Several years ago I met Gregg at Badwater in Death Valley. We were in line to check in at Furnace Creek and I heard the last name. It was the same as an aunt of mine. Turns out we are related.
At Badwater he ran well and finished near the top. Later that year, he and his wife moved to Asia and I had not heard from him – until the other day. He sent an email about running the Spartathlon in Greece. It’s a 246-kilometer (153 mile) race between Athens and Sparta. The Spartathlon aims to trace the footsteps of Pheidippides, an Athenian messenger sent to Sparta in 490 BC to seek help against the Persians in the Battle of Marathon. Here’s his email:
I just finished running Spartathlon. It was nearly as hot as Badwater (100.4), ok maybe not as hot as Badwater, but it was far to hot for this race, considering it is normally 86. The race by the way is fantastic; I would highly recommend that you make a trip out there if you get the chance.
So, I took a photo of my feet after the race and thought you might like the photo, being that you are the foot guy. Might make for a good example. The blister appeared to start from underneath the pad of my foot by my big toe. The pressure built up so much that it formed the blister on top of my foot as well – as you can see from the photo. Pretty cool if you ask me. I probably ran with it for 50 miles, since I didn’t change my shoes and didn’t feel like taking them off. They lanced it when I finished… as I was receiving two bags of IV fluid. Haven’t had any problems with it since, although it has taken a few days for the pressure under my foot to slowly recede.
As you can see in the photo, there is blood in the blister. Here’s where you have to be careful and take precautions to prevent infection. I don’t encourage people to lance these on their own, but in aid stations with the right equipment and knowledge, it can be done. When I do it, I always give the athlete the warning signs of infection: redness, warm to the touch, pain, fever, pus, and swelling. If you have a blood blister, be careful.
Really though, Gregg’s feet look pretty good for just having run 153 miles. Don’t you agree?
I have written a lot about patching blisters. Many of these patch jobs are what I would call routine. But every so often I get to try something new. Today’s post is about one of those times.
At the TransRockies six-day stage race this past August, a runner came in with a blister in the crease of skin at the base of the big toe.
The photos show my patch job from two angles. After draining the blister and prepping the skin, I started with a two-inch strip of Kinesio Tex tape. I cut the tape so the finished piece was about three inches in length. I rounded each end and made it a small oval on one end with a larger oval at the other end. The tape was applied over a dab of zinc oxide. I applied the tape at the base of the toe to start and then slightly stretched each end of the tape – the small oval end going up and between the big and first toe, and the larger oval side going around the outside of the big toe. The two ends did not touch on top of the toe.
The beauty of this tape job is that the Kinesio Tex tape is soft and easily forms to the curves of the toe. Another plus is that it will not bunch up in the crease of the toe. Try this with another tape, Leukotape, duct tape, Elastikon, or white athletic tape, and you’ll see how those tapes do not form to the curves of the foot and will have creases and folds in the tape.
This tape patch can be done to any toe and any other part of the foot. With care in the skin prep phase, and putting sock on and taking them off, it will stay on for several days. Be sure to rub the tape for 20 to 30 seconds so its adhesive can bond with the skin.
Kinesio Tex tape is available at Zombierunner.com.
Quite some time ago I wrote about the “Little Toe Triangle.” Working recently at Badwater, I was reminded again about this little appendage. A runner had completed the grueling 135-mile Badwater race through Death Valley and had come into the medical room for foot care.
He really had pretty good feet. With on exception – his little toe on his right foot. A callus on the bottom of the toe had evolved into a substantial blister that had ruptured. The skin was movable from the bottom of the blister all along the inside of the toe to near the top, where the blister ended. There was no quick fix. The image here is not this runner’s toe, but very similar.
Removing the skin was not an option. I pulled the skin into place, added a dab of antibiotic ointment, and wrapped it with Coban self-adhering wrap.
Unfortunately, this runner was planning on running a 100-mile race this weekend. He and I talked about his options and I gave suggestion on how to manage the skin. I would doubt his ability to finish a 100 miler with this severely blistered pinky toe.
The number of problems with these little appendages has impressed me. “What problems?” you might ask. It’s all about that little triangle of skin where most problems occur.
If you look at your little toes, your toes may be well rounded and soft. Or they may have the often-typical triangle look where the skin on the bottom of the triangle is hard and callused. The skin on the bottom of the toe forms the point of the triangle. The problem is that on many of our little toes, this bottom point is hard and callused skin. The hard skin is prone to blisters forming underneath as pressure creates friction. Often this hardened skin is partially under the skin of the next toe, another pressure area. The outside of the foot, the little toe area, is often more wet and damp than the inside of the shoes, leading to macerated skin. Once softened, this skin can easily blister underneath, or worse yet, the skin can separate, leading to major skin problems.
One of the best ways to tame the callus on the bottom of the little toe is the Heel Smoother Pro. I reviewed this great tool last November. It comes with two tips. The smaller one is shaped like a little Christmas tree. The curved sides are perfect for toes. This is the best callus tool I have ever seen.
The little toe is so small that it is hard to patch well. The use of Micropore or Kinesio tape is a good choice. Even better, in my opinion, is reducing the hard callused skin. Injinji toe socks can also be helpful. Good shoes are vital too. Shoes with a good toebox that allows the toes room to wiggle are good. Once the skin has blistered, 2nd Skin is good to use as a patch. Cut it to fit the blister. Too much and it becomes bulky and rubs on the neighboring toe.
During a race or hike, be watchful of your little toes. This small but potentially troublesome triangle of skin deserves special care.