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The Agony of De Feet

Every ultrarunner has experienced painful hot spots, blisters, and toenail problems. In fact, depending on race conditions, foot problems may be the leading cause of runner dropouts. Obviously, that makes prevention and treatment of such problems an important tool in the bag of every ultrarunner. As such, some basics of foot care are described below. For full treatment of the subject, I highly recommend John Vonhof ’s Fixing Your Feet. This frequently updated book, along with Vonhof ’s website, www.fixingyourfeet.com, has guided ultrarunners for more than a decade. Before dealing with specific problems, let’s take a quick look at measures to prevent foot problems in the first place.

To begin with, wear well-fitting shoes. The shoe should fit snugly around your heel with little upward movement once it’s tied. It should also not be so big that you need to painfully tighten the laces to prevent your foot from slipping when running downhill. On the other hand, the toebox should be roomy enough that you can wiggle your toes as well as leave half an inch between your longest toe and the front of the shoe. It goes without saying that the shoe’s interior should not have any rough or irritating spots.

Once you have a well-fitting pair of shoes, take a few more preventive steps to minimize foot discomfort. First, keep debris from entering your shoe by means of gaiters, shoe choice, or running technique. If significant debris does enter your shoe, empty it out unless you’re close to the finish or are prepared to deal with the consequences. Second, keep your feet dry through shoe choice, sock choice, and limiting exposure to water. It may be worth changing out of wet shoes and socks during an ultramarathon, but only if your new kicks are likely to stay dry for a significant period of time. Third, wear socks that work for you, whether thick or thin, single-layer or double-layer, mini crew or knee high. Whatever you do, avoid cotton socks, which don’t wick away moisture. Finally, take care of your feet by trimming your toenails, tending to cracked skin, and, if you find they coincide with your blister problems, filing away calluses. See the accompanying “Blister Prevention” essay for additional tips, including the utility of maintaining proper hydration.

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Blister Prevention

John Vonhof

Blisters are very predictable. Take three elements—moisture, friction, and heat, all common to your feet when you run—and the likelihood of a blister appearing is high. The longer these elements exist on the feet, unattended to, the greater the risk. So what can you do to reduce one or more of these elements?

The first order of business is to recognize that you, and you alone, need to find what will work on your feet. Others can give suggestions, but what works for another may not work for you. What follows is a synopsis of options you need to consider.

The First Line of Blister Defense

There are several blister-reducing options that should be your first level of defense. Proper socks are a key priority. Moisturewicking socks are available from almost every sock manufacturer, and given a choice should always be picked before an all-cotton sock. Double-layer socks offer an inner layer that moves against the outer layer, reducing friction to the skin. Try several different types of socks of various thicknesses and fabrics.

Lubricants are next on the list. While it was once common for runners to use Vaseline or Bag Balm as a foot lubricant, most are now using newer, state-of-the-art lubricants that may contain silicone, pain-relieving benzocaine, or anti-friction polymers. The trick with lubricants is to reapply them frequently, being sure to clean off the old layer before another application. If your skin becomes too tender from the softening effects of the lubricant, then a powder may be in order.

Powders can help reduce friction by absorbing moisture. This reduces friction between the feet