineering marvel. With an intricate biomechanical composition of 26 bones each, together they account for almost one-quarter the total number of bones in the entire body. There are 33 joints to make the feet flexible. About 20 muscles manage control of the foot’s movements. Tendons stretch like rubber bands between the bones and muscles so that when a muscle contracts, the tendon pulls the bone. Each foot contains more than 100 ligaments that connect bone to bone and cartilage to bone and hold the whole structure together. Nerve endings make the feet sensitive. With each step you walk or run, your feet are subjected to a force of two to three times your body weight, which makes the feet prone to injury.
The big toe, commonly called the great toe, helps to maintain balance while the little toes function like a springboard. The three inner metatarsal bones provide rigid support while the two outer metatarsal bones, one on each side of the foot, move to adapt to uneven surfaces.
Your feet are each supported by two arches. The transverse arch runs from side-to-side just back from the ball of the foot. This is the major weight-bearing arch of the foot. The medial longitudinal arch runs the length of the instep, flattening while standing or running and shortening when you sit or lie down, giving spring to the gait. The lateral longitudinal arch runs on the outside of the foot. Both longitudinal arches function in absorbing shock loads and balancing the body. These three arches of the foot are referred to singularly as the foot’s arch.
With a basic understanding of the foot’s construction, it becomes increasingly important to be aware of how we affect our body’s biomechanics. At some point in training for an event, we need to try to mimic the event itself. Wear the same shoes and socks that you plan on wearing during the event. Wear the same clothes; carry the same weigh in a fannypack or backpack; even get out in the same weather. Even though we may not realize it, these factors can change our stride, work different muscles, and put pressure on different body parts—including the feet.
The next post will explore how to avoid biomechanical problems.