COACH’S CORNER – FOOTCARE FOR ULTRA RUNNERS (BLISTERS)

Coach’s Corner is a feature for AURA members, where qualified trained professionals provide you with advice and tips on improving and enhancing your ultra running performance.

Contributed by Glen Smetherham, Consistent Running Online Run Coaching head coach Glen Smetherham is a Level 2 Advanced Recreational Running Coach accredited with Athletic Australia. With a focus on how the individual is responding to training, coach and athlete working together is the best way to achieve running goals. Glen is always working on finding the best methods and training practices to help athletes achieve their running goals. He has completed over 25 ultra marathons from 48kms up to 350kms, as well as many other endurance events.

FOOTCARE FOR ULTRA RUNNERS – BLISTERS

Feet are pretty important to ultramarathon runners.

One 2011 study with 500 respondents amongst the 701 runners competing in the 2009 Western States Endurance Run and the Vermont 100 Endurance race found that among all runners, blisters (17.3%) were the third highest reason for dropping from the race.

Nausea and/or vomiting were the highest at 23% and muscle pain came second with 20.1%.

All were three ahead of exhaustion.

Even amongst the finishers, 40.1% reported problems with blisters whilst another study in 2014 reported 76% of participants in a four-stage multi-day race complained of blisters. The highest predictive marker for reduced blister incidence was previous ultramarathon race experience.

With these statistics, it’s surprising how many times you will hear ‘I don’t get blisters’ before an ultramarathon though. Generally, the longer the race, the higher the chance you will suffer from them.

Even if you haven’t suffered in the past, it’s worth knowing the basic mechanism of blister formation and have a plan for prevention or treatment.

Blisters in their most basic form occur due to increased heat stress between the surface of the skin and the rest of the body. They occur more readily if conditions are warm and moist, such as inside a shoe after running long distances.

Prevention of foot blisters starts with choosing correctly fitted shoes. For longer ultras some runners could benefit from changing to larger shoes at some stage during a race due to an increase in foot volume. If starting with a larger size though, it’s important to make sure this doesn’t result in any excess movement within the shoe and using a technique such as lace locking can help (there are plenty of videos online to show you how).

The next step is to make sure that you have comfortable and clean socks that not only fit well, but manage the moisture well.

Frequent sock changes may very well be helpful for some runners. The goal is to make sure that the outer layer of skin (epidermis) doesn’t shear against the lower layers of the epidermis or the dermis. If there is high friction and the socks grip skin, there is a higher chance of blisters.

One particular option to prevent this is to lubricate the skin so the sock slides easier over the surface. Another option is to wear two pairs of socks, but it’s important the socks don’t grip each other and move as one. Applying tape, padding or moleskin to trouble spots can be very helpful but again, there should be low friction between the outer layer of the tape and the sock.

A common mistake made is using rigid sports tape, because with the rough surface gripping the sock, and the other side stuck to the skin, it’s quite often a recipe for blisters rather than prevention. So a better option would be to use kinesio tape (or something similar) as it has a much smoother outer layer.

The number one thing you can do to prevent becoming like one of the 17.3% mentioned in the first study is to act quickly as soon as you notice any hotspots or get any debris in your shoes. Stopping to deal with any problems before they get worse may cost you a couple of minutes at the time, but it could possibly save your race.

If you’re lucky and the hotspot hasn’t progressed to a blister, then either a quick reapplication of tape/lubricant, a change of socks, clearing out shoes or another preventative method may be all that is needed.

If a small blister has developed, then it’s best to keep it intact and cover with a protective dressing. In some cases, where it seems inevitable that the blister will pop, you may choose to drain it and then apply a dressing, rather than needing to stop again shortly down the trail. An antiseptic and sterile dry dressing should be applied and then as previously mentioned options to prevent further problems.

If you suffer from frequent blisters occurring in the same location, the best option I have found to prevent them is to use a product called Engo Patches. They are a durable patch which sticks to the inside of your shoe and drastically cuts down friction levels. For more information on Engo Patches, and some more detailed advice on how to avoid and treat blisters, check out the website blisterprevention.com.au.

Glen Smetherham, Head Coach
Consistent Running Online Run Coaching