In less than two weeks is the running of the Western States 100-Mile Endurance Run. I will be at the 55.7-mile Michigan Bluff aid station, along with Tonya Olson and others on the medical team. Our aim is to make sure you are healthy to continue on towards Placer High School and a good finish.
For the past six years, the mountains have been dry and the trails dusty. Feet get caked with dirt. Blisters are caused by the dust and dirt as an irritant inside shoes and socks.
2011 was the last snow year. I have looked a bit online and am unclear on snow conditions this year. But this much I am certain, there will be snow and feet will be wet. How much snow remains to be seen.
I am 100% certain that runners will have long sections of wet trail, either from the snow, snow run off, water on the trail, and stream crossings. That equals miles of running with wet feet. I’m also 100% certain that we’ll have lots of wet feet, blisters, and maceration. In fact maceration could easily be a bigger problem than blisters. Don’t forget to avoid pouring water over your head where it will run down your legs into your shoes, contributing to maceration. Lean forward rather then standing straight up.
A blister can be lanced and taped, and runners can continue without to many issues. Maceration is a different story. Once your feet are macerated – the skin shriveled like a prune, there is no quick fix.
With prolonged exposure, the skin on your feet goes through four stages as the maceration progresses to severe cracks and tears in the skin—that can be race ending. As the skin on your feet moves through the four stages, the skin folds over on itself and can crack or tear. This can be painful. Many runners come into aid stations complaining of bad blisters only to be told they don’t have any – it’s severe maceration.
I expanded the section on maceration in the 6th edition of Fixing Your Feet. Starting on page 188, are 12 pages with sections about Cold and Wet, Maceration, Trench Foot and Chilblains, Frostbite, and Snow and Ice. Included are tips and products to help with those conditions. If you have a copy, read the sections – and have you crew read them also. On page 101 is a section on High-Technology Oversocks like SealSkinz and Hanz, Serius, and eZeefit waterproof type socks. Another sock worth mentioning is ArmaSkin socks, which is used as a sock liner and fits tightly against your feet. They would be my choice for a wet race. I’d also wear gaiters to keep snow, dirt, and grit out of my shoes.
As far as skin preparation, here’s what I would do – expecting wet feet. My drop bags would have clean socks, small containers or baggies with powder to help dry wet skin, and container or tubes of any of the following: RunGoo, Trail Toes, Desitin Maximum Strength Original Paste, Boudreaux’s Butt Paste, or a strong zinc oxide paste. I’d also carry some in my hydration pack. I would apply a liberal coating of one of these from toes to up the heels and then roll my socks on. Rolling socks on will help prevent smearing and thinning the paste on areas of the feet.
Since proactive care is better than reactive, I’d check my feet at most aid stations, adding paste as necessary. If my feet were feeling bad at an aid station, I’d apply some powder to help dry the skin, and have some food while letting the powder do its job. Then apply more paste and clean socks. If your feet are badly macerated, it will take drying them, coating them with powder, and rubbing it in and letting it sit for a while, then stripping off the powder and adding more of your choice of paste. That may easily mean 15 minutes or more. If you don’t take care of macerated feet, they’ll get worse over time, requiring more care and longer time – and there may come a point when it’s irreversible in the time you have.
The time you take in aid stations does add up and it can quickly erase any time cushion you may have to finish within an allotted time. But skip quality care, rush too fast, ship hydration or eating, and you’ll pay the cost.
Remember your first line of defense should be your crew. They should know what you want for foot care and how to do it correctly. There aren’t enough medical people to take care of everyone’s feet and we may be busy with others, adding more time to your aid station visit.
Yes, as I said earlier, I will be at Michigan Bluff and Tonya and I will do our best to help you. But heed my warning. We cannot work miracles when you have failed to take care of your feet from the start. In the same way we cannot take away the pain and problems with black toenails and toe blisters caused by your not trimming your toenails, we cannot repair badly macerated feet when you have not tried steps to control the maceration.
I ran Western States in the late 80s and one thing I learned is the outcome of the race in your hands. Whether is your training, conditioning, choice of footwear, choices of food, what’s in your head, your choice of crew – lots of things affect your race. I encourage you to take the time necessary to care for your feet.