UW MEDICINE ARTICLES
MARATHON RUNNERS' FOOT-CARE
There are a few important, but often overlooked strategies for keeping your feet happy during your marathon training and race. If neglected, your feet will be barking at you for the duration of your adventure, drastically decreasing your enjoyment. By taking a few simple precautions and strategies, you can give your feet a much better chance of cohabitating with you during your long distance runs.
It is recommended to stay away from the typical cotton athletic sock. This material tends to absorb moisture and foster blister formation. Synthetic materials or wool will tend to wick away the perspiration from your feet and help to prevent blisters. Some runners prefer dual layer socks, and others, sock liners. Be aware that there are specific socks marketed just for long distance running.
Shoe selection and fitting is crucial to foot comfort during your marathon adventure. Make sure to shop early for shoes prior to your race so they will be well broken in by race day. Shop for shoes in the afternoon, when your feet are more swollen. Have your favorite socks and orthotics or insoles with you when you go for shoe fitting. It is advisable to try on several different shoes from several different manufacturers. Don’t expect shoes to stretch and make sure you have from ½ to 1 inch of space from your longest toe to the end of the toe box. It is not in the scope of this article to recommend any specific shoes, but rather we would recommend a reputable running shoe store. Many of which have knowledgeable staff and will take the guesswork out of shoe shopping.
The shoe insole is the cheapest part of any shoe and you should have a low threshold for obtaining after market insoles or even custom molded orthotics. Pressure spots on the bottom of the feet, bone spurs, bunions, plantar fasciitis, and callus formation are all reasons to pursue insoles or orthotics. Most quality running shoes have removable insoles and most running shoe stores have after market cushioned insoles and over the counter orthotics you can purchase.
Avoid athletes’ foot:
Athletes’ foot tends to flourish in the runner. This is because your foot is in a constant state of perspiration and for the most part contained within the dark warm confines of the shoe and sock. No wonder the fungus is so happy down there! To combat the constant threat of athletes’ foot, we recommend airing out your feet as often as possible, changing socks throughout the day and having a couple different pairs (even if identical) of running shoes and alternating these from run to run so they will have time to dry out. Also consider shower sandals when showering at health clubs and foot powders such as Desenex or Tinactin.
There are many creative ways to lace your shoes to compensate for bone spurs, high insteps or narrow or wide feet. Here is a link that visually demonstrates several techniques.
Blister prevention and treatment:
The preferred form of blister prevention differs widely from runner to runner. Some like the use of skin lubricants like Body Glide, Silicone Glove, Sport Slick, Vaseline, or Bag Balm. Others prefer to keep the feet dry using powders like Zeasorb or Gold Bond. There are some that need to tape the skin ahead of time to prevent blistering. To do this: Use alcohol to cleanse the affected area, then apply a skin adherent spray, wait the prescribed amount, then moleskin, and finally a paper tape covering. We prefer 3M-micropore tape. Once a blister forms, if tender, you can poke and drain the blister with pin or needle. Leave the skin intact as this forms a protective layer over the sensitive area of skin.
Trim your nails straight across. When in doubt leave them a little on the long side. Try to avoid digging at them in the corner. If you find yourself doing that a lot, you may have chronic ingrown nails. A podiatry visit is in the future for you!
The best instruments for filing callouses are special scrapers that look like cheese graters. You can also use a pumice stone or emery board. Larger severe calluses should be treated by a physician.
Take care of things early!
Avoiding waiting till the last minute to take care of ingrown nails, shoe fit problems, and breaking in new shoes. Give your feet plenty of time to adapt to higher mileage. Many of the overuse and blister problems you will encounter during a marathon will come up only after your run over 16+ miles. For this reason it is important to get in some extra long runs a few weeks before you race to find out how your feet will react to the stress and what strategies can be used for prevention.
Experiment with foot-care techniques.
Feet are not all equal. There are varying strategies for blister prevention, orthotic or insole use, shoe lacing, and sock usage. The ultimate combination of these techniques will be different for every individual and some experimentation is necessary. There are several foot issues for which professional help is recommended. Consider professional consultation earlier to get things taken care of and avoid a dent in your training!
Authored by UW Medicine Sports Medicine Physicians
For more information on UW Medicine Sports Medicine services visit us at uwmedicine.org/sportsmedicine