Blister Basics Part I

Ever have a big, fiery red puffed up blister on your foot, toe or heal? Not a lot of fun, is it? It can make shoe wearing and even walking miserable or nearly impossible. And they can take SOOO L-O-N-G to heal.

I saw and treated a lot of blisters in my day as an athletic trainer. There was a special process we’d go through to lance, drain, pack and pad them, so the athlete could bite their lip and return to practice or competition. And I still find myself treating my own today.

But a lot of those blisters could have been avoided. Some of the blister-causing culprits I saw were:

 

  • Improperly fitted shoes.
  • Shoes that had gotten wet and dirty and, consequently, dry and stiff. No pliability left.
  • Too old or too worn out shoes. (Sometimes athletes just couldn’t relinquish them.)
  • Wrong shoes for the activity. Tennis for running. Running shoes for tennis.
  • Old, dirty socks worn, worn and re-worn until they could stand up on their own.
  • Worn out socks with pills, errant threads floating around, threadbare areas and holes.
  • Shoes stiffened from sweat.
  • Socks that didn’t fit.
  • Wrong sock for the wrong activity.
  • Dirty feet and toes.
  • Improperly trimmed toenails.
  • Untrimmed toenails.
  • Feet not properly dried following a shower or sweat-inducing exercise.
  • Grit and dirt in the shoes or socks.
  • Old insoles that needed to be replaced.
  • Calluses that hadn’t been cared for properly or filed down sufficiently.
  • Doing too much too soon on soft, unconditioned feet.

 

Did I say doing too much too soon on unconditioned feet?

That last one is probably one of the biggest culprits. Feet need to be conditioned to do the work you expect of them. You need to work up to the mileage and pace you want to maintain.

 

Blister Care—

Some things have changed about blister care since I was treating them daily. Some of the super neat treatment options were arriving on the scene while I was still in school learning how to be an injury-preventing, injury-identifying, and recovering-from-injury athletic trainer. Our understanding of how blisters are caused has evolved, and that understand has allowed developments in better treatment.

But there is no one-type-of-prevention-fits-all to follow.

You can conquer and reduce the number and severity of blisters if you know the basics.

 

NEXT WEEKI’ll take you through the physics of blister formation. Then we’ll talk about how to reduce their occurrence and treat them if they do arise. Literally.

 

Until then,

look through your closets and drawers for socks that have seen better days and need to be retired to the laundry room as rags. (Hint: look for thread bare areas, broken down weave, holes, runs, pilling, and stretched out elastic. Thank the socks for their faithful service, and then use them for something else.)

 

Blessings,

Andrea

May you prosper in all things and be in health, just as your soul prospers (3 John 2).

Photo by Craig Whitehead

On the Mountaintop—A Beautiful Marriage of Body and Spirit

I’m spending this weekend in the White Mountains of Arizona with my beloved, to celebrate 35 years of life together, and to refresh and invigorate my body, mind and spirit.

Being outside in the cool air and towering pine trees, (the largest grove of Ponderosa pine trees in the world), and inhaling that rich pine scent is like a hypodermic needle shot of anti-depressant and happiness booster for me.

And it’s truly a emotional, physical and spiritual experience. And science can back that up.

 

Spirit does affect the body, and vice versa—

When you experience something pleasant or enjoyable, brain chemicals are released and those chemicals cause a chain reaction throughout the body. Senses are heightened, happy hormones are released along with soothing brain chemicals. Happiness permeates your body systems. And all of that can heighten your joy.

When people say something is good for the spirit, like my mountain experience, they aren’t kidding. While scientists don’t completely understand why and how it happens, they can see the positive effects from it. The Greater Good Science Center located in Berkeley, California dedicates itself to uncovering why and how experiences enrich our lives and make us happier.

Joy-infusing experiences make us feel physically better, they improve health and can heal. They soothe us, refresh us, and give life meaning.

And we often feel a greater connection to God. The spirit that gives life meaning, that makes us so much more than just a living organism focused on maintenance, staying alive, and propagating ourselves, is stimulated by the experience, and the body reacts.

If that’s the case, how can we separate the two, when they’re so closely intertwined and interconnected? If a ravaged, pained body can affect the spirit so severely; and a ravaged, pained spirit can affect the body in a similar manner? If a healthy body and improve the spirit’s outlook; and an uplifted spirit can do the same for the physical component.

 

God has indeed made us very complex individuals. And is that any surprise?

 

The spirit of life we hold within us was breathed into us by Him. It is so much a part of Him that when it leaves our bodies at death it returns to Him. (Absent from the body but present with the Lord.) We are made in His image. Both the body and spirit give us life, in different and in complementary ways. And that’s one of life’s mysteries that makes human life so rich. One we should embrace.

 

The body and spirit interactions in which we can rejoice.

 

Are we more spirit than body?

When you’re standing on a mountaintop, inhaling the thinner, fresher air, feeling the cool breeze caress your face, smelling the exquisite scents peculiar only to juniper and pine-clad landscape, tell me which you feel more of at that moment. Body or spirit?

 

Or is it a beautiful, complex marriage of both?

 

 What do you think?

 

NEXT WEEK: More reasons why I think the body is just as important as the spirit.

Until then, enjoy your surroundings and the marvelous effects they have on both your body and spirit!

 

Blessings,

 Andrea

May you prosper in all things and be in health, just as your soul prospers (3 John 2).

 Photo by Andrea A Owan

Walking, Running and Hiking Socks—It Pays to Know What’s Available

Been to your neighborhood outdoor recreation store lately to buy socks? The array of choices and purposes can be mind-boggling! What happened to just having a nice, cottonish sock with adequate heal and toe padding, and maybe a gradation of thickness, depending on what kind of weather you’d be hiking or exercising in?

Unfortunately (because you need to do your homework, know your sock choices and try them out), and fortunately (technology advancement in materials means they now make socks for every kind of feet, environment and need), you have a variety to choose from and try. Because your feet, comfort, blister prevention and exercise enjoyment depend on it, it pays to know your options. So let’s do some general studying. You’ll be doing yourself a monumental favor!

 

Going past the basics to specialty socks—

Walking, Running and Hiking:

In this category, you’ll find socks made for

Moisture Wicking— (and keeping the feet as dry as possible). Especially good for you super-sweaters. Offered in road and trail versions, different heights, and a variety of material blends.

Hiking—high calf or crew, hikers will choose wool or wool blend in different thicknesses, depending on the weather. But make sure if you wear wool you frequently check the sock for fabric clumping. That can cause blister problems.

Sock Liners—Runners, walkers and hikers sometimes wear liners between their woolies and the shoe in order to wick moisture away from the foot and reduce friction (or shear), which reduces your chances of being disabled by blisters from too-moist feet.

When I discovered these babies, I thought I’d nearly died and gone to heaven! They made hiking SOOOO much more enjoyable. One of the things that had turned me off to hiking (aside from the leaden boots that used to be standard fare), was the bulky feeling of the socks inside the boots. (Remember, I spent most of my years as a bare-foot or ped-footed gymnast, so anything heavy on my feet made me miserable.) These liners gave a silky feel to my feet and legs and made getting those SmartWool hiking socks on over my feet a breeze. They also reduced hot spots and blisters, and wick moisture from your feet, so I was immediately sold. I wear them under my ski socks, too.

I swear by sock liners when I’m wearing hiking boots! If you’re on a long trek, with an overnight stay, it cuts down on the amount of outer sock washing. Washing the thin liners is quick and easy, and if it’s during the summer, they usually dry overnight, or you just clothespin them to your backpack the following day to hang dry as you’re walking. Always carry at least two pair of liners with you for this. They’re light and compact enough to stuff in your backpack without taking up too much room. (Of course, discount the hang-to-dry part if you’re knee-deep in snow during the winter.)

Double-layered Socks—These are now my go-to socks! I love, Love, LOVE theme! A REI associate recommended them to me while I was shopping at their Seattle flagship store. They’re ankle height and are SOOOO comfy! I’m planning to wear these on our pilgrimage, even in cold weather. I’ll have lightweight, ankle gaters on to keep the pebbles and dirt out, and if it’s really cold, I’ve got lightweight silk long underwear. And maybe I’ll wear an additional pair of sock liners underneath the double-layered models.

 

Is that overkill? Not for me, personally. Triple layers help some people tremendously. For some, they might not like that additional layer. You need to find out what works for you.

 

Compression Socks—I’ve heard both pros and cons on these. One runner wrote a long article disparaging these socks and giving his reasons why. Research hasn’t drawn a positive conclusion on them, but as some experts state (and I would agree), if they make you feel better and don’t cause any harm, go for it! (One of my doctors personally swears by wearing them on long plane flights so combat circulatory problems.)

Some of the stated benefits include: improved circulation, reduced swelling, increased comfort, improved maximal oxygen consumption, quicker recovery, and reduced leg fatigue. Some people wear them strictly to enhance recovery, so their feet will be perky enough to put in mileage day-after-day.

 

But beware of wearing compression socks in the heat! You may set yourself up for heat rash (I’m prone to this, with horrible red splotches popping up at the top of the sock and about two inches beyond that.) You don’t want to stress your circulatory system!

 

Other options—

 No socks—Then there’s the sockless aficionados. This used to be more of a problem when athletic shoe insoles couldn’t be removed. Then your foot sweat seeped into the insole/liner, which caused the insole to stiffen and lose its support capabilities. But some of my athletes at Indiana University (many whom were national champions, Olympic Trial competitors, or went on to be Olympians) loved the no sock feel. With all of the nerve endings in the feet and toes, it helped them feel the ground more. Their shoes were incredibly stinky, though! And stiff from all of the sweat salts.

 

Know how to put on a sock?

Yes, there is a right and wrong way to put a sock on your foot.

  1. First, turn them inside out to make sure they’re pebble or dirt or pile-free. Then turn them back.
  2. Then, roll the ankle portion down to the toe area as far as possible.
  3. Slide the sock over your toes and carefully work the sock up your foot, ankle and calf.
  4. Make sure any seams are not directly over your big or little toes, to rub on these appendages when the shoe is on and cause problems.
  5. Smooth and straighten the sock out.
  6. Put your shoe on and make sure the socks are situated on your foot in a comfortable manner.
  7. Lace up your shoes and have at it!
  8. Take the time to remove your shoe and sock during your walk or hike, if you must. It’s common to get little pebbles, dirt and dust in your shoes and socks that create friction problems. Clean them out, and start again. Your feet might enjoy the fresh air! J

 

Wearing gaters helps alleviate the dirt and pebble problems.

 

WARNING!If you do elect to wear layer upon layer of socks, go up at least a ½ size in your hiking boots or shoes. You don’t want that puffy, padded sock to get squashed (so long cushy padding!) or make the fit so tight your foot is screaming in pain! And make sure you try the socks on with the pair of shoes/boots you want to buy, while you’re in the store!

 

Advice you might want to consider, or not—

A friend of mine who walks the Camino de Santiago nearly every year suggests buying a boot or shoe a size to a size-and-a-half larger, to allow for your feet to swell on lengthy mileage days. But I wouldn’t do that. With shoes that much larger, your feet will slop around in them at the beginning of your walk/hike, and you’ll increase the friction and shear forces assaulting your feet. The result? Instability and increased hot spots and blister formation. He also tells people they will definitely get blisters, which might be because of this shoe way-too-large shoe practice.

But your feet will swell, and there is a remedy for that.

 

Train, train, and train some more!

There’s no substitute for putting in the mileage ahead of time during training, so your feet will widen and toughen up and be prepared for the mileage you’ll be walking. Or you can consider buying larger shoes as you progress on your hike. Evidently some thru-hikers have been known to do this when walking the Appalachian and Pacific Coast Trails—ordering larger sizes to be shipped ahead to a pickup location or actually leaving the trail to shop at suppliers stationed along the route.

 

Wanna avoid wet feet in rain and are too cheap to buy moisture-wicking socks or expensive rain gear?

As athletic trainers at the University of Wisconsin, (where I was an undergraduate student trainer), it wasn’t unusual for us to be subjected to standing water on the non-draining AstroTurf during spring football training. That was something our cute little white nylon Nike tennies with the red swish couldn’t handle. Porous, they were!

So, rather than tough it out and risk getting sick from standing around for hours (in the cold, wet weather, under the stadium lights) in soaked feet, another female athletic trainer and I started the following uniform craze:

 

  • Put sock on.
  • Put sock-covered foot into a plastic sandwich baggy.
  • Liberally wrap the top of the baggy (around the ankle) with white athletic tape to create a halfway decent seal and secure the baggy to the sock.
  • Put baggy and sock-covered foot into your stylish red-swish Nike.
  • Walk out to the football field and pad up-and-down the sidelines while the team practices.
  • Squish back to the training room after three hours, remove the shoe, tape, baggy and sock and put on dry shoes.
  • Clean the dirt and mud from your Nikes, air them out overnight, and do it all again the following day.
  • Voila! Dry feet (that didn’t freeze or look like prunes)!

 

Ultramarathon runner John Vonhof says you can do this with recycled bread bags. Haven’t tried that one myself, but it might be worth it to carry a couple of recycled bags along on my pilgrimage. In case I encounter a deluge!

 

NEXT WEEK: Preventing and treating foot blisters.

Until then, have fun trying new socks, and enjoying your walk and hike more!

Blessings,

Andrea

May you prosper in all things and be in health, just as your soul prospers (3 John 2).

Photo by Andrea A Owan

Knowing Your Socks—Materials Matter

Ever spend much time considering the socks you wear, especially the ones you put on for exercise walking, running or hiking? If not, you should. They’re critical to your foot health and exercise enjoyment. And the all-important blister prevention.

 

4 Basic Functions of Socks—

Socks do have some important functions, besides just keeping your feet warm and comfy, and maybe adding extra padding. The functions are:

Protection

Warmth

Cushioning

Absorbing or wicking moisture from the feet

 

While you may head to the ubiquitous white, six-pack tube socks for every need, those might not be the best choice for your feet or your activity. A shapeless cotton sock may be more harmful than helpful.

There’s much to consider when selecting a sock, something I’m really just beginning to appreciate.

 

My experience—

Growing up in Hawaii, socks were not a go-to wardrobe item. At least not often. Open-toed shoes and slippers were clothing staples, and Keds for physical education classes were the norm, which were often worn sans socks. And as a gymnast, bare feet or little white Peds anchored on the feet and ankles by elastic were the norm. I spent hours stitching quarter-inch elastic in crisscross fashion on my peds; and when they got holes in the balls of the feet, I’d use those as top layers to two or three (or more) bottom layers. Even back then, I wanted as much padding as I could get on my feet. Having all that cushion also helped when I ground my socks in resin to keep my feet well-anchored to the balance beam.

But what’s available now is light years away from what you could find on the shelves several decades ago.

 

Sock materials and construction—

Cotton. Silk. Spandex. Nylon. Wool. Blends. A ton of choices. What works for someone else may not work for you. What works for one type of activity and shoe may not work for others.

Dense weaves provide more cushion and often more warmth, which may not be ideal if you’re out running or hiking in hot temperatures. Double layers of socks (as I used to wear as a gymnast) provide cushion and the added benefit of reducing friction, critical to longer days of walking or hiking. (Can anyway say blister prevention?!)

 

 Different benefits from different materials—

Let’s look at the benefits and drawbacks of each type of material, so you can get an idea what you might want or need.

 

Cotton—While these might be your first and cheapest selection, it is probably best to avoid them. Cotton socks, especially 100% cotton, provide no moisture wicking, so when you sweat, your feet are more likely to get wet, possibly cold, and blistered.

Cotton blends—Anything containing cotton plus spandex, rayon, acrylic, or nylon provides some stretch, better conforming to the foot, and some advantages over the 100% cotton models.

Silk—Once a man and woman’s staple, and primary choice, silk socks are now most often used as liners. I have a pair of silk liners I LOVE! I wear them between my wool hiking socks and boots. They reduce friction and have the added benefit of allowing me to slide my thick hiking socks on without much effort. I also wear them between my ski socks and ski boots. Very comfy! I have to replace them, though; I’ve worn them so much they have runs in them. Can’t bring myself to toss them out!

Wool—The advantages of wool are that it usually provides more cushioning, definitely provides more warmth, and wicks moisture away from your sweaty foot. But it’s also a comfortable sock to wear in the heat.

Wool blends—Again, comfortable in temperature extremes. They can also be soft and long lasting.

Fleece socks—Fleece is soft and warm and dries faster than wool. Fleece socks can be baggy, though. I like to wear fleece as ankle warmers—they roll down around the ankle and keep me warm.

Synthetic blends—The majority of synthetic sock materials are blended with cotton, nylon, spandex, or acrylic. They can offer protection against a wide range of problems, such as moisture-driven blisters, friction hot spots, and droopy socks that just don’t want to stay up. Many are moisture wicking, which is great for reducing blisters. Some have good insulation properties to keep you warm (such as ski socks). You can find them in single or double layer (now my favorite type of sock to wear).

 

Check your drawers—

Pull out all of your socks. What kind of blend do you have the most pairs of? Can you remember why you bought the socks? (They were cute and stylish? On sale? Cheap?)

Ask yourself what kind of activities you do on a regular basis. What kinds of needs you, and your feet, have for socks. What your budget is. (Try not to skimp in the sock department.)

 

 

Go window shopping—

Go to your department store and look around to see what they carry. Inspect the package to see what the material content is.

Head to your local outdoor activity or shoe store, particularly the stores specializing in walking or running, to see what they carry. Get with the professional staff at these stores to see what they recommend, what they wear when they’re out for a day hike.

 

Change your shopping approach—

It may be time for you to start being a little more need-based than utilitarian in your approach to buying and wearing socks!

 

NEXT WEEK: We’ll look at the different kinds of socks available for exercise.

 

Until then,

take care of your feet!

Blessings,

Andrea

May you prosper in all things and be in health, just as your soul prospers (3 John 2).

Want to Keep Your Feet Happy? Get to Know Them!

When you begin a walking, hiking or running program, what’s the first thing you need to take into consideration, after making sure you’re ready, willing and able to partake in one of those activities?

If you’ve been reading Workout Wednesdays for a while, you’ll probably hit on the right answer.

Your feet.

And if your feet are so important, it’s critical that you know them well, so you’ll be able to take better care of them and reduce your your chance of suffering injuries from the toes all the way up to the ankle, legs, knees, hips and back!

What do I mean by knowing them well?

 

Give them a close examination—

Sit down with your favorite pair of walking or exercise shoes and really take a good look at the shoes and your feet.

  1. Examine how narrow or wide your foot is.
  2. Do you have a high arch when your foot is relaxed? Or is it flat? There are lots of technical names for the kind of arch you might have, like a functional flat foot, a rigid, pes equinus (where the arch doesn’t flatten out when you stand on your feet, so all of the pressure is on your heel and ball of your foot; and you have limited ankle range of motion).
  3. Where do you tend to get calluses on your feet and toes? On the side of your big toe? The heel, or ball of the foot?
  4. Do your calluses get really thick and then crack and bleed? Where does that happen most often on your feet?
  5. Is your second toe longer than your great toe? (Something that may indicate you are prone to having a balance problem.)
  6. Do you have bunions or corns, plantar warts, or any other issues you need to address?
  7. Are you prone to getting ingrown toenails? Blisters anywhere on the foot?
  8. Examine your toenails. Do they run into the toe of the shoe when you’re walking? Have they thickened?
  9. Is the structure (and size) of one foot drastically different from the other, requiring different treatments or support material for each foot?
  10. Stand on a piece of paper and trace outlines of both feet. Do they look identical? What’s the length and width difference?

 

*A good way to determine if you have a compensating arch that drops a little when your foot gets loaded with weight is to get a brown paper bag that’s bigger than your foot. Get the bottom of your foot wet and then rest your foot on the flattened bag for a second. Then stand on the paper bag for a couple of seconds. Look at the foot form left on the bag. Is it flat? Is there an arch? Did it change when you went from non-weight bearing to full weight bearing? Where does it look as though your foot is not making any contact with the ground?

 

Knowing these aspects of your feet will help you when you head to the store to purchase shoes and any supportive insoles you think you need or just want to add for some cushion to your feet.

Now for the shoes—

Take a really good look at your shoes—tops, bottoms, sides, toes and heels. And the insides.

  1. What kind of wear patterns do you see?
  2. When you hold your shoe up and look at it from the back, does the heel look worn down on either side? A wearing down of the inside ankle bone side indicates that your heels tend to pronate (roll in) when your foot strikes the ground? If they lean to the outside ankle bone, then you might have what’s called hind foot supination.
  3. What does the toe box area of the shoe look like on top and underneath the shoe? Does the toe box look as though it leans to the outside or inside, giving you an indication of the pressure your foot exerts on the material or sole when you’re walking? Is there a more pronounced wear pattern on the outside of the toe area, indicating your foot rolls to the outside and you tend to push off the fourth and fifth toes (supinate) during push off?
  4. Does the insole provide sufficient padding for your feet, or did it break down quickly and leave you with little or no arch support?

 

Case study—

In the pictures below, you can see the dramatic wear patterns of my Altra road shoes, with the distinct medial breakdown of the right shoe in the heel area and the outside (fourth and fifth toes) in the toe area.

I have significant rear or hind foot pronation and forefoot supination. For some reason, the right shoe has taken a particularly hard beating and already—after six weeks—needs to be replaced because it’s no longer giving me the support I need.

Two possibilities come to mind:

  1. I wore the shoes on both blacktop and trail, which may have stressed the shoe material too much; or
  2. The shoes simply don’t provide me with the arch support I need in my right foot, which is a problem for me. I suffered a severe fracture (segmental, displaced) of the outside leg bone (fibula), which caused my right leg to be slightly shortened and twisted. I already had foot problems. This may have worsened the condition.

Clearly I need some kind of posting, or support, on the right foot.

What’s frustrating is that when I walk, I can feel the broken down shoe actually shifting my foot more severely to the inside, which creates more problems and causes me to try to reposition my foot in the shoe while I’m walking! Not good or efficient.

My trail shoes have not shown such severe wear patterns, so I think the material and lighter support in these road shoes may be the culprit for me.

 

 

 

 

 

 

 

These are all critical questions to ask yourself when you’re going out to buy new athletic shoes. Take notes with you, or take the shoes with you to show the shoe salesperson. They can better recommend shoes and insoles for your particular needs.

And when you go, take the socks you are most likely to wear with you to try on the shoes. That will help you decide which shoes will fit and be most comfortable.

 

And speaking of socks! We’ll be discussing those next week. They’re a critical component of exercise and can make or break an otherwise enjoyable hike or walking outing. One experienced hiker said he’d lean toward buying a cheaper pair of boots and an expensive pair of socks for his trips.

Yes, they’re that important!

 

So until next week,

Keep those feet happy and moving!

Blessings,

 Andrea

May you prosper in all things and be in health, just as your soul prospers (3 John 2).