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.

Lubricants – One Bad and Lots of Good

August 4, 2012 by · 1 Comment
Filed under: blister care, Foot Care Products, Health, Sports 

This post came about because of a Backpacker magazine article about skills. One of the items was about endurance and was for, “Blistered feet during a high-mileage trek.”

The tip was to, “… protect against hot spots by applying a skin lubricant like Vaseline to high-friction areas…”

I’m sorry, but I think Vaseline is a bad choice.

When I ran my first ultra, back around 1982, there was not a huge choice in lubricants so Vaseline was commonly used. But I learned very quickly that its stickiness helped it collect dust and grit, sand and dirt, and other things that found their way into your socks and shoes. Once absorbed into my socks, it also became stiff. I looked for an alternative and discovered Bag Balm, which I used for years.

Over the years, Vaseline has been surpassed by lubricants that are slicker without attracting “stuff’ that can cause hot spots and blisters, that last longer, that don’t cake up on your socks, and that are much more effective.

So, here’s my choice for a bad lubricant: Vaseline.

And here are my choices for good lubricants:

Sportslick Skin Lubricant 

  •             Tube
  •             Solid Stick
  •             Pocket Slick

BodyGlide 

  •             The Original Anti-Chafe Balm
  •             FootGlide Foot Formula
  •             Ant-Chafe with SPF 25 Balm
  •             BodyGlide Anti-Chafe for Her
  •             Liquefied Powder
  •             WarmFX Anti-Pain Balm

BlisterShield

  •             Powder
  •             Roll-On
  •             Towelettes

RunGuard

  •             Anti-Chafe Stick
  •             Anti-Chafe Stick, Sensitive Formula

Hydropel Sports Ointment

Bag Balm

Many of these are available through ZombieRunner. Click on “Anti-chafing & Skin Care.” I you are looking for a new lubricant, or want to try one of these, check them out through  ZombieRunner.

Disclosure: Clicking through to ZombieRunner and making a purchase credits me with a few pennies to support this website.

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.

Looking at Shoe Uppers

May 3, 2012 by · Leave a Comment
Filed under: Foot Care, Footwear 

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.

Shoe with a mesh upper
Shoe with a mesh upper

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.

Shoe with a non-mesh upper

Shoe with a non-mesh upper

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.

When Tape Goes Bad

March 25, 2012 by · 1 Comment
Filed under: Foot Care, Foot Care Products 

Today I worked the medical aid station at mile 20 of the Oakland Marathon. Saturday I restocked my foot care box, adding supplies that I had depleted during the past events. I also cleaned up my Baggies of patches, and other small items.

One of the things I noticed I was short was tape. I added a roll of Leukotape and some Kinesio Tex. The Leukotape was out of a box off my shelf. I knew it had been on the shelf for while, but was unsure how long.

A short time into the race, I had several runners come in for some taping over hot spots. I cleaned the skin with an alcohol wipe, assessed the problem, and peeled off a bit of Leukotape. The first strip stuck okay. But after that, I could tell the tape did not have its usual stickiness.

I unrolled more and more, but the tape was bad. It would not stick.

Thinking about it, I think the tape was several years old. Maybe even three years. I am pretty good about checking my tapes – but this one slipped by me. So my advice is to check all your tapes before a race.

Tips to Tape Your Feet

September 4, 2006 by · 1 Comment
Filed under: Footcare, Footwear, Health, Sports, Travel 

Many athletes have tried to tape their feet only to find it doesn’t stick well and comes off sooner than they like. There are several reasons for this so in this post, I’ll give you some tips on taping your feet:
•    Skin is naturally oily so you must remove the oils with an alcohol wipe. I often use several wipes. These are available at most drug stores, in a very small tear-open packet.
•    If there is dirt caked on your feet, get as much as possible off the skin.

•    If taping over a hot spot, apply a very small dab of lubricant to the hot spot area so the tape will not stick.

Read more

Extreme Conditions for Feet

July 22, 2006 by · Leave a Comment
Filed under: Footcare, Footwear, Health, Sports 

Sunday I leave to help at the 135 mile Badwater Ultramarathon that takes runners from Death Valley to the Mt. Whitney Portal. Many of the runners continue on to the summit of Mt. Whitney, another 10 miles—making it a run from the lowest point in the Western Hemisphere (280’ below sea level) U.S. to the highest in the contiguous U.S. Run on the road, the race exposes runners to extreme heat, up to 130F, and possible sandstorms.
     My role will be to provide foot care as part of the medical team. Don and Gillian, the owners of ZombieRunner.com will be there too helping with foot care. With the recent heat wave, it is expected to be hot—with predictions of 122F. The pavement can be even hotter!
     So how will extreme heat affect the runner’s feet? For some, their shoes may come apart. Some will pour water over themselves in an effort to cool off, and the water will run down into their shoes—in many cases causing blisters to form. Some will blister from the distance, from wearing shoes that become too tight when their feet swell, from the rubbing of the socks or the shoes on their feet, from friction, and from heat.
     We will tape feet, apply blister patches, lubricant or powder, file toenails, file calluses, modify shoes to eliminate hot spots and friction, and more. Our arsenal of gear includes Micropore tape, Kinesio tape, self-adhering wrap, tincture of benzoin, alcohol wipes, Body Glide, Hydropel, Gurney Goo, Zeasorb powder, lots of Spenco products (2nd Skin, Blister Pads, QuikStik Pads), 2×2 gauze, scalpels and needles, gloves, nail drills, nail files, callus files, several types of scissors, tweezers, Engo Patches, antimicrobial wipes, and a few other items.
     When I get back next weekend, I will give a report on the challenges we faced, and what worked and what didn’t work. These are extreme conditions for feet and it will take a lot to keep them happy. We’ll do our best.

Lubricant or Foot Powder?

September 24, 2005 by · Leave a Comment
Filed under: Footcare, Footwear, Health, Sports 

Many athletes have been raised on the common belief that one of the best ways to prevent blisters is to use a lubricant. The use of a lubricant has been proven to reduce friction which causes hot spots, blisters, and after prolonged friction, calluses.
     Vaseline has been used for years but is no longer the best choice. It’s greasy, can cake up on socks, and tends to attract grit particles that can become an irritant and themselves cause blisters. Better choices are newer products like BodyGlide, Bag Balm, Blistershield Roll-on, and SportsSlick. Many of these are petroleum-free, waterproof, non-sticky, and hypoallergenic.
     For athletes in conditions where their feet are exposed to extended periods of moisture, there are several lubricants that are better than any others. Hydropel and Friction Zone are advanced skin protectants. These are water and sweat-resistant.
     Use a lubricant where you need it—between the toes, on the balls of the feet, or on the heels. If you have a history of blisters, you’ll know where it should be applied.
     Some people, however, use a lubricant and still have problems. If this is you, a good idea is to try using a powder. Lubricants will soften the skin and for some, this makes the feet more sensitive to the stresses of walking, running, hiking, etc. In some cases, you might even feel the weave of the socks as an irritant. The softened skin can lead to painful feet, and in some cases, even blisters.
     There are some great powders to try. Zeasorb and Odor-Eater’s Foot Powder are both great super-absorbent and will not cake up. Gold Bond is also a high-quality powder. A unique powder is Blistershield’s Miracle Powder. Its super slick compound reduces friction better than any other powder while repelling moisture.
     There are several tricks to using either a lubricant or powder. They need to be reapplied if your event lasts more then several hours, or if you go through a lot of water or a lot of dirt or sand. Clean off the old coating before applying the new one. Shake the powder into your socks and then shake the socks to distribute the powder. If you are prone to athlete’s foot, use an anti-fungal powder or lubricant.
     Lubricants and powders are valuable tools in the war against blisters. Try one and if problems persist, try the other. They’ll keep your feet happy.