Moisture on Your Feet – Moist, Very Wet or Very Dry

September 22, 2013 by · 1 Comment
Filed under: blister care, Foot Care, Health, Sports, Travel 

Back in May I posted an article about Training With Wet Feet. My being invited to work on the medical team at the Jungle Marathons in Vietnam and the Amazon prompted the article. While the Vietnam race had to be cancelled, the Amazon race is happening – in a bit over two weeks.

As I wrote in that article, it was long felt the best way to manage your feet was to keep them as dry as possible. This was more and more evident as Denise Jones and I worked the Badwater Ultramarathon in the heat of Death Valley each July. Runners who kept their feet dry typically finished better than those who had wet feet. This was also based on our experiences at Western States and other events.

Then came the invite to help at the Jungle Marathons.

The Jungle Marathons are run by Race Director Shirley Thompson and the Medical Team Manager is Vicky Kypta. They found their runners had a better race when they trained with wet feet. As part of their instructions to their race participants, they stress the importance of training with wet feet.

The reason for this is the Jungle Marathons are wet. Very wet is typical in the jungle. Whether through rivers or streams, the Amazon is full of water.

When I am helping runners at the race in early October, I will be closely monitoring the condition of their feet. I expect runners will use lubricants and other products to control the moisture, or powder, socks, well-draining shoes, and maybe a few home-grown tricks.

Over the past few months, I have shared some of the findings by Rebecca Rushton, a podiatrist from Australia. In her Blister Prevention Report, she talks about managing moisture control. She supports her report with studies from medical and other professional journals. What she found through the studies is that you could reduce the incidence of blisters by keeping the skin either very dry or very wet.

Rebecca writes that, “… the very high or very low skin moisture strategies aim to reduce the coefficient of friction value between the sock and the skin to below blister-causing levels.”

The Coefficient of Friction

The coefficient of friction (COF) is the number that represents the slipperiness or stickiness between two surfaces. According to studies, this number is generally below 1.0. Inside the shoe, the COF between the foot’s skin, and the sock and insole can range from 0.5 and 0.9. Compare this to the COF between a sock and a polished floor – about 0.2.

In Rushton’s report, she illustrates this with an example of a runner whose feet sweat a lot. His socks become damp, creating a moist condition. The COF in this case might be 0.7. By moving away from a moist condition to either very dry or very wet, the runner might reduce the COF to 0.5. If the runner’s blister-causing threshold is 0.6, getting to 0.5 will reduce his chances of blistering. Reducing the COF between your skin and socks/insole combination is important to having healthy feet.

Moist Skin

Moist skin produces higher friction than very dry or very wet skin. Whether skin is dry and becomes moist through sweat or through a water moisture source, or is very wet and becomes moist through heat or simply drying out, when it hits this middle stage, it becomes more susceptible to blistering.

Very Dry Skin

Drying the skin can be done with powders, antiperspirants or other drying agents, used by themselves or in conjunction with moisture control socks. Keeping the skin very dry is tough because our feet sweat naturally. Humid or hot conditions can also make it hard to keep the skin dry. Dumping water over your head to cool yourself can result in water running down your legs into your shoes – defeating your efforts to keep your feet dry. Airing your feet with shoes and socks off can help. If you use powders, make sure it is high quality and does not cake, which can be an irritant. When counting on any of these methods to keep your skin dry, you mush also have shoes that allow moisture to escape. That may include shoes with mesh uppers and drain holes in the arches and heels.

Very Wet Skin

Increasing skin moisture leads to very wet, lubricated skin that reduces the skin’s coefficient of friction. This can be through the use of a lubricant and or by simply having wet feet. The thing to remember is that over time, 1-3 hours, friction will increase as the lubricant is absorbed into the socks – so ongoing application is required.

Amazon Wet Foot

Amazon Wet Foot

Remember too what happens to your skin when you spend too much time in the water. It becomes weaker and less able to resist trauma on wrinkly skin. In extreme cases, the skin can fold over on itself and split. Severe maceration can be painful and athletes say it feel like a giant blister on the bottom of their feet.

In the Amazon Jungle Marathon, the trick will be to dry the feet at the end of each day’s stage. Because the feet will be wet during much of each day’s stage, the runners will have to find the balance between very dry and very wet, avoiding moist as much as possible.

Here’s some advice from my previous post about training with wet feet.

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.

Rest assured that I will write about how everyone’s feet held up in the wet Amazon jungle.

Credit is due to Rebecca Rushton for her Blister Prevention Report. Her website is Blister Prevention. Check out her website and sign up for her newsletter and free reports.

Here is the link to the Jungle Marathon Amazon.

If you want to read more, check out this article I did in November 2012 about Stuart Crispin who completed the race in Vibram FiveFingers.

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 Great Vibram FiveFingers Review

November 25, 2012 by · Leave a Comment
Filed under: blister care, Foot Care, Footwear, Sports, Travel 

Last week I read a report over at BirthdayShoes.com about a guy who completed the Jungle Marathon in the Amazon in Vibram FiveFingers. I was fascinated by what I read and contacted the race director who made the connection. Stuart Crispin sent me the article he submitted to Vibram.

“I recently completed the 2012 Jungle Marathon in Brazil, and in doing became the first person ever to take part in and finish this grueling event wearing a pair of Vibram FiveFingers (VFFs). With the help of a pair of VFF Spyridons men’s 43 I even managed to finish the worlds toughest endurance race, as listed by CNN, in 5th place overall. I did not wear toe socks at any time during the race. [Stuart's overall time was 47 hours, 43 minutes.]

Stuart Crispin at the Jungle Marathon

Stuart Crispin at the Jungle Marathon

 The race is a six-stage, seven-day self-supported foot race. Runners have to carry all of their food, clothing, hammock, sleeping bag/liner, medical kit and other mandatory kit, as well as 2.5 litres of water (picked up at every checkpoint). My rucksack at the start of day one weighed about 12.5kg. The longest stage on day five is a non-stop 108.5 km ultramarathon. The total seven-day distance covered was over 255km across swamps, dense jungle, mangroves, sandy beach, creeks, rivers and dirt roads. (Details at junglemarathon.com).

Before flying out to take part, I wrote to the race director who advised me not to wear VFFs suggesting they might not offer enough support for such a long distance race. I also emailed a previous competitor, who is also a physiotherapist for her advice on wearing VFF. Her response was ‘… FiveFingers will be a disaster… they will not offer your feet the support they need… they are not designed for such long distance running… and they won’t have enough grip to help you stay upright on the seriously wet and muddy terrain, particularly on the severe ascents and descents.’

Despite this advice I opted to go with my Spyridons. Thanks to the clever Kevlar lining in the sole I had every confidence they would give my feet enough support to avoid injury to the sole of my foot while running through the dense jungle, where the floor was covered in sharp spiky objects as well as spiky stinging insects like scorpions. I felt no impact at all underfoot and the Spyridons’ grip was more than adequate to cope with the muddy terrain. A week before going to Brazil for the race I wore my Spyridons to hike up Snowdon, the UK’s third highest mountain. They were great for that too, although while walking across large, wet slightly tilted rocks and boulders I could feel my feet slip slightly, but I think that may have happened in walking boots also. The hike up to the summit left me in no doubt that my Spyridons were the right choice for the Jungle Marathon.

The tough material used for the upper is still in exactly the same condition it was before the 255km race. There are no tears or cuts at all to the upper of both shoes, and the soles too are also damage free. The only minor sign of wear and tear is a very small section of the material on the outside of one of the big toe pockets, where it has very slightly come away from the sole. But in order to see it you have to look closely and after such a long way in some seriously aggressive and tough terrain, including deep bogs and swamps I think that is extremely impressive and shows how robust the Spyridons are.

I did have a concern about using the Velcro strap version as I wondered how it would hold up in the swamps and bogs. Some of the bogs were up to 1km long and over knee deep with mud. My concern was whether the strap would stay secure and tight when pulling my leg up out of the mud, as I did not fancy losing a shoe. However, the VFFs are designed to fit snugly to the foot so although on a couple of occasions the strap came undone the shoe remained firmly in place on my feet. But this did not happen during every swamp or bog, and there were many.

Every single day of the race I had several other competitors asking me about my choice of footwear, often questioning whether I would be able to finish the race. My reply was the same every day, that they were extremely comfortable and I felt no pain or any objects under foot at all. They looked amazed but also looked very impressed. Many of them said they were going to try using VFFs after the event. Perhaps even more impressive than the toughness of the shoe, is the comfortableness of the Spyridons for running and hiking. After running 255km I did not have a single blister on either of my feet, and that is dispite starting and finishing every day with wet soggy feet. The only sores I had on my feet were between a couple of my toes caused by sand getting between them during the 108.5km long stage. I had already run several miles on sand during the previous four stages without any problems with the sand at all. During the long stage I think it only happened due to having had wet feet since 4.30am at the very start of the stage when we started with a river crossing, and by the time I ran on sand I had been running with wet feet in 35 degree heat in almost 100% humidity for over 12 hours. Perhaps if I had put on a pair of toe socks I may have been able to prevent the sores at all but as they were only minor I opted to just carry on to the finish.

The race director, who advised against wearing VFF, saw me on day four at the first checkpoint and said she couldn’t believe I was still going wearing them, and going so well. She said every day she expected me to pull out with trashed feet and after the race told me how seriously impressed she was with me for finishing in 5th place and wearing VFFs for the entire race.

I had reservations myself about wearing VFFs and I don’t think my Bikilas, KSO’s or Classics FiveFingers would have been up to the task. But thanks to the Spyridons trail running qualities I was able to wear them. In my opinion the Spyridons are the most comfortable running shoe I have ever worn. I have run over 20 marathons on both road and off road, and several ultramarathons including multi-day events in the Sahara, the Atacama in Chile, the Himalayas and Scottish highlands, as well as 100km and 100 mile non-stop races. I have worn several different brands of running shoes, some of which have left me with horrendous blisters. Some have been ok when it comes to blisters, but even if I finished blister free I always felt ‘hot spots’ which is the start of a blister. I have never worn a running shoe that has left me with zero blisters and zero hotspots.

I would have no hesitation at all in recommending VFF to other runners and for trail/off road running at the moment in my mind there is no better option than the Spyridons.

I will definitely be using Spyridons for my future off road running and will continue to recommend them to other runners who always approach me at races and while I’m out training, asking about them and how they feel.

I would be happy for you to use this review if you wish, as I would like other people to know about my experience of using VFFs. I searched the web before the race looking for other reviews or advice on using VFFs in such extreme environments but the information out there was limited. No one has ever worn Fivefingers in such an event and I would be happy to share my experiences with others. I am also a qualified personal trainer, as well as a London based firefighter, and will recommend the sensible and safe use of VFFs to some of my clients where suitable.

Stuart Crispin
London

I asked Stuart a few questions and here is what he wrote back, “The Jungle Marathon was my first multi-day race wearing Vibrams. Before that I ran the London Marathon in VFF Bakilas but since I hadn’t run further than 12 miles in them before the marathon the jump in distance was rather silly and I did get some minor pain in my left foot. But I didn’t get a single blister or hot spot and like in the jungle I ran with no socks. My longest run before the Jungle was 14 miles off road and I ran with wet feet and again had no blisters. I have run several multi-stage ultras and marathons and only the VFFs left me with no blisters. I know they probably won’t work for everyone but I won’t run in trainers ever again. Before wearing VFFs I used Injinji toe socks and they definitely helped reduce the amount and severity of blisters I got from running than when I wore normal socks (including two socks).”

Thank you Stuart for this great report and congratulations on your finish.

If you are interested in learning more about the Jungle Marathons, the links are below. Shirley Thompson, the race director, puts on challenging races, well run with a great safety record, and a professional staff. It is my hope to be at both these events next year.

The Jungle Marathon – Amazon (2013 October)
The Jungle Marathon – Vietnam (2013 June)

In October 2010 I wrote a blog post about a runner at the six-day ThanksRockies who wore FiveFingers for the 115 mile race. If you want to check out the link, here’s the post: Vibram FiveFingers at the Gore-Tex TransRockies.

 

Training for Blisters in Wet Conditions

September 15, 2012 by · 2 Comments
Filed under: blister care, Foot Care, Health, Travel 

I have worked a lot of events. Every one has its one set of conditions that stresses the participants’ feet. Sometimes, it’s the dry heat of Death Valley or the rainy British Columbia coast, or the ups and downs on the trails of the many trail hundreds.

For years, the norm has been to avoid getting your feet wet. Wet feet often mean skin that is soft and can become 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.

And then there’s the Jungle Marathon.

The Jungle Marathon is held in the Amazon Rain Forest of Brazil. This year’s race is held over October 4 to 13.The race is in the stunning State of Para – often referred to as the Caribbean of the Amazon. Competitors have the choice of two distances: 240km or 100km, which will be completed in stages throughout the week. The longer distance will include six stages and the shorter will include four. Imagine running through the jungle with stream crossings, wet foliage, wet trails, mud, and extremely humid conditions. Your feet are always wet.

At the Jungle Marathon runners have to be self-sufficient, carrying their food and provisions during the race. They are provided bottled water at designated checkpoints. Nights are spent sleeping in hammocks at campsites along the shores of the river.

Shirley Thompson is the race director and she stresses, “Our medical team has many years experience in remote locations. Your safety and well-being is our prime concern and we employ only the most experienced personnel to assist us.”

Shirley 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. We also tell them to buy your book and try to find a strategy that works for them. As far as footwear is concerned, we always emphasize trail shoes with good grip, and that comfort is the main factor.

I personally spend quite a bit of time in the jungle preparing the trail and doing a trial run of the course, and I always use the same strategy, which I found years ago in your book. I spray on two coats of New Skin Liquid Bandage, then wear SealSkinz hi-tops, with a thin lining sock. I have never had a blister.”

Vicky Kypta instructs new medics who join the team on foot care and she gives clinics for competitors in the United Kingdom on foot care and preparation for the race. I emailed her and asked about their strategy for managing runner’s feet. Here is her response.

River crossing

River crossing

“Feet are soaked from the start of each stage, so in the end it made more sense to get people used to their feet being always wet. We found runners had less problems during the race when they had trained with wet feet. There was a lot of hideous feet in the first couple of years of the event before we adopted this strategy.

As far as blister prevention is concerned, we encourage all runners to find a shoe/sock combination that works for them and to train in them including getting them wet. During the race, the runners are told to stop and deal with any hot spots as soon as they start which includes not waiting to get to a checkpoint. It is amazing how just stopping for 20 minutes to deal with feet saves so much time and pain later in the race.

Some runners have their own preferences on how to treat blisters and if they do then we follow their instructions otherwise we tend to drain non-blood filled blisters. On those hardy enough we the inject compound tincture of benzoin to help seal the space created by the blister, to serve as a local antiseptic, and to prevent further abrasion or loss of skin. However, due to the intense burning sensation experienced for a few moments after injection not all runners want this method used – so for all others we drain the blister and then use the benzoin over the top to provide a tacky surface to help the tape stick. Over the top of the blister we then apply a layer of fleecy web and tape over that using zinc oxide tape.

Over toes we just use tape without the fleecy web as otherwise it becomes too bulky resulting in the runner being unable to put their shoe on.

Some runners like to use Compeed on their blisters and whilst they are very good at protecting the blister we have found through experience that with an ultra event such as the Jungle Marathon, they are very difficult to remove should there be any further problems with the blister later on during the race and more damage is often caused in attempting to remove them so we therefore don’t encourage their use.

Jungle Marathon foot care

Jungle Marathon foot care

Over the years we have been very fortunate and have had very few macerated feet as at the end of each stage we get the runners to remove all the tape and to thoroughly dry out their feet. Blisters and problem feet are then freshly taped later that evening or the next morning ready for the next stage.

Despite the incredible punishment the runners feet endure during the Jungle Marathon, year after year we have very few cases of macerated or infected feet which I believe stems from early and effective treatment of problems as they arise.”

Vicky holds foot care clinics including medical care prior to the races to help provide the runners with increased knowledge to enable them to treat themselves more effectively which will hopefully reduce the amount of foot problems even further.

The Jungle Marathon helps their runners successfully complete the race because of their unique approach to foot care. Here are my observations:

  1. They encourage participants to train with wet feet
  2. They even suggest soaking your shoes and socks before heading out for a training run
  3. They give specific advice that runners find the best shoe and sock combination for their feet when wet
  4. After each day’s stage, they have runners remove their tape, which allows the skin to dry out – re-taping afterwards

This combination of advice and attention of the runners keeping their feet healthy for the multiple stages of the race works well. I commend Shirley and Vicky and the Jungle Marathon for their success with foot care.

I encourage you to check out their website and Facebook page. If you are looking for a stage race with adventure, this is a well-organized event.

Here’s the link to the Jungle Marathon’s website.

Here’s the link to the Jungle Marathon Facebook page.