Training With Wet Feet

May 5, 2013 by · Leave a Comment
Filed under: blister care, Foot Care, Health 

For years, the norm has been to avoid getting your feet wet. When feet get wet for extended periods, usually the feet have skin that is soft and macerated. In long events, and especially in multi-day events, that can lead to trouble. Taping or patching wet feet, or macerated feet, is very difficult. So it is best to keep your feet as dry as possible.

This has always been the rule.

In the past few years, adventure style races have become popular, which puts runners in conditions where wet feet are the daily norm. Most often, these races are six to seven days in length. The race often includes running through the jungle or mountains with stream crossings, wet foliage, wet trails, mud, and extremely humid conditions. In these conditions, your feet are always wet.

If you think this doesn’t apply to you because you are doing a “dry” race, please consider this. Even dry races with no water crossing can produce wet feet. Dumping water over your head at aid stations to cool off will get water in your shoes. Plus our feet naturally sweat and this buildup can result in wet feet.

Shirley Thompson, the Race Director of the Jungle Marathon told me, “We always advise runners to train with wet feet so that they can focus on a strategy before they get to the jungle. As far as footwear is concerned, we always emphasize trail shoes with good grip, and that comfort is the main factor.”

So how can we do that? For training runs, soak your shoes and socks before heading out. Step in puddles or use a hose if they dry out. Try to keep them wet as long as possible. If you feel a hot spot or blister start, stop and adjust your shoes and add tape, lube or your favorite blister prevention product. Take time to find the best shoe and sock combination for your feet when wet.

Personal Foot Care of Wet Feet

Because your feet will be wet, often at the start of each stage, it makes sense to do some of your training with wet feet. Use the same shoe and sock combination that you plan to use for the race – and get them wet. Walk and run in them. Not just a 30-minute run, but hours! Put some distance on your wet feet that is the same you expect to do during the race. Try to also to do back to back wet feet training days. It’s that simple.

As said earlier, stop and deal with any hot spots as soon as you feel them. Check for folds in your socks, friction from dirt or sand, pressure inside your shoes – and get rid of these irritants. Lube the area or apply a piece of tape or blister prevention patch to help. This may seem like common sense, but many people ignore this simple step.

At the end of each day’s stage, remove your wet shoes and socks, dry your feet and air them as much as possible. If your feet have tape on them, remove the tape to dry the skin underneath. Wear sandals or Crocs around camp to keep your feet away from the wet ground and dirt and sand. Walking around barefoot will often aggravate wet, cold, and soft macerated skin. Later in the day or the next morning, re-tape your feet and patch any blisters.

Because you cannot count on medical people patching your feet the way you want them patched or that they will be available, you must learn how to patch your own feet. I have helped at events where I have patched feet all afternoon and evening, and then had people line up in the morning for more work. Sometimes the medical staff is stretched thin or cannot get to everyone. Be prepared to do your own patching and have your own equipment. Better safe than sorry.

Many times at races, I have seen athletes who have not trained their feet for the event. They enter a race and don’t put the necessary miles on their feet, don’t have the right shoes, don’t know how to manage and patch their feet. I encourage you to take the time to train with wet feet and condition them for the extremes of your race.

A Foot Care Success Story

March 17, 2013 by · 2 Comments
Filed under: blister care, Foot Care, Foot Care Products, Health, Sports 

Every so often I hear a foot care story from an athlete that intrigues me. It’s fun to read their story about their issues with their feet and then the steps they took to find answers.

One of the best examples of this is Nathan’s story on page four in the 5th edition of Fixing Your Feet. He told the story of how he studied foot care techniques and learned hot to manage his feet – and successfully finished Racing the Planet’s Australia race.

Then the other day I received an email from Karen. I liked her story and asked if I could share it with my readers. She agreed. Here is what she wrote.

First, I am extremely prone to blisters. Initially I thought it was friction. I tried Hydropel, but its sticky nature attracted dirt but did nothing to calm my problem. At Fruita one year, Lisa and Jay (Smith) Batchen shared their knowledge in a presentation about the three primary causes and the light bulb went off. Hydration is my primary issue – specifically bloating.  The bloating happens because I’m no longer processing fluids.

After working thru formulas and cause and effect for several years on my own, I finally solicited help from Scott Jurek -I knew him from Coyote events. Mutual friends had helped me focus on running nutrition, but I wasn’t making progress on my own. Scott helped me maintain my ability to process fluids and enabled me to delay bloating and blisters.

When I get blisters, they’ll either start as a hot spot on my pads or a painful toenail. I get them under my toenails (which I keep extremely short) or the entire pad of my foot/feet will get it. Over New Years with a very low mileage base, I went to California and ran/hiked 34 miles. Had a hot spot early that I actually taped, and a blister on a toe but that was it – a sign that I was on the right track!

I’ve also become smarter on dealing with my blisters. I still get them, but they aren’t crippling. Once after my first attempt at the Leanhorse 100, they were so bad they caused me to miss the cutoff, and they got dangerously infected. Two years later, I went back and finished – it was my first 100. I still got blisters but they didn’t prevent me from meeting my goals.

Here’s what I do now for my feet other than monkey with hydration:

  • Work on my calluses and keep my toenails trimmed
  • Get my orthotics re-surfaced at least a couple months before event
  • Keep my shoes and socks current too and only use Smartwool socks
  • Train on the exact terrain I expect and work on the plan for my feet – it’s just as important as my physical and nutritional race plans
  • My starting feet recipe is to use BodyGlide on my feet before putting on socks. Then change my socks every 20 miles if I’m running anything over 50K.
  • Carry a foot kit on my back at all times with a couple Engo Pads for hot spots on my orthotics, a couple of alcohol wipes, blister pads and a safety pin, and duct tape for real emergencies on a pencil or on my water bottle
  • A full fledged foot kit for crew or in a later drop bag with new supplies for my carry kit, Desitin if it’s wet conditions, and tape/scissors/tincture for the next defense. An injection devise and zinc oxide and Second Skin/New Skin as final defense. I had to do all three lines of defense to actually finish Leanhorse, but we did it.

Thank you Karen for sharing your foot care plan.

Blister Prevention – The Long Version

January 13, 2013 by · 1 Comment
Filed under: blister care, Foot Care, Health 

Today’s post is long, but illustrates a valuable point. The Facebook post below started a long chain of responses – all suggestions on what the poster could do to eliminate her blister problem. There were a total of 64 responses. Let’s get right to what was initially posted.

Original Facebook Post

So some of you may remember the nasty blood blister I got during Boston in 2011. I am very unhappy to say I have another one as a result of yesterday. Today I will be doing a GREAT amount of reading on not only how to treat but prevent this from happening again. My next long run is 20 miles. I think that moleskin is going to become my new best friend for EVERY long run.

Side of the foot blister

Side of the foot blister

Fifty-four Responses

I use Sportslick and only wear Wright socks (thin, double layer) for long runs. For my last Ironman I put anti-perspirant on my feet everyday for a week before the race. I got no blisters. Good luck!

Soldiers have been known to wear panty hose footies during marches. And tape every hot spot.

Going to look up mole skin because since I lost 90+, my sneakers were huge on me and I didn’t realize it so after the bursitis incident I walked a few miles and had horrible blood blisters that were UBER painful. I applied Band-Aids the next day and kept hustling… moleskin eh? Thank you and healing love to your blisters. They hurt!

May be time to re-evaluate your shoes. I got a whopper this summer after a 20 miler. My inserts in that particular pair of shoes were causing me to run a little odd.

Moleskin! I used it with any shoe that pinches or rubs, especially heels. I found cleaning my skin with alcohol first helps it adhere the best and stays even after taking showers!

If you have sweaty feet be warned moleskin can be sweated off. It is probably the best out there though to prevent blister. If it gets rolled or folded it can make the problem worse.

I use Sportslick and wear Wright socks as well. No blisters as of yet. It got me through my first marathon with no blisters and it rained that day and my feet were soaked. It didn’t do much for my bruised toe nails though lately I have been using Monkey Butt” anti-chafing powder when training for triathlons. Have had great results with this product with my bike shorts. But for feet, I would recommend Sportslick as it is a thick petroleum based ointment. Best of luck! And remember, one foot in front of the other. It doesn’t have to get any more complicated than that!

New shoes may also be the answer. I switched from running in Nike Air Pegasus years ago to Mizuno Wave Riders with little to no blistering. Turns out I needed a narrower toe box and the Nike Pegasus toe boxes would stretch a great deal over time.

Research socks and use a Bodyglide type product
.

I have hyper mobility in my feet. I was using Sauconys. Horrible foot pain. Got some Mizuno. Best shoes ever! I can run without pain!

I use anti-perspirant and change my socks every 5 miles
.

Try Balega dry fit socks. I NEVER get blisters anymore and I’ve completed two marathons and two Ironmans in them. Used to get blisters all of the time before I switched!

Mizunos + Bodyglide + a great fitting pair of socks = No blisters… ever again!

I get the cheap Monistat anti-chafing cream and put that on my blister prone areas, and it works perfect!

My latest blood blister peeled off the end of my toe just this week! I had a little party!

Have you ever tried Smartwool socks? They are pricey, but worth it. I haven’t had a blister since I started wearing them on my runs
.

We always wore two thinner pairs of socks in high school if we had history of blisters… one pair inside and it worked like a charm.

Inside out [socks].

Here’s my 2 cents! I keep my toenails as short as I can handle- short! Smear on some Vaseline between my toes wear the same brand of sox and so far so good.

Moleskin is amazing, and glide works well too. I have heard if you’re in a pinch use deodorant where there is any friction.

In the years I have done marathons/half marathons, I find that having the right shoes, using wicking socks (I too use the Wright socks), and use talc/baby powder in between my toes I do not get blisters.

I gave up on running because of constant and ongoing blisters, I tried several shoes etc nothing helped, I loved running but those blisters were so painful, what is moleskin?

Totally agree with Smartwool socks. They rock.

Try Nuskin. I have a friend who is a marathon runner and this company is her sponsor. Supposedly very good!

Love moleskin! I get wicked blisters without it and none with it. The stuff rocks! Superb for healing blisters too!

Military uses just basic slip on panty hose/dress socks especially with long hauls when carrying 80+lbs in the desert – it works and it is cheap.

Mole Skin and my hiking boots = Love.

Panty hose and then socks over?

I swear by these don’t know if you have used/seen them – Nike Elite Anti-Blister Low-Cut Tab Running Socks.

I spray my feet with Trislide if I start getting any rubbing in my shoes. I can run barefoot and not get a blister no matter how long I go.

SUPER HELPFUL! OKAY NOW FOR TREATMENT FOR MY EXISTING BLISTER? IDEAS? I HAVE RUNS THIS WEEK.

There are lacing techniques that you can try to that help prevent this – as with some of the other comments; you may need a different shoe or sock. I’m sorry, that’s such a pain! I recently switched from Saucony to Mizuno’s & have had a really great experience so far.

Try the book Fixing Your Feet by John Vonhof. We ultra runners swear by this book.

Yeah I do believe my Saucony Kinvaras are out for this very reason. Both times I wore them – in Boston and again yesterday it happened.

The best stuff for blister is Compeed. It is now sold by Band-Aid as Blister Band-Aid and still says Compeed on the box. You can put over the blister and still run without feeling anything. I always carry with me on races. Just in case!

To heal the latest blisters I had to pop them as they were so big I couldn’t put shoes on. Then I cut the size of the blister out of the center of the moleskin and place it over/around the blister. Kept blister clean and voila, perfectly fine that night!

Yes – pantyhose and then socks over – they glide and no friction in between skin and toes.

I play hockey and some girls get the worst blisters from skates. It was actually a doctor on our team that recommended using duct tape! It does work better than moleskin and with good socks. This is at the stage where you are getting irritated in a certain spot, not of course after the blister has formed!

I second the double sock and panty hose method. I actually found ones you wear for ballet flats very helpful. Not sure how they would do on long hauls as I was a short and medium distance sprinter. Cheap and easy.

I have ran a ton of marathons and have stopped getting blisters when I purchased a good pair of socks and bought my shoes a size and a half bigger. So one good sock and big shoes = happy feet.

What you are describing sounds like poorly fitted shoes to me. Make sure you get fitted a good running shoe store, and tell them up front that you have a problem area. A good running shoe fitter should be able to fix the problem.

Knee high pantyhose along with powder maybe but the pantyhose should protect your feet from the friction.

You need to check out Incrediwear.com – they have the best socks for runners. My husband does marathons and I’ve recently started running myself. There is no question our feet don’t hurt and they wick away the sweat. They are made with bamboo charcoal and they increase blood circulation.

Wright socks!! I get them sometimes. But I wear Vibram FiveFinger shoes. And any other running shoes I have are minimalist shoes. So not socks… But if you do wear socks. Get some 2-layer Wright” socks! They are awesome. Or an old army trick. Wear nylons/knee highs under socks.

You are not supposed to pop blisters ever. If they pop on their own fine. But I would cover it up with something like the moleskin or a blister Band-Aid and wear good socks and shoes. I like the knee-high panty hose idea. Good luck & feel better!

Duct tape.

I hate to hear that girl…I run in Asics, and those socks I told you about and have never had a blister…sorry feel better girl!

I remember that blister because I had an awful one at the same time! I finally stopped getting them when I went to a actual running store, they fitted me with a pair of Sauconys with a wide toe box and laced them just from the middle of the shoe and up. In all the miles I ran after that never got another blister and my black toenails grew out and had no more problems with that either! It’s the wide toe box that saved my feet.

If the blister is open, use vitamin E oil on it at night. Air it out as much as possible. If the blisters are so large you can’t wear shoes, take a cleaned (alcohol) safety pin and drain. Don’t tear skin off. It is best not to pop but sometimes it’s needed. Motrin for the pain may seem extreme but if you r in so much pain and start altering your stride you’ll get even more blisters.

Try Second Skin. It works very good for soldiers. In two days your feet will be like new!

I never got blisters-and i used to run 65 miles a week. My trick was either Thorlo socks, or wearing two pairs of snug socks. And wearing shoes that were a full size larger. My favorites are Kswiss performance. When running distance, your feet swell so much, you need the space to be able to accommodate it.

Vibrams! They literally took away all my feet problems, including blisters. I love them.

Essential oils are helpful for treating the actual blister. Lavender and tea tree (also called Melaleuca) will help it heal. Apply 2-3 drops of each every couple hours – or when you think of it really. I hope it feels better… they are nasty.

I grease my toes and footpad down with simple cocoa butter Vaseline before any run or distance walk! Haven’t had a blister since! Took a couple times to get used to the immediate feel, but now a year later with no blisters, I hardly notice I’m doing it any more! It’s cheap & simple! And, foot fitting socks! I have my favorite kind that I own multiple pairs of, got them at the local Fred Meyer!

I do the same for long runs. And sometimes baby powder to. Helps with the moisture.

After all 54 responses, I had to weigh in. Here’s what I wrote:  

As the author of Fixing Your Feet, I’ll comment that some of what has been suggested here is good but some is not what I would recommend. There is no “one right” answer to the ago-old blister problem. There are many causes and many answers. Try some and find what works for your feet. What’s important is fit, socks, trimmed and filed nails, reducing calluses, and a high-quality lube if needed to reduce friction.

Later, I emailed Jenny and based on what she described and the picture of the blister, here is my response to her.

Let’s talk treatment first. Because it’s a blood blister, I’d try to keep the roof intact. If it opens, your circulatory system is open to possible infection.  I lance them, but I am used to doing that, and give the athlete a lecture on infection. Generally if you soak your foot in warm/hot water with Epson Slats, several times a day, the blood and fluid will be reabsorbed – and the blister will harden. Over time, after that, the top layer of skin may slough off but by then, the possibility of infection is over. Start there. If the blister ruptures, make sure you use an antibiotic ointment and keep it covered. Signs of infection are redness, heat, swelling, pus, pain, and streaks moving up the foot. That becomes serious. Make sure your Tetanus shot is up to date (usually about every 8-10 years).

As far a prevention goes, here are a few thoughts:

  1. I think I see the edge of callus at the forward edge of the blister. I don’t like calluses. Try and reduce any you might have.
  2. Do you have bunions? If so, that changes a few of my ideas.
  3. I’d guess that you have a shoe issue (meaning fit). If you have wide feet, or the shoes you wear are too narrow, you’ll have these problems. I read you wore the same shoes both time this happened. That’s a good sign you don’t have a good fit. A better fitting shoes could solve your problem.  Can you get fitted at a good running store?
  4. Something else I see is that the bottom edge of the blister is right at the edge of where the insole hits the side of the shoe. This again gets to the issue of fit. There is pressure there, creating friction, that cayses the blister, that builds from this bottom edge upward.
  5. One option is to protect the area with a strip of tape. Duct tape isn’t the best, but would work. Don’t use white athletic tape. It won’t stick. I prefer Leukotape.
  6. You could cut a horizontal slit in the side of the shoe over the pressure point.
  7. I hate moleskin and never use it. It does not stick well, does not conform to the shape of the area, and is too thick. Stick to tape. The ONLY kind I would recommend is Profoot Velvetex Moleskin (available on Amazon).
  8. Only wear moisture wicking socks.

Something to understand, that I preach all the time, is that what works for one person will not necessarily work for another. That goes for socks, shoes, lubricants, powders, etc. We each are an experiment of one and need to determine what our feet need. Keep me posted.

Sometimes Your Feet Quit

September 30, 2012 by · 2 Comments
Filed under: blister care, Foot Care, Sports 

In August I worked the Gold Rush Adventure Race in the California Sierras. Throughout the race I worked at three checkpoints. As racers needed foot care, I carried my lounge chair and foot care box to where their team was set up and did what I could.

Most racers had hot spots, blisters and sore feet. A lot of times, athletes tell me that have blisters and yet, after cleaning their feet, none are visible. They may have a very sore spot or a hot spot, but there is no blister. Sometimes I can tape over the area or place a Spenco patch to provide a bit of cushioning. I often add an Engo Blister Prevention Patch to their insole underneath the tender area on their foot.

A lot of the racers needed blister care and taping. My whole aim when patching feet is to get the racers back in the race. I do what I can to drain and patch blisters on any part of the foot.

One of the racers came into checkpoint where they were transitioning from bikes to foot. At this point, they had been on their feet for almost two days. They started with a long paddle, followed with a long bushwack up a canyon, and then a really long bike section. The team was near the end of pack. The four members sat and discussed their options and whether to continue. The next section was a long trek of about 36 miles.

The racer needing foot care took off his shoes. As he sat back in my lounge chair, I removed his socks. His heels were fine, however he had major problems with blisters at the ball of the foot where the toes started. Both feet were the same. I cleaned his feet and did an evaluation.

I wish I had taken a few pictures of his feet but I was too involved in getting his feet patched so the team could continue. At the base of each toe were blisters. Many extended to several toes. Some of the blisters extended up between the toes. The majority had blood in the fluid. There were blisters at the base of the toes from one side of the foot to the other side – on both feet. His feet were swollen so the blistered skin was stretched tight from the fluid. In addition, several of the toes had blisters on the bottoms or sides, several with blood inside.

The blood in the blisters was my major concern and that there were so many of them. I usually drain blood blisters and with clean skin and a dab of antibiotic ointment – in a 24-hour race, I’m comfortable doing that. I always ask the person if they are up to date with their Tetanus shots and give them instructions about infections.

I talked to the racer and gave him my honest opinion – that he not continue in the race. We talked and I gave him my reasons. The next section was about 36 hard miles of cross-country trekking. His feet would get wet, and this would soften the skin and lead to further skin breakdown. The blisters were in a hard area to patch and it would especially be one long patch at the base of all his toes. The swollen condition of his feet was not going to get any better. And most important, the blood in so many blisters, even with the blisters lanced and patch, would increase the chances of an infection. Plus, if his feet took a beating during the trek, the blisters would become a huge open unpatchable mess (for lack of a better term). And of course, his feet would hurt badly.

He took my advice and I wrapped his feet as shown in the photo.

Wrapped feet with blisters all the way across the base of the toes

Wrapped feet with blisters all the way across the base of the toes

 

 

 

 

 

 

 

 

 

 

 

 

 

I think I can count on my fingers how many times I have advised racers to stop because of foot problems. Sometimes your feet simply quit. They have had enough.

Could this have been prevented? Based on my experience, I have to say, probably. Changing socks, treating hot spots, earlier blister care, better socks, moisture controlling lubricants, airing feet at checkpoints, and better shoe fit. In a team event, such as adventure races, every member of the team must help the other members with foot care. Every team member must be honest with their teammates about the condition of their feet. In solo races where athletes are racing alone, they need to be constantly aware of their feet. And where there are crews, these important people must ask questions about the condition of the athlete’s feet.

There are no guarantees in a race of any length. Our feet propel us forward, but every so often, out feet quit.

Holey Socks?

April 14, 2012 by · Leave a Comment
Filed under: Footwear Products, Sports 

I just had to share this photo. A few weeks ago I worked at the 21-mile aid station at the Oakland Marathon, which was also the eight-mile aid station for the half-marathon.

Back in the 80’s I ran the old Oakland Marathon and after a few years the event died. Then three years ago, Coorigan Sports took resurrected the run.

So on a Sunday morning, we set up the medical tent. It was me and six nurses from the Alameda County Medical Center. We stood outside the tent and watched the runners and walkers coming by.

I brought my foot care kit in case a runner needed help. I actually got quite a bit of business. The usual hot spot and blister care.

Then a young lady stopped. She wanted a blister patched.

She was wearing two pairs of socks. She took off her socks and I made the necessary blister repairs.

Are these your socks?

Are these your socks?

Then I helped put on her socks. Look closely at this picture and you’ll see the the threadbare sock under the ball of the foot. The rest of the bottom of the sock is so thin you can almost see through the fabric.

I told her she needed to toss the socks and gave her a few tips on socks.

It bothers me to see runners and walkers spend money on a race, wear good shoes and the right running clothes, and forget something so simple as a good pair of socks.

Please, take a minute and check your socks. If you have any like this, toss them.

You’ll be doing yourself a favor.

It Only Takes a Pebble

October 1, 2011 by · Leave a Comment
Filed under: blister care, Foot Care, Health 

There is an old Chinese proverb; “Failure results not from the length of the journey or the height of the mountain but the pebble in one’s shoe.”

We have all had it at some point – the pebble that is.

The infamous pebble

The infamous pebble

We are running or walking or hiking and feel a small irritant. We think to ourselves that maybe our sock bunched up. But, after a bit, we realize its something else. So we move our foot around a bit or kick it up against a rock or log, or maybe sideways on the ground. The hope is that that kick will move the irritating thing to the side where we won’t feel it.

Sometimes it works for a while. But it always comes back. We are always better off to stop, take off your shoes, and clear whatever the problem is. Even the smallest pebble can cause problems. It can start with a hot spot and develop into a blister. It can cause a hole to develop in the sock. It can tear into the insole’s covering.

So stop and remove it.

Several weeks ago I was at the Gold Rush Adventure Race and encountered a similar situation. One of the racers came into the transition area and in the process of changing socks, I told her I’d clean out her shoes. The race route had taken runners through muddy areas and some had gone down into her shoes.

As I used my hands to clean inside her shoes, I found very rough hard edges under both heels. I thought it was a defect or tear in the insole. Surprisingly, it was hardened mud that was so hard, it took a lot of pressure to remove it from the insole. This must have hurt through the socks – but the racer had not bothered to clear out her shoes.

In reality, it might be a pebble – or mud. In either case, you are always better off to take a moment and get rid of the irritant.