Runners foot care

“Your feet are your friends” unknown, but this sage wisdom has been handed down for a long time...

You need to start looking at your feet each day to better understand their needs and how they are taking care of you. Understanding the way your feet work will keep you running many happy miles. Dr. Tim Noakes states “Treat the cause, not the effect. Because each running injury has a cause, it follows that the injury can never be cured until the causative factors are eliminated.” Would you ever think of treating your hands with the casual disrespect we give our feet? Probably not, because you and everyone else takes notice of them – yet we often forget our most prized running instrument. The tool that contains 26 bones, 33 joints, 12 tendons, and 18 muscles is a wonder and something DaVinci called a wonder of engineering.

I should say upfront that most of what I know about foot care has come from years as a distance hiker and leading groups afield. But what I know (and share today) about running foot care comes from the 300+ page, definitive tome of foot care called Fixing Your Feet by John Vonhof. He has a blog as well but this book is so well thought out that it is in its 4th edition with Wilderness Press and I highly recommend this book.

So here is the nice thing about reading a blog – nobody will see what you do next.
Take off your shoes and we’ll have a brief foot tutorial and review - with you “kicking the tires” to see how these things work and if you are properly caring for them. Go ahead, your privacy is assured – but your running future is at risk if you do not take a look at these things…
Look for changes:
Redness, cracks in the skin, nails are OK, any itching or scaling? Blisters or sore spots, callus buildup, plantar warts or corns etc – should be things you are looking out for & aware of in the developing health of your feet. Our noses, ears and feet with continue to change over the course of our lives and this program and your new pastime will impact your feet - so get a baseline look now and watch what happen over time.

Keep them smooth and clean.
Brush off the feet before going into socks and ensure nothing is in your shoes that should not be there. Use of lotion on your feet helps skin remain soft and then that skin is less likely to thicken – think about applying before bedtime and sleeping in clean socks to keep moisturizer close to the skin. Callus is generally accepted in the medical community to be a sign of abnormality, high friction, biomechanical issues or poor fitting foot gear. These should be sanded down, smoothed and reduced by gradual filing as often as possible. Failure to take care of this may cause the callus to dry and crack (producing a painful, tender injury to skin below) or deep blisters beneath the callus material which heals much more slowly than regular blisters. Soak feet in warm water or shower prior to filing/sanding with a pumice stone for best results.

Stop “hot spots” or blister right away.
If you feel friction inside the shoe stop and immediately examine the problem. Carry tape or mole foam when you anticipate trouble and apply as needed to stop friction. Even duct tape will work; trim edges to prevent “rolling” while you run as tape peeling up will make blisters worse. I love the Engo patches and have shown these to classes before – they are a Teflon type sticker that you can adhere anywhere inside the shoe as needed.

Trim your toenails before you need to – straight across to prevent ingrown nails. The failure to trim nails flush with the toe causes snagging on socks or shoes and can lift the nail off the nail bed. Long nails can cause “black toe” bruising and bleeding in the shoe! Yuck. During exertion feet will swell. Feet are largest in the afternoon, which is why it is the best time of day to buy shoes. Feet, running at days end will be very large, and so it is critical that nails be kept at the proper length to avoid impact injury.

Feet age – like we do they change over time. 1) They continue to enlarge and change in size. 2) The toenails often thicken. 3) The padding on the bottom of your feet thins and we lose some of the spring in our step as a result. 4) Feet stiffen and some range of motion is lost over time. 5) Balance sensitivity changes over time with some losses expected. 6) Arches flatten slightly

Proper shoe sizing, foot pedicures, new insoles and arch support in your shoes, stretching and strengthening exercises can offset these changes to your feet and keep you happily running.

Troublesome toes: Many folks have a condition called Morton’s toe (named for the doctor who discovered the condition). The second metatarsal bone being longer than the first, the second toe is the longest one on the foot and shoe sizing must accommodate this difference. Estimates range from 15-60% of the population having this condition. The second toe length can affect gait and contribute to over-pronation as well as callus formation where the toe bears additional weight. Simply being aware of the condition can allow for accommodations such as sizing, orthotics or additional padding.
Little toes can develop what Vonhof calls the little toe triangle. Check your little toes (or nested toes) to see if they are round and smooth on the bottom or if they have a small hardened triangle of skin developing. This triangle is very vulnerable to blisters and even tearing and so it should be soaked, reduced and moisturized to remain trouble free for long runs.

Feet can produce a pint of fluid in perspiration each day! This has to me managed for the runner.
Blisters and foot pain are most often caused by a triad of elements; friction, moisture and heat. Eliminate or effectively manage at least one of the triad and you’ll run with comfortable feet. Complex foot issues can be mitigated using socks, powders, and lubricants in your primary care plan. Additional preventive support can be found with; taping, skin conditioners, antiperspirants, orthotics, specialized lacing, shoe and sock changes, nutrition and hydration, and gaiters.

Socks are as important as your shoes and they need to match up with your shoes well. Your socks assist in injury prevention if they provide cushioning, protection and temperature management. Some of the best socks for running are now made as Right and Left in each pair. Socks do not have a break in period but you should test your socks for 3+ miles or more in your shoes prior to race day to ensure; they feel great, will do what they are supposed to, and do not give you blisters. Synthetic fibers are best and keep feet dry. Feet that are too wet or dry and grabbing something in the shoe/sock are the ones that blister.

Women’s fitted socks, toe socks, anatomically fitted (right & left) socks, anti microbial fibers, seamless socks, double layer socks, compression socks, Teflon enhanced socks to reduce friction are all currently available. There are even waterproof socks called Sealskinz but my experience has shown that these get so sweaty inside that they may be unmanageable for many runners.
Pay attention to the size of the socks as the number on the package may be “sock size” which fits a range of shoe sizes and may not numerically correspond to your foot size. Remember you are buying socks to fit your feet and not the shoe size, which may be larger to accommodate your foot swelling while you run.
Popular fabrics that review well include; Coolmax, polyester, acrylic, olefin, merino wool, bamboo, drymax, x-static, blister guard, are all great fibers currently being used in running socks.

Many running shoe companies make a sock that works well. Other names include: Balega, Bridgedale, Thorlo, Drymax, Under Armour, Injinji, Wigwam, Teko, Wrightsock, Defeet, Fox River, Goldtoe, InGenius, and Smartwool. These are available at Zombierunner.com, Zappos.com, Roadrunnersports.com, REI.com and other retailers.

Lacing can change the fit of your shoe and take pressure off of trouble areas in many cases – refer to the book “fixing your feet” by John Vonhof or Runnersworld.com, or Ian’s link, posted here on the blog, for lacing suggestions and diagrams. There are products that offer micro tensioning for laces; stretch laces that look like springs, lock laces with tension adjustments, and sausage style laces that offer tension adjustments. These may help you micro fit the shoe and unlike the “garden weasel” seen on TV many of these lacing gizmos work.

Footbeds are available for a number of foot types and gaits. Over the counter insole products are shapeable and trim to fit for your shoes. When sizing these tools at home follow directions closely! Many of these products are expected to last about a year under normal use and are often superior to the insoles that come with your shoes. SOLE, Spenco, Superfeet, Hapad, and Sorbothane all make a reputable footbed product. These are not orthotics as a podiatrist would make for you and cannot correct gait issues. They may provide additional support, prevent injury and reduce chafing in footwear. If I reveal my bias here though – many PT’s who are in the running expert-type-zone feel that using a footbed or advanced support works at the pain or problem but not the source of the issue - which may be feet in need of balancing (in terms of strengthening and flexibility) - therefore footbeds may only be the shortcut. I’ve used them and they feel good…

Self massage devices, floor rollers or tennis balls can be used to massage and rejuvenate feet with great results. Many ultra runners swear by the monthly pedicure which includes some foot massage and foot maintenance.

A foot soak you can do at home which will deodorize, soothe and soften feet (while being antibacterial/antifungal) is Pedifix FungaSoap. Contains tea-tree oil, Epsom salt, & peppermint, costs about $11.00 at pedifix.com. I have had good success with this product as a way to prep my feet for nail trimming and sanding off callus material. It smells great and leaves feet very clean and soft. Let me know if you have another trick and I’ll post it here.

Ankle strengthening and balance exercises to increase proprioception aid in having stronger healthier feet and serve to offset aging and prevent injury. These need not be complicated – as John showed us last week - standing on one leg and remaining balanced, for progressively longer intervals, is one simple method and there are many others. Walking barefoot around the house a bit is another.

A great web resource - from the man who wrote 350 pages on footcare is http://fixingyourfeet.com/blog/
Read up, incorporate a few tips each week for your amazing feet, and remember that “Your feet are your friends”