Foot Care and Prevention
Filed under: blister care, Foot Care, Footwear, Health, Sports, toenails
I believe strongly in prevention as a proactive measure in foot care.
Tim Noakes’ sixth law of running injuries must be heeded—any running injury can be cured only after the cause is found and eliminated. All of us who run, hike, or adventure race at some point have problems with our feet or sustain foot injuries. The prevention chapters are numerous and lengthy because many factors contribute to foot problems and injuries, and for every factor, there is a preventive measure that can reduce or eliminate it. Prevention is the key to saving your feet. Dave Scott, a good friend and ultrarunner, put the foot problem in proper perspective: “When you don’t take care of your feet during a long run or race, each step becomes a reminder of your ignorance.”
It’s very easy to relinquish our responsibility for preparedness and let someone else dictate what we should do. We tend to listen to those whom we look up to and to those who are more experienced. In many ways this is OK, and it is often the way it should be. However, only you can determine what works for your feet.
Knowing your prevention options is important. That’s being proactive. I get emails every week from athletes who are looking for answers for their feet issues.
Some have my book but others don’t. Some have the book and have gone through the chapters to find possible treatment options. Others have the book and haven’t read it – and want me to answer their questions.
I try. Sometimes it works and sometimes not. While I answer from my experience and knowledge, I don’t have your feet. And that’s important.
Your feet have your abnormalities (hammer toes, bunions, thick toenails, skin that calluses, a tendency to athlete’s foot, a tendency to blisters, etc.), your ankles, your shoes and socks, your fit (good or bad), your training base, your stride and gait, and more.
You are the best person to find what works for your feet. Others may give suggestions. Fixing Your Feet can give suggestions and I may offer a few via email or in this blog, but you need to try them on your feet to find the one that works best.
You are the key to prevention.
Please, don’t show up at a race with a bad case of athlete’s foot, holes in your socks, shoes that have outlived their support, insoles that are flat as paper, toenails that are long and untrimmed, shoes that don’t fit, huge thick calluses, blisters that are unhealed, thick nails from untreated toenail fungus.
Yes, I have seen all of these.
Again, you are the key to prevention.
Fit and Inserts
In choosing footwear, fit is everything. You may buy a new pair of shoes, not get a good fit, and use them for short runs or races without much problem. But the longer you’ll be wearing them at a time, the more important the fit.
Here’s a trick to help get ensure a good fit.
Rich Schick, a physician’s assistant and ultrarunner, shared that he believes the key to getting the proper size shoe is the insert – often called insoles. “If the foot does not fit the insert, then the shoe will have to stretch to accommodate the difference or there may be excessive room in the shoe, which can lead to blisters and other foot problems.” He thinks there is too much confusion about straight lasts, curved lasts, semicurved lasts, and so on.
Rick suggests, and I agree, that you don’t need to know any of this if you use the insert to fit your shoes. The same holds true for the proper width of shoe. Simply remove the insert from the shoe and place your heel in the depression made for the heel (in the insert). There should be an inch to an inch and a half from the tip of your longest toe to the tip of the insert. None of your toes or any part of the foot should lap over the sides of the insert. If they do, is it because the insert is too narrow or is it because of a curved foot and straight insert or vice versa? The foot should not be more than about a quarter inch from the edges of the insert either. This includes the area around the heel, or the shoe may be too loose. Check to see if the arch of the insert fits in the arch of your foot. Finally, if all the above criteria are met, then try on the shoe. The only remaining pitfalls are tight toeboxes and seams or uppers that rub.
Remember to take into a account the type and thickness of socks you’ll be wearing. If you are going to replace the stock inserts that come with the shoes, make sure to follow this tip.
Getting Help for Foot Problems
If you have persistent foot problems or recurring pain that you cannot resolve, seek medical treatment from a medical specialist. There are pedorthists, physical therapists, athletic trainers, massage therapists, and sports chiropractors that can provide assistance for strengthening, alignment, rehabilitation, and footwear design and fit.
Listen to your whole body; especially your feet. Be attentive to when the pain begins and what makes it hurt more or less. Then be prepared to tell the specialist about the problem, its history, what you have done to correct it, and whether it worked or got worse. Conditions that could require the services of a specialist include ingrown toenails, burning feet, cold feet, warts, arch pain, forefoot pain, heel pain, and severe cases of Athlete’s foot.
- Podiatrists are Doctors of Podiatric Medicine (D.P.M.), specialists who work on the feet up to and including the ankles. The American Podiatric Medical Association and American Association of Podiatric Sports Medicine.
- Orthopedists are orthopedic surgeons, experts of the joints, muscles and bones. The American Academy of Orthopaedic Surgeons and American Orthopaedic Foot and Ankle Society.
- Pedorthists work with the design, manufacture, fit, and modification of shoes, boots, orthotics, and other footwear. The American Orthotics and Prosthetics Association and Pedorthic Footwear Association.
- Physical therapists are licensed to help with restoring function after illness and/or injury. Most work in close relationship to medical specialists. The American Physical Therapy Association.
- Athletic trainers are licensed to work specifically on sports-related injuries. The National Athletic Trainer’s Association.
- Massage therapists work with athletes in reducing pain and tightness in muscles, tendons, and ligaments-the body’s soft tissues. The American Massage Therapy Association.
- Chiropractors are doctors of chiropractic medicine who specialize in the alignment of the body’s musculoskeletal system. The American Chiropractors Association and International Chiropractic Association.
It is easy to email others and seek answers, especially online forums, but there comes a time when professional help is needed. The above are the best at whet they do. Check out their web sites for more information.
Take a Good Look at Your Feet
Let’s confess. You get out of the shower and pull on your socks (male) or put on nylons or shoes (female). Right? You don’t even really glance at your feet. 
Unfortunately, that split second, usually automatic action, causes us to miss things our feet are trying to tell us. So, let’s slow down and see what we might have missed.
1. Start with the toes. Use your fingers to spread them apart and make sure they are dry and there are no signs of athlete’s foot. Look for calluses on the side or bottom of the toes.
2. Now the toenails. Check for nails that need a trim or filing, signs of ingrown toenails and toenail fungus?
3. Move on down to the bottoms of your feet. Check for any unusual bumps that might be plantar warts.
4. Now around to the heels. Look for cracks in the skin, scaly skin or calluses that indicate dryness and the need for a moisturizer.
5. Finally, move around to the sides of the foot. Check for calluses that could be reduced.
This quick check can take only a few seconds but can prevent problems later. Learn to use your fingers and hands to gauge the health of your feet.
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