Filed under: blister care, Foot Care, Foot Care Products, Footcare, Health
After years without an expedition length adventure race in northern California, the Primal Quest Adventure Race returned this past August. Even though there were openings for 20 four-person teams, only 11 teams toed the starting line in South Lake Tahoe.
For those unfamiliar with adventure racing, races generally consist of a mix of disciplines: trekking, mountain biking, orienteering, white waters, rafting, kayaking, and ascending and rappelling. Some events have caving and other exotic disciplines.
This year’s race stated with a downhill run to kayaks on the shore of Lake Tahoe, after which they paddled north, and then took off on mountain bikes for a long ride. Unfortunately, much of the 80+ miles turned into a hike-a-bike. Then at Kirkwood, they took off on foot for a long trek / orienteering section. For some teams, this section took hours longer then expected.
I was at TA3 (transition area) and we expected the first team early Friday morning, but in fact they arrived almost 24 hours behind schedule. The rest of the teams were spacer further and further apart as time progressed.
My point is that many of the racers had been on their feet for more than two and three days by the time they reached us. Then teams went back on their bikes, into kayaks, and into another long trek. Some teams were short-coursed – taken ahead on the course
Fast forward to TA6, a day and a half later and teams are still racing. Some of the racer who have done the full course to this point have had little time to rest and their feet are extremely sore to the point of being very painful. They may also have some degree of maceration going on too.
One such racer, Thomas, asked me to look at his feet. There were no blisters on the balls of his feet, just very soft and tender skin – very sore with some maceration. I told him I could help.
I cleaned his feet and allowed them to air dry. I applied Tincture of Benzoin Compound to the skin from mid-foot upwards to the base of the toes. Over this I place a piece of soft, 1/8 inch thick Hapla Fleecy Web (adhesive felt), cut to follow the shape of foot at the base of the toes, square at the bottom, and curving up a bit on each side of the foot. At the base of the felt, mid-foot, I placed a strip of Leukotape to help hold down the bottom edge of the felt. Benzoin was used under the tape and edges were rounded. The last touch was two figure 8’s, cut from HypaFix cotton tape, placed between the 1st and 2nd toes and the 3rd and 4th toes, with the bottom of the 8 under the foot and the top of the 8 on top of the foot. This anchors the forward edge of the felt against the skin and keeps it from rolling, especially on downhills. Each figure 8 is about three to four inches in length and the tape is two inches in width.
I received a report later in the race that the patch job had held. After the race ended, Thomas let me know the patch had helped his race.
The adhesive felt helps pad the forefoot and provide cushioning to the sensitive tissues, and can help relieve pain and discomfort from maceration. This is not moleskin, or a version of moleskin. It’s a thicker product and much softer. The felt can be found in 1/8 and 1/4 inch thicknesses. In the Amazon we used fleecy web that is 1/8 inches thick. In the Amazon Jungle Marathon I used the patch job many times on macerated feet – after drying the skin as much as possible.
Medco Athletics sells adhesive felt in a variety if thickness and lengths. You can search on “adhesive felt” or for a specific product I have used, “Fleecy Web.” To give you an estimate on pricing, four Hapla Fleecy Web 9” x 16”, x 1/8 thick sheets sells at Medco for about $26.00. The Hapla Feecy Web is 100% cotton and is latex free.
It also works well for padding around blisters, bunions, heel bumps, and more. Because it is thicker than tape, I would use Benzoin to help it stick better and consider adding extra tape as I described above.
This weekend close to 400 runners will start at Squaw Valley and make the trek over the Sierras towards Auburn – 100 miles away. It’s the Western States 100 Mile Endurance Race. I love the race, having completed it three times in the late 80’s. It’s tough and throws a lot at the runners. Cold, heat, extreme heat, streams running down the trail, rocks, dust and grit, water crossings, long ups and long down through numerous canyons – and for many runners, a second sunrise with renewed heat.
I will again be working at the Michigan Bluff aid station doing foot care. Later, I will be at the finish line taking care of feet as people finish. Having worked this race for years, I have a good idea of what foot problems to expect. Here’s what I commonly see and a few tips.
First, here are common problems:
- Toe blisters. Under the toenail, on the tips of toes, between toes, and under toes.
- Heel blisters. Either at the rear of the heel or at the sides.
- Ball of the foot blisters. Either in a certain area or across the whole foot.
- Side of the foot blisters.
- Stubbed toes. From hitting rocks or roots.
- Sprained ankles.
- Sore feet.
Here are some tips:
- Cut toenails short and them file them smooth. No rough edges to catch on socks or hit the toebox of your shoes.
- Reduce your calluses as much as possible. This close to the race, don’t file too much off. Aim to get reduce the thickest rough patches.
- Use Engo Blister Prevention Patches in problem areas – sides of the heels and ball of the foot. They will greatly reduce friction and shear.
- Pretape any problem areas.
- Check your insoles for thick edges at the sides of the heel – always a problem area. Thin these down or change insoles. Most side of the heel blisters are caused by these edges.
- Don’t use Vaseline as a lubricant. Stick to SportSlick, BodyGlide, or a similar lube.
- Change socks frequently and clean your feet. Today’s trails shoes often have mesh uppers, which allow sand, dirt, and trail dust inside the shoe, on and into your socks, and on your feet.
- Know how to manage your feet and patch blisters on your own – or your crew should have these skills. You can’t count on aid station people knowing what you need or want or doing it on your time schedule. There may be other runners in front of you or they may be out of supplies.
- If you feel something inside your shoe, stop and clean it out. Even a small rock can cause problems.
- Wear gaiters to keep rocks and trail grit and dust out of the top of your shoes.
- Build your own quality foot care kit. Stock it with what you need and learn to use everything.
Maybe I’ll see you at Michigan Bluff. I hope it’s just to say Hi as you run through.
Have a great race.
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.
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.
Last week we were in Palm Desert and spent a day as spectators at the PGA Bob Hope Golf Classic. How does this relate to foot care? Read on.
Between one of the holes was a patch of sand where we had to walk to get to another green. As we walked across the sand, I must have picked up a few grains of sand. I didn’t notice it at first. We stood around, watching several rounds of golfers come through. Occasionally we moved back and forth between the 16th green to the tee box on the 17th hole – maybe 50 yards.
Then I felt an irritant in my right shoe. It was a small sharp pain under my heel. Not a big thing, but an irritant nonetheless. I ignored it but it made its presence know every time I walked. Finally I removed the shoe and found one small grain of sand. One grain!
Time after time, we find junk in our shoes and too often we ignore it. Over time, this junk, sand, dirt, a small stone, leaf, or piece of a branch, can cause trouble – for which you’ll pay. A hot spot, a blister, a tear in the sock, or a tear in the insole covering. Or, even worse, we alter our gait – and one thing leads to another – and our knee, hip, or back starts to hurt.
Maybe this seems like a no-brainer, but I have seen athletes suffer because of ignoring this advice. If you feel something in your shoe – stop and remove it. Your feet will be happier.
Last week I pulled my back
out and so have since grown accustomed to ice and pain medications. Visits to a
local chiropractor have been extremely helpful. In one visit he suggested a
heel pad to help my right to left lean. I immediately thought about Hapad.
Hapad is a great company
that I have not mentioned for a long time. They are highly respected as a
provider of pads for our feet. Here is one quote, “Among orthopaedic foot &
ankle specialists… ‘Hapad products are recognized as the most affordable and
most effective method for treating patients' painful,
Hapad products are
manufactured from only the highest quality materials. 100% natural wool felt
provides a comfortable correction. Hapad felt is resilient and long lasting…
yet very affordable. In fact, Hapad products are usually less expensive than
the flimsy foam insoles found in most drug stores. Since these products are
normally recommended by physicians, they are sometimes difficult to find in stores
so Hapad sells directly to you. The pads shown here are metatarsal pads. The pads have an adhesive patch to hold them in place.
Metatarsal, neuroma, tougue,
heel, arch and scaphoid pads; insoles, wedges, and more. These are great
products that I highly recommend. Hapad products are inexpensive and they are
comfortable in hot and cool weather. They can be used to cushion an area, provide padding and support, and can be used for injuries or normal wear.
Give them a call at 800-544-2723
or check them out at their website. Your feet will thank you.
Over the years I have seen many people complete marathons and ultramarathons – walking or running. Most do well, suffering the usual malady of blisters, toenails issues, and an occasional ankle sprain. There are some, however, who finish their events with feet they can hardly walk on. Complaints range from, “My foot feels like one big blister.” to “I can’t walk!”
These athletes usually have one thing in common. They have stressed their feet beyond what their feet are comfortable doing. There are several typical scenarios. The most common is they have simply done too much too soon. The second most common is that they have encountered conditions beyond what they were prepared for. Since all of us, even non-athletes, can learn from these experiences, allow me to explain.
Sudden increases in mileage put undo pressure on the bones, tendons, ligaments and muscles of the feet. If you typically walk 3 miles a day and then suddenly walk 10 miles, you can expect your feet to feel sore, hot, and painful. Increasing your running miles from a 10K (6.2 miles) to a half-marathon (13.1 miles) will result in similar complaints. The rule-of-thumb for runners has always been to increase weekly miles by no more that 10% a week. This is good advice for all of us.
Whenever we go for a walk or run, we might run into the unexpected. We step off a curb or roll our foot on a rock and turn an ankle. We hike on a trail and are not used to uphills and downhills, the tree roots and rocks, and the uneven terrain, and our legs, ankles, and feet become sore. It’s hot and we sweat more than normal, and this moisture leads to hot spots and blisters. We wear a new pair of socks, thinner than normal, and our feet move around inside the shoes, creating blisters. We wear a new pair of socks, thicker than normal, and the pressure inside the toebox leads to painful toenails.
Whatever our activity, we need “do the time.” We must put the time on our feet to get them ready and in shape to handle the stresses we will ask them to endure. If you have a vacation coming up, or a marathon, count backward on your calendar and block off time to get yourself ready—including your feet. Putting in the time on your feet will lead to happy feet.
Baby boomers are everywhere. About every eight seconds another baby boomer turns 50. In 1957 there were 4,300,00 new babies born, the highest yearly count in the boomer years from 1946 to 1964. I was born in 1947 when the number was 3,817,000. So what do many of the new baby boomers have in common? The answer is aging feet.
What do aging feet look like? Allow me to paint a word picture. Toes start to curl. Tendons start to tear. Arches start to fall, and the foot becomes longer and wider. Nails thicken and crumble as toenail fungus becomes commonplace. The skin hardens and more calluses develop. In some cases, toenails become longer and untrimmed because of the loss of flexibility to reach them. The fat pad on the bottom of the foot thins and the feet often have a more boney appearance.
As weight increases, even to the point of obesity, the pressures and stresses on the feet add to breakdown of joints, tendons and ligaments, and nerves. With obesity comes a greater risk of diabetes, the nation’s number one cause of amputated feet. Circulation is impaired and sores and skin breakdowns do not heal, become infected and develop into foot threatening ulcers.
The picture I painted is often not pretty. As you might expect, daily foot care is important to one’s well being. When caught early, problems can be treated before they become difficult or impossible to treat. Well fitting shoes are key to healthy feet. If you have persistent foot pain, see your doctor.
Whether this post applies to you, a parent, or some other loved one, take a moment out of your day to check your feet, or make sure they are.