Frequently Asked Questions (FAQs)
The frequently asked questions below are compiled from those I have been repeatedly asked. Most come from emails, but some are written based on questions asked at events. If you have a question that you don’t see here, please send me an email at firstname.lastname@example.org .
Blister Care Questions
Q: Blister Care for Stage Races – My wife and I are getting ready to run Desert RATS and I was wondering if you could give me the down and dirty on foot care for stage racing? My plan is that if I get a blister I will drain it and hose it down with NewSkin, then tape it up for the next day. Is that even close to being a workable strategy?
A: Stage racing foot care is largely proactive prevention rather than reactive. That means reducing calluses, trimming toenails short and filing them smooth at the tips, wearing the best possible fitting footwear, good insoles that won’t give you blisters at the side of the heal (a very common problem area), wearing the best possible socks (I prefer Drymax and think they are the best), changing socks regularly, airing and elevating feet when resting and sleeping, the use of Hydropel as a lubricant (which also helps control moisture), knowing how to do preventive taping, knowing how to patch hot spots and drain and patch blisters, carrying a good foot care kit, and educating yourself about foot care. Sounds simple right?
Q: Curling Toes – I run a few times a week (not very high mileage – typically no more than 10 miles per run). Unfortunately, I easily get blisters on my 4th and 5th toes (little toe). I’ve started using a blended sock to wick moisture (can’t remember the brand right now) as well as Band-Aids and Body Glide. Nothing seems to be work really well. Looking closer at my toes, I’ve noticed that my little toe curls under the adjacent toe, which I believe is the main reason for the blisters. So, a couple of days ago, I took some cotton ball and a Band-Aid and placed it in between my toes (hoping to pull my little toe away from the other one). It provided a little more comfort than usual, but I think there has to be a better way. Any suggestions? Would tape be the answer and, if so, what is the best way of wrapping it?
A: Yes, on some folks, the pinky toe curls under the 4th toe. This can lead to blisters on either or both toes. First, make sure your toe box is wide enough for your foot. If the toes are squished, this can aggravate the problem. You could try Injinji socks. These are the socks with individual toes in the sock for each toe. Some folks will try lamb’s wool between the toes. You could try taping your toes. Micropore paper tape comes in 1/2 and 1 inch widths and holds up well. It is thin and adheres well. I prefer to tape bottom to top, avoiding the crease at the bottom base of the toe. Then run another strip side to side. You can pinch the excess tape at the tip of the toes and either leave them or trim them off. Micropore is smooth enough not to bother the skin on non-taped neighboring toes. It usually can be found (or a similar paper tape) in drug stores. There are silicone toe spacers available and you could try one if you wanted.
Q: Toe Joint Pain – I have had a joint pain that “reaches in” from left big toe. After it is aggravated, it does not like to be bent (gently) up or down.
A: Make sure it is not at the base of the big toe as that is a different case. Pain at the base of the big toe is often associated with sesamoiditis. These are two small bones at the base of the toe. They can become inflamed or bruised. An X-ray would show if they are fractured. Pads, soft insoles, or cutting out a section of the insole under the bones can help.
Lubricants and Powders
Q: Lubricants in Hot Temperatures – Brazil135 was fantastic. I concluded the race without any foot problem by applying lanolin and Vaseline several times a day. I wonder if you could comment on the use of the above lubricants in high temps such as Badwater in July.
A: I would avoid Vaseline. It is too sticky and over time, cakes up on the socks. It also then tends to catch all the grit and sand that ends up inside your shoes. In high heat, it is also very liquid. Better to use Hydropel, SportsSlick, or BodyGlide.
Q: Lubricants and Powders – I stopped by your site and wanted to know if you could comment on the use of Vaseline or petroleum covered with powders.
A: Vaseline is the old standard for a lubricant. The problem is that it is sticky and attracts grit, gust, sand, and whatever the athlete comes in contact with. It tends to also cake up over time and can almost harden over time on socks, shorts, or other materials. Newer lubricants are less sticky and are much slicker and better at lessening the effects of friction. Putting powder on a lubricant can be done but usually athletes use one of the other. I have only seen a few use both. Powder may cause the lubricant, especially Vaseline, to cake up.
Toenail Care Questions
Q: Mixing Socks – The information you provide in your blog is very much appreciated. I understand the issues with powders and lubricants when used with the Drymax socks and was curious if you knew how the performance is affected if they are used over Injinjis.
A: Good question. Wearing Drymax over Injinjis I think would defeat the value of the Drymax socks. The Injinjis are wicking socks and hence will spread the moisture over the whole sock, where, in theory, it will dissipate and/or evaporate. The idea behind Drymax is that the inner weave of the socks is water hating, therefore moisture is not held against the skin. If the Injinjis are inside the Drymax, the Injinjis will be wet, thus retaining moisture against the skin. Just my 2 cents.
Q: Moisture and Socks – I read the recent blog with the info from Drymax about powders and lubricants. All makes sense. I wear WrightSocks and love them for the most part and understand the double layer concept and have experienced them in action. The question is about the moisture being “wicked” away and having nowhere to go, because of the shoe. Does this not still apply to a double layer sock? The moisture has an additional place to hide away from the foot, but still no place to go. Once a saturation point has been reached will the moisture go “back through” to the foot?
A: You made an important point and I think you are right: “Once a saturation point has been reached…” I think too many people think socks will be the miracle worker when it comes to saving their feet. A lady wrote me that she spent a lot of money on Drymax trail socks and wore them once in a 100k run where it rained in a torrential downpour at the 5K mark. Later she developed hot spots on her toes, which by her own omission, she said often had calluses. She abandoned her run and felt the socks let her down by not preventing the hot spots. I told her no socks will work at moving that much water off one’s feet.
The value in double layer socks is that the layers can move against each other, thereby reducing friction. I wore some for years and liked them. The second layer adds another wicking layer to the sock. Hope this answers your question.
Q: Using Kinesio Tape – I recently got your book Fixing Your Feet. It’s an excellent resource. I am running my first 100 mile race on Saturday. I have done pre-taping before with success, but recently got some Kinesio tape because it was recommended in your book and by others. My question: do I apply the Kinesio tape just like the other tapes you mention in your book? Do I need an adhesive before applying? Do I put anything over it like duct tape or body glide to make sure it doesn’t roll off? I am wearing Injinji toe socks if that makes any difference. Thanks for any suggestions you can offer.
A: Use a tape adhesive with any tape, Kinesio-Tex included. The tape stretches in its length but do not pull it tight as you apply it. It does not need anything on top of it once applied. Be sure to roll your socks on and off so you do not pull the edges of the tape loose. Round off any corners of tape. If taping toes or heels, pinch any edges and cut off the pinched tape, like when wrapping a present. After applying the tape, gently massage the taped area for about 30 seconds to help the tape’s adhesive bond with the skin. Use powder or lube on any still sticky areas not covered by the tape.
Q: Base of Toe Pain – I’ve been getting this first time pain at the base of my second toe – next to my big toe. It’s a dull ache and it’s been hurting after my runs. I take a few days off and it feels better. Then after a short 6 miler it hurts again. It’s a dull, bruise type ache. It’s definitely in my toe and a metatarsal. I attempted the SD100 two weeks ago, but my toe didn’t start hurting until a week after the race.
A: You could have Morton’s neuroma caused by a pinching of nerves between the metatarsal heads. Normally this creates tingling or pins and needles sensations at the toe. Ice, wider shoes, and a small metatarsal pad helps. Or it could be metatarsalgia, pain usually under the metatarsal heads. Pressing on the metatarsal heads often indicates the problem. It can be caused by too narrow shoes, or laces tied to tight. A small pad can help or cut away a bit of the insole under the affected head. Wider shoes often help too. Make sure it is not at the base of the big toe as that is a different case.
Q: Bottom of Foot Cushion – I have apparently worn out the cushions on the bottom of the heels of both feet. In 2006 and 2007 at Western States I dropped at 34 miles. Now I have something in my left foot that we thought was Morton’s Neuroma. Got the injections, and it got a little better, but after surgery last September it was worse. Then the first of this year it started getting better but I can still have the same kind of pain there even with a nerve now gone. Now I think it might be something else, maybe circulation or something else? Maybe he took out the wrong nerve.
I go about 5 to 10 miles before it gets real painful, even though it gets numb at about 3 to 6 miles. If I stop and let it rest for about two minutes, I can then go 3 to 5 miles again before it gets painful. Then repeat the rest and go another 3 to 5 miles. That is the nerve problem? Then when I get to about 20 to 25 miles the heels get real painful from lack of cushion. Got any suggestions, as what kind of products that would help my two problems?
A: As we age our feet naturally lose padding from the fat pads on the bottom of our feet. In my mind, this is a good argument for quality insoles and even good cushioning shoes. Gel insoles or heel pads are an option for added cushioning but remember they weight more than the usual insoles. Surgery for Morton’s neuroma is pretty straightforward. I don’t see how the wrong nerve could have been taken. Have you tried a pad under the metatarsal heads? Are your shoes wide enough? Even go for a second opinion since you have had the problem recur?
Q: Wrinkled Feet – I completed my first 100K this past Saturday and am still paying the price today. We had heavy rain and there were quite a few water crossings. With all the moisture, the bottoms of my feet became heavily wrinkled, and then the wrinkles tore and split. I haven’t done anything with them at this point, thinking that it would be best to let them dry out and harden. But they still hurt as much now as they did at the end of the event. Should I be going the other direction – lubing them up with Vaseline or something like that? I would like to get them healed so I can get back out on the trails!
A: The most important is to skip the Vaseline. A lot depends on how this the splits are? Several layers of skin? Many layers? And how long? The deeper the split skin and the longer the splits, the longer it will take to heal. These have to heal from the inside out. Watching for infection is very important. Severe maceration of the skin on the bottom of the feet is hard to treat so one can run without the skin going back to its original condition. When I have worked with podiatrists, even they are stumped. Drying the feet well, the use of powder or another drying agent is very useful. Often, the skin will go back to it correct shape in time. Yes, it can be painful. You cannot rush the healing process. Trying to run when the skin is not healed can create other problems. Here are a few more tips:
- Soak your feet 2-3x a day in a clean warm bath with a heavy concentration of Epsom salts.
- Dry your feet completely after each soak. Use a hair dryer to blow dry your feet.
- Apply a thin amount of triple antibiotic ointment to areas where the skin is broken. Gently rub the ointment in so the skin will dry out.
- Wear a clean pair of white cotton socks after each treatment.
Wear sandals or other open shoes so your feet will stay dry.
Q: Lacing Boots – Do you have a resource for the different lacing options on hiking boots? I have one pair of boots that are super comfortable everywhere except the top of my foot where the laces cross. After a short while, it feels like I have a bone bruise. What lacing options can relieve this? Thank you very much for your assistance.
A: If you have my book, go the chapter on lacing techniques. I would use the lace techniques where it skips the eyelets over the painful area. That’s the simplest way and it should work with boots.