Preparing Your Feet for Marathons
Marathons are not for the faint hearted and require plenty of determination and hard work. Those who sign up know the importance of training prior to the event, building up your mileage gradually and including a conditioning and strength programme to avoid injury.
However, how many of you think about preparing your feet? Given that foot pain is the second most common drop-out reason after dehydration it seems like a pretty important area to address. Read on to find out how to get your feet marathon-ready and get you over the finish line.
A common question I am asked – “What footwear is best” or I often hear people in my clinic stating “I only wear good shoes”. So what makes a good shoe? Generally people perceive an expensive shoe to be a good one but this definitely is not the case. Others believe certain brands are better – this is partly true but is down to the individual. Let me explain…
A good shoe is a shoe that fits you and is fit for the job at hand – or foot in this case!
We are bombarded by the media with flashy marketing sales pitches about the latest footwear technology. Reading through online forums on which running shoe to run out and buy can leave you feeling dizzy. Then you might turn to your running club crew for advice – again all will give you great advice on which runner they found best. But this doesn’t mean it’s best for you. Just like our face, body and skin type are different, so are our feet.
So to answer the question – there is no specific running shoe or brand that is “the best”. Instead of naming footwear brands or telling clients what runner they should get I tend to just give the following tips
- Take the time in the shop to make sure the shoe fits and feels comfortable. You should never have to “break-in” footwear. So if in the shop it feels a bit niggly or unsupportive take it off and try another.
- Footwear should fit lengthways but also widthways. Have your feet measured and check that there is at least 1cm (thumb-width) gap between the tip of the shoe and your longest toe (which isn’t always the big toe!). The width should fit the widest part of your foot and your heel sit snugly in the back. Remember your foot swells during a long run so take this into account. It’s best to try on footwear at the end of the day when your feet are a bit more swollen.
- Visit a reputable shop that specialises in running footwear and has a person actually qualified to assess you. Do not be persuaded into buying something you don’t need or do not feel comfortable in. Listen to your body – it knows what’s best for you.
- Learn how to tie your shoelaces to suit your foot type. Who knew that there are particular ways to tie your laces to suit your foot shape? From high arches, to narrow ankles and even a longer second toe this video shows you how.
- Minimalist or maximalist running shoe? There is research to support both. The general consensus amongst sports podiatrists is to swap around your running shoes. Two benefits (1) hygiene and (2) varies muscle activation. The forces going through our muscles vary in different shoes so changing around your running footwear can prevent overuse injuries.
- Once you have found the shoe(s) that suit you make sure to wear them for a few shorter runs first and then at least one long run (20k+) before the marathon just to be sure they don’t rub or cause any aches and pains.
- You may find that old trustee pair of tennis shoes were perfect for the 10k but once you start increasing your mileage you really need to purchase a shoe that has better support. There are articles out there that suggest you change your running shoes after 300, 500 or 800 miles. There is no definite number. Listen to your body. If you were having no trouble and suddenly you’re feeling a twinge it may be time to head to the shops.
So no brand-pushing or marketing here – whether that helps or not, I don’t know. It’s up to you to find the best running shoe for you. Take your time in the shop, do your research and try on many different shoes. If it feels good then it’s probably “the best” for you. And let’s not forget about socks. Look for something seam-free and moisture-wicking (i.e cotton free). The right shoes and socks are a great start to get you through those miles.
Skin and Nail Care
Increasing your miles means increasing the repetitive forces and pressure on your feet. This can lead to pathologies of the skin and nails of the feet. While sometimes they are just inevitable there are things you should do to prevent them or at least stop anything from getting worse.
Let start with toenails. It’s very common for runners to have thickened, black or loose toenails. This is from repetitive trauma i.e. the toes hitting the top of the shoe with every step. To prevent nail trauma keep your nails trimmed and filed. Tie your running shoes correctly and make sure they fit well. While it’s a good idea to have your running shoe a little bigger to allow for swelling when running, if they are too big or loose the foot will slip forward. Protective silicone toe caps are available to buy from chemists or online but make sure to trial these on shorter runs because they can slip off or cause friction.
If your toenail is loose or painful it is best to see a podiatrist to have it managed correctly. Better to have it removed and properly dressed than ripped off by a sock or bedsheet (ouch!) Same with ingrowing toenails ~ I beg you please do not cut down the side of your nail! So many times I have had a squirming patient in the chair come to be rescued after their failed attempt at removing a nail spike. Guess what? They have left a bigger, deeper, more painful spike behind – it’s not pleasant for either of us!
Our skin is our protective layer and will respond to the forces we put it under. So when you start pounding the roads it’s inevitable that you will build up areas of protective hard skin on your feet. However when callus and corns become painful they need to be treated. Applying a cream with the ingredient ‘urea’ will help to keep callus under control (See my blog on Foot Cream to find out more about this). A routine podiatry appointment to have the callus and corns removed will leave your feet feeling much better but should be done at least a couple of weeks before a marathon.
So what is a corn? – another common question in the clinic. Put simply they are cone shaped areas of hard skin that need to be enucleated or “scooped out”. Paring or filing the top will give you a bit of relief but the center core will remain and build up again. Avoid using medicated corn plasters as these contain acid which burn the corn but also all the healthy skin around it. I’ve seen some nasty cases of people that put them between the toes and ended up with an ulcer.
There are recommendations out that for “toughening up” the skin of the feet to prepare for marathons. People soak their feet in foot baths with alcohol based products or apply formulas directly to the skin which dries it out and allegedly “toughens” it. I put this question to a group of experienced podiatrists and athletes and the general consensus was that this is not good practice. This type of treatment is good for feet that sweat excessively and are prone to a fungal skin infection but won’t really help to prevent callus or blisters.
Sometimes no matter how well your footwear fits or how much you take care of your skin, blisters can happen. There’s plenty of advice out there on blister prevention. Rebecca Rushton is the podiatrist guru on blister prevention so check out her website here for the best advice.
Rebecca and many podiatrists and athletes swear by Engo Blister Prevention Patches. These patented patches stick to you footwear making them a more skin-friendly and cost-effective alternative to blister patches such as Compeed. Great as a preventative measure and also handy to bring along with you on the marathon just in case. Plasters and blister patches generally won’t stick to the skin unless it’s clean and dry so during a marathon you need something that’s going to stay in place.
But what do you when you get a blister? To pop or not to pop?
If the blister is intact the best thing to do is not to pop it, but protect it. Often when something hurts people put padding on it. However it’s actually better to put padding around the blister so to deflect pressure from the area. A little trick us podiatrists like to call ‘offloading’. Podiatrists use semi-compressed felt which can be bought online or in any good chemist. I’ve added links to websites that sell this padding and photo examples of offloading below – a picture paints a thousand words. Sorry I couldn’t find anyone with an actual blister but hopefully it gives you the right idea. If you’re stuck make-up pads with some medical tape can work just as well but might not stay in place so well.
If the blister has popped, it’s best to remove the loose skin as bacteria can get trapped under it. This can cause an infection and slow down healing time. A podiatrist can debride the blister removing all the tissue that slows down healing and then apply an appropriate dressing with offloading. If you can’t get to a clinic use a sterile blade to remove all the loose skin and apply a hydrocolloid dressing like Compeed or Duoderm.
There is nothing worse than a niggle or an ache in your foot when going for a run. Look after your feet and they will look after you. Happy running and best of luck to those training for marathons!