Wednesday 2 August 2017

Foot Problems?

My foot post Northern Traverse
I have learnt many things over my years of running and I am a firm believer that the best learnings come from experience rather than reading someone else's experience. However from my first 100 miler I have suffered with foot issues which have resulted in many a ruined race. I have learned so much that it is time I shared my thoughts on the subject. These are only my views on it and what works for me. I'm sure many will disagree but if you've worked out the answer for your self then read my thoughts and disregard at will.

Blisters and foot maceration can really be a race ender. I ran the Northern Traverse in 2016 and ran for 150 miles with ok feet. The skies opened and my feet got soaked and over the next 40 miles I developed the worst maceration I have ever had leaving me barely able to put one foot in front of the other. The pain is often described as like walking on broken glass and I concur. It is also often confused with blisters. Fact is maceration is nothing to do with blistering, they are totally different. How often do you raise the subject of maceration to someone before they say "Little bit of Vaseline, never had a blister". Doh!

A blood blister
Right I'm no medic so don't hold me to this but a blister on your foot is caused by heat resulting from friction. That friction could come from a number of things like your shoe rubbing your foot or toes rubbing together or even some foreign object in your shoe rubbing your foot. This causes the skin to separate and a bubble of liquid to appear which is sore and when it bursts is really sore.  Now maceration is caused by your foot coming in to contact with moisture for a prolonged period of time which in turn causes the actually make up of the skin to break down. Your foot resembles a giant wrinkly prune.  This causes extreme pain and sensitivity. I'll keep it that simple as that because all I'm trying to say is they are very different. Out of the two give me a blister any day. A blister can be tolerated and dealt with as the problem arises whereas maceration needs to be prevented or you will gradually enter a whole world of pain.

These are nice to run on.
I'll start with blisters because this is pretty simple. This info is really based around you having a dry race. You can use all the lotions and potions you wish which will indeed help with Anti-friction but you have to reduce the friction first. Whatever you put on your feet will rub off or disappear in to your sock in a few hours anyway. So firstly I use nothing on my feet for blister prevention maybe a bit of powder but that has another purpose that I'll come onto in a bit. So just nice clean feet and trimmed toenails. It wouldn't hurt to give them a wipe especially between your toes before putting your socks on. As for socks the best quality wicking socks you can afford I personally use Bridgedale that are specific to trail running they are relatively thick with some padding in high rub areas. They also come with a three year guarantee which I have successfully claimed on. Don't be fooled by thickness thinking your feet will be too hot. I've used thick socks in extreme heat and it hasn't been an issue. The thickness also helps with the wicking. The better quality socks have real attention to detail on the seams too again reducing friction. Ok they are £15 a pair but this is important. Also keep in mind that high quality sock manufacturers will recommend you don't put anything on your feet because it will affect the performance of the sock. Next is shoes, your shoes should fit ever so slightly on the large size so plus a half shoe size.  I do this because during a race your feet will spread and swell and fill that shoe very quickly. If you have narrow feet get a narrow fitting shoe or vice versa don't buy on brand alone. Use your laces too for finer adjustments to get that perfect fit. Obviously you are going to get any rubbish out your shoes as and when it occurs but if you are going over 50 miles a sock change is good idea. Pull up a chair, wipe your feet clean and lightly powder them, fresh socks and off you go. Finally consider wearing gaiters to keep any bits from going in your shoes. Cleanliness is everything. This is all I do and it works better than any thing else I've tried.

Maceration drying out and a Verucca
If you do get a blister you have options which are either leave it or pop it. If its small and the race isn't too long I tend to leave it which is ok until it bursts then its going to sting like mad but you'll get through. If it bursts or you have to pop it and its on a toe just wrap it in kinesio tape and crack on. Worry about getting the tape off later. In a long race you have time to pop, drain and tape blisters. The time taken will soon be made up, so take the time and deal with it. The worst place to get a blister is on the sole of your foot because it is almost impossible to tape but there is an answer. It really is a last resort and is not what the product is for but it works. Pop and drain the blister, clean the area with an alcohol wipe then whack a compeed over the blister. This is a real last resort but will get you to the end of your race the only problem is getting the damn thing off after. I had this done to me at Spartathlon and it got me to the end but it took me a week to get the thing off, every time I pulled it, it just ripped the skin underneath.

Trying to remove compeed
post Spartathlon
Now some of the previous info is transferable for maceration but you have to make a judgment call on race day. I estimate my feet can hold out in wet conditions for about 8 hours, much beyond that and they are going to really deteriorate. So if my feet are going to be wet for a prolonged period I am going to be thinking about maceration rather than blisters as my main problem. I'm talking a wet course because of a storm, heavy rain, stream crossings and one of the most important but most overlooked wet grass on a dewy morning. Firstly let me say and you'll know this if you are a sufferer, none of the creams work. I have tried everything on the market and the only product that came close was Hydropel but they don't make it anymore. Anyway this is my routine now. I make my decision on race morning and firstly I get a good foot powder like two toms and smother my feet especially the soles. Really get it on there. Then I wear Injinji liner socks. The lighter the better. Then I wear the lightest waterproof sock I can find. My personal choice is Seal skinz because they are always on sale and I can get a really good pair for about £15. Then just wear your normal shoes and gaiters, yes they will be snug but just adjust your laces. I know you will think your feet will get too hot and the sweat will be worse still. Fact is this is part of your call on race morning. Yes it does give you warm feet but this will be counteracted by the moisture you come into contact with. I proved this at Western states where it was extremely wet under foot for 20 miles but near 100 degrees. I wore waterproof socks for the 20 then changed into normal for the rest of the race. Worked perfect and no feet problems. Now if your feet are going to be wet all day you need to change. So at half way get your shoes and socks off straight away, have a towel in your drop bag, clean and dry your feet and leave them to air for a few minutes while you eat etc. Now just start again, powder, fresh liners, fresh seal skinz, fresh shoes. Off you go. Ideally if you had a crew you could do this at 30 mile intervals but that's not always practical. I did this routine at the Lakeland 100 on a sodden course, my feet were in contact with water for 29 hours and I had no issues at all. Baring in mind using my old routine it may well have ended my race but instead I ran into Coniston with sore quads not sore feet. The only thing you really have to watch is water getting in the top of the sock which is possible to avoid if you are careful but if you are wading through rivers up to your thighs and you are susceptible to maceration you are knackered. You would definitely need to look at your feet every 30 miles.
Maceration left

The thing with maceration is once you've got it, it is too late! It is all about prevention. As soon as you feel that needle sharp pain coming on you need to act! If you are multi daying at say Dragons back you have chance to repair your feet with fresh air and time the only cure for maceration. Just let them air for as long as possible each evening and use the techniques above and everything will be just fine.

Maceration Right
Right as I've said this works for me and a thousand other runners will disagree well that's cool and I'm so glad you've found your answer. This is mine.

1 comment:

  1. Fantastic advice, i had trenchfoot on a ldwa 100 a couple of years ago and from 80 miles it was torture! When i finished my feet where a real mess. Got it again at Dorset 100 last year and it ook me out.