Foot Care Desperation
I get emails every week from athletes with foot care questions. Some are easy. But I love challenges and even more so when the person is dedicated to finding answers. This post is on the long side, but it is important. I hope you will read through to the end. Several months ago I received an email from Jakob Herrmann. Here is what he wrote:
The Desperate Foot Care Question
I don’t like to bug you with this question but I’m getting desperate. I’ve studied your excellent written book and have researched online but never found a true solution for my problem. If you do not want to answer this then I understand and simply delete this email.
My issues are my heels. I always had calluses on the outer-bottom sides of my heels and they became a problem when I started to run ultras 3 years ago. Especially on 100 milers I am getting blisters underneath them despite carefully taping my feet.
About a year ago I started to remove those calluses with pumice and I got them all almost gone. The skin feels very soft; however, I still get those blisters underneath them despite of the skin being much softer.
Left foot with flap of blister showing
What I then do is to cut off all the death skin on top and remove the blister. This always leaves a deep hole in my heel. During the healing process I use pumice, Footherapy’s Apricot Walnut Foot Scrup and True Blue Spa’s “Heel of Approval” heel treatment cream. Once the skin grows back it’s again soft and nice; however, on my next 100 miler the whole process starts over and I get a blister underneath that area on my heels.
I’ve attached pictures of my last blisters, how I take care of them and how it looks once it’s fixed. The way I fix this problem feels like I’m going around a circle. Any help is great appreciated.
So, I Emailed Jakob.
John: Have you reduced the callus to soft skin?
Jakob: Before I removed my calluses on my heels the skin was hard like a crust on top of the normal skin. After I started to remove it the skin was soft; the hard crust was gone but it wasn’t as soft as the rest of the skin on my feet. I think I’ve made it better but not perfect. And yes, the same thing happens on both heels.
John: Many times with good skin care after a blister, the roof of the blister will reattach to the skin underneath. Have you given this a chance or do you simply cut off the top?
Left foot after tape is removed
Jakob: When I fix my blister I cut off the whole piece including the roof. The end result is like what you see on the first picture.
John: I have seen a lot of heel blisters caused, in my opinion, by the edge of the insole where it touches the inner side of the shoe. Do your insoles have a rough or thick edge at the point where the blisters form?
Jakob: I’ve checked my shoes and their edge of the insole, where it touches the inner side of the shoe, is not too bad at all. There is a bit of an edge but nothing major.
Meeting at Badwater
We emailed back and forth several times. I asked questions and he sent photos. He was doing a great taping job. I talked to Jakob when we were both at Badwater this July. I gave him some Kinesio-Tex tape and suggested he use it on one heel, while taping his other heel as usual. What I wanted to determine is whether there would be a difference in the tapes. I had my suspicions, but knew this was a perfect opportunity for a good test.
Jakob’s Two-Tape Test
Left foot with Kinesio-Tex tape on heel
Here’s an update what happened with my feet at the Mt. Disappointment 50 mile race.
As discussed I’ve taped one foot the way I always do with the Elastikon tape and the other with your Kinesio-Tex the way you showed me.
First up, the taping with the Kinesio-Tex is so much easier. It goes on very smoothly whereas with the Elastikon tape I always have to be so careful not to have wrinkles within the tape. I had the Kinesio tape on within 5 min where it took me over 10 minutes for the Elastikon tape. I really liked that.
The Kinesio tape also feels much smoother on the skin and it more comfortable to wear.
During the race both feet felt the same. However, around mile 30 my Elastikon tapped heel started to hurt like it usually does but the Kinesio tapped heel didn’t hurt at all. I was super excited about that.
Right foot after race (taped with Elastikon)
On the last few miles eventually both of my heels started to hurt but the Elastikon foot hurt more. Every time I hit a stone on that heel it shoot a pain through my leg whereas the other side I could feel the stone but it didn’t hurt that much at all.
Also removing the Kinesio-Tex tape was super easy. It just came off like that. The Elastikon tape is always more complicated to remove. I have to pull it very slowly not to rip open the blister.
Once both tapes were gone I saw that both heels had blisters again; however, the heel with the Kinesio tape looks so much better.
Left foot after race (taped with Kinesio-Tex)
What this Taught Me
In my next post, I will talk about what Jakob’s two-tape test taught me.
Comments
3 Comments on Foot Care Desperation
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Imelda Fagin on
Mon, 14th Sep 2009 7:57 am
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Steve Quinne on
Mon, 14th Sep 2009 8:30 am
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Johanna on
Mon, 21st Sep 2009 10:25 am
I love this in depth discussion and can’t wait to hear your ‘diagnosis’.
By the way, about Jakob’s original blister picture with cap of skin: the skin looked so thick. It didn’t seem like such a good idea to remove it. It looked like it could have protected the foot and was still living.
I started using Kinesio tex tape on my backpacking trips … I tape all of my toes , the balls of my feet , and my heels.. I carefully do this every morning before hiking.. I hiked around 50 miles with no blisters .. I have peripheral neuropathy in both feet and this regimen with 3 pairs of socks and carefully fitted boots works well .. Before this I was plagued by blisters , which were severe enough to put put me in the wound care clinic at the hospital … I also stop every 3 or 4 miles and switch socks if they are wet … MY biggest problem is sweating … If I am in good shape ( like this year ) I dont sweat as much … which helps greatly in preventing blisters… Thanks for all of you help … because of your methods here you allowed me to continue backpacking , without which I surely would not be doing so any longer … Thanks .
I discovered your blog for the first time this morning, and after reading this post on heel blisters, I would like to ask your advice. I am a 57-year-old woman who will be walking the Portland Marathon in less than two weeks, on October 4th. (I can no longer run that distance due to knee issues, although I will run for short stretches as I feel able.) This will be the second year I am walking it, and I have been faithfully training and building up my miles in preparation for the big event. I live two hours from Portland, and because of that distance I am unable to train “in person” with Portland Fit, so I follow their online training regimen from my home town. Last week I did the 20-mile walk, which went fine until around mile 17, when I began to experience pain in my heels (a first for me). Upon arriving home, I discovered that I had bloody heels and blisters on both feet at the base of my heels. Three or more blisters on each foot - some long skinny-ish ones as well as some fat round ones - that extend around the perimeter of the area where the heel curves around to the bottom on my feet. All of the blisters were open and have been draining since last Wednesday, but of course my main concern is how best to get them to heal before Oct. 4, and how to best protect my heels during the marathon, even if they are not totally healed. My questions include: 1) should I leave my heels open to the air during the day? 2) what about ointments - or should I just leave them dry (my heels tend to dry out and crack if left dry for too long, so that’s a dilemma) 3) should I tape them on the day of the race? If so, how, and what brand of tape should I look for? 4) what type socks are best for me to wear that day? If you and/or your readers have any advice for me, I would sincerely appreciate it. Thank you so much in advance! ~ Johanna
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Circulation