Lisa de Speville, who lives in Johannesburg, South Africa, is a close friend who often emails with insights on blisters and foot care. Yesterday I received the following email and asked whether I could share it with my readers. Her email contains insights on little toe blisters, issues with minimalist shoes, and fit of shoes modified with gaiters.
Here’s her email.
Last week I ran in the 5th edition of the Namib Desert Challenge. I had the pleasure of running in their inaugural event back in 2009 and so it really was a treat to return. Great event, well-organized, wonderful region of Namibia and a lovely warmth and hospitality from the organizers.
Since about June last year I’ve been running in more minimalist shoes. I’ve always enjoyed a softer, more tactile shoe and I took to the pair of Asics Gel Fuji Racers that I won at a race immediately. I liked them so much that I was even running them on road. I like to keep trail shoes for trail and road shoes for road so in about August I bought a pair of Inov-8s. The brand is relatively new in SA so I thought I’d give them a try (my road shoes have been Addias Response or Supernova for more than 10 years). Let’s see… I’m in the Men’s Road X 255 (6mm lift), which is not flat as a pancake. Both the Asics and Inov-8 are quite roomy and my feet enjoy this.
Certainly over the past three months I’ve felt a change in my soles – more firm and muscular, which stands to reason if they’re strengthening and working harder. It is muscle after all. Before I started adventure racing and running ultras my feet were 1.5 shoe sizes smaller and I have a feeling that my feet are another half-size bigger in recent months.
So, the time comes for the Namib Desert Challenge and I get my favorite race shoes stitched with Velcro for my desert gaiters. Everything is ready. I hadn’t worn these shoes for a while. They were still relatively new – perfect for going into a multi-day race – as I’d bought two pairs of the same at an end-of-range special many months ago. I’d flattened the first pair so they were in no condition for this race.
When I put my foot into the shoes in the days before the race to get a feel for them again they felt a little tight, especially across the width of my forefoot. And more than just newness. This is why I figure my feet are a certainly a half-size bigger. Nothing that some lace-loosening wouldn’t sort out.
I started to develop what I call ‘triangle toes’ almost immediately. This is the one thing I avoid like the plague because I hate having sore little piggies. Triangle toes is where the underside of the little toe – and sometimes the neighbor next door – becomes pointed. A blister forms here and can result in a ‘toe sock’ – where the skin of the whole toe comes off, almost like a sock. It’s nasty and I not very fondly recall some incidents of almost toe sock about 10 years ago in adventure races. Since then I take special care pre-race to make sure my little toes stay ’rounded’ and that any harder, potentially triangular skin, is filed off regularly.
I dealt with the resulting blisters – stage 2 or 3 they came up on both little toes – by draining, leaving overnight to dry and then added some tape for the stages. I tried to flatten the triangle under the tape, but it ended up triangular again at the end of the stage. For the most part they gave me little trouble.
At the start of the 55km ultra stage on Day 4, I was debating whether to remove the inner soles for give my feet more room so that the little toes would have more width. It felt odd so I started with them in and my laces not too tight. By the first waterpoint I needed to change something so I took out my innersoles. I had to re-tape a toe a little way further because the change in space altered something. After this, no problem.
I’ve never run in shoes without innersoles and it really changes the feel of the shoe. The Adidas Response TR shoes really suit my feet – I’ve been running in them for 13 years! Taking out the innersole changes them to the Inov-8 feel. Flat and bland inside, which isn’t a bad thing – just different. It also makes the sole feel so much more flat and less cushioned – I felt like I was running in a non-cushioned shoe… for 47km!
Fortunately I was none the worse for wear but, for sure, if my feet hadn’t been conditioned from 10 months of running in ‘flat’ shoes my feet would have felt it. I ran the 5th and final stage without the innersoles too.
Aside from the triangle toes, my only other foot ailments included an injured big toenail on my left (not sure why? perhaps from a kicked stone?). The toenail developed a blister underneath, which was easily solved by drilling into the nail to relieve the pressure. I only discovered this one after the second stage when inspecting my feet. The other blister came up on the long stage under the ‘joint’ of my left big toe, where it connects to the foot. I have some scar tissue there from when I sliced my toe open many, many years ago. It occasionally twinges and at this race, on the long day, I caught exactly this spot so many times on rocks – prodding in. I couldn’t have purposefully aimed as many times in that exact spot! Again, not a bother (fortunately!) and easily solved by draining. On the final stage I didn’t hit it once and so it didn’t flare up again. For the rest, beautiful feet after 230km.
As I haven’t had triangle toes for years, this confirmed for me that width-ways just-that-little-too-tight squeezing of the forefoot is almost guaranteed to cause triangle toes and the resulting underside blisters, with the potential for toe sock, somewhere you do not want to go. In fitting shoes we tend to focus on the amount of space at the front of the shoe but definitely need to pay attention to left-right wiggle room.
Finally… one of the runners had really badly injured toenails (most of them) and the tops of his toes. The reason… too small desert gaiters for his shoes! I don’t know what kind they were (not mine) but they were Velcro attached (around the shoe) and pulling at the top and front of his shoe and causing toe injury. Live and learn.
Lisa de Speville
Johannesburg, South Africa
Adventure Racing: www.ar.co.za
Last week I wrote about prevention and being proactive. I emphasized that you are the key to prevention. I want to share an email I received from a friend that is a great example of this in action. Lisa told me about her friend and gave me permission to share the story:
My friend ran a 50km x 2 (100km total, over two days) race a few weeks ago. Over the past six months he has put a lot of work into his running training and has been running beautifully.
I was away so when I got back I dropped him a text to see how his race went. He told me what happened and in the conversation said that he would be losing many of his toenails. I ask why and he said he forgot to cut his toenails.
As you can imagine I didn’t reply to this at all because I would have thrown some insulting words his way.
He has been trail running for more than a decade and been doing adventure racing for over a decade. He spent a fairly sizable amount on his race entry and it must be about 900km to travel to the race. He put in six months of training to get stronger and faster. And he forgot to trim his toenails! This is more than elementary and is totally stupid. It’s tough to have sympathy (I have none!) when friends do silly things like this. He knows better.
This story speaks for itself. I have often talked about how athletes spend a lot of time and money in preparation for an event but fail to plan for good foot care. More times than I care to remember, I have seen athletes quit a race or be pulled from a race because of feet gone bad. It doesn’t have to be that way.
I’ll say it again, you are the key to prevention.