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Taping advice for 100km Oxfam walk

Discussion in 'Biomechanics, Sports and Foot orthoses' started by RachWadd, Mar 24, 2015.

  1. RachWadd

    RachWadd Member


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    Hi all,

    I have a patient who is taking part in the Melbourne 100km Oxfam walk after easter and she has asked me to tape her feet prior to help prevent blisters.

    I am wondering if any of you have had experience in this walk or one of similar length, and could give me some advice on the best taping or strapping techniques and materials that work best.

    I was going to use a mix of hypafix, strapping tape and fleecyweb over the digits, posterior heel and medial 1st MPJ area.

    Any other advice?

    Rachwadd
     
  2. Turtle

    Turtle Member

    Hi Rach,
    I have been involved in a few of these as a participant and podiatrist. I think the big thing with this kind of event is the preparation, in that participants should have a well tested plan well in advance of the actual event (months). I think a large chunk of the blisters seen can be prevented by:

    a) Appropriately fitted shoes (and orthotics if required) which have been worn for 150-450km of training walks, including a few 30-60km walks, covering the diverse types of environments that the walk covers.
    b) Appropriate moisture management including quality socks.
    c) Reduction of other risk factors such as debridement of heavy callused areas 1-2 weeks before event.
    d) Address any mechanical factors that may be causing blisters (eg functional hallux limitus->pivoting around hallux->blisters)

    Ultimately, I avoid padding/strapping unless the above do not work. If all of the above have been checked off and the patient is still getting blisters you can start using your padding and strapping techniques. If you do intend to pad and strap as a preventative measure, make sure the patient has trialled this padding and strapping in the lead up to the event. You really don't want to do anything new for the first time at the event.

    The general rules I follow:
    - Remember 2nd year undergrad: No creases in the skin or tape.
    - Round all your corners or it will roll up
    - Use skin-prep or friars balsam under the tape
    - extend any padding and taping beyond the areas of greatest friction - if the edge of the tape is exposed to significant shear force it will roll.
    - only pad/strap areas that are known to blister or develop hotspots

    As far as specific techniques go, it really depends on where the blisters are developing and what is causing them.

    Materials: I primarily use fleecy web and hypafix.

    I don't think zinc oxide is good for first line blister prevention. It macerates the skin underneath, is prone to wrinkling when exposed to shear forces, can result in sensitivity and should a blister develop underneath is near impossible to remove without tearing the blister.
    Things like blister-blocks and compeeds have a similar issue to ZO. Fine for going dancing on a night out, but not for walking 100km.

    Any padding or strapping applied can inadvertently cause blisters. The only time I think padding or strapping should be used in the prevention of blisters, is when nothing else works.

    It is worth volunteering at one of these events to see the effects of poor or inappropriate padding.

    Cheers,
    Alex
     
  3. RachWadd

    RachWadd Member

    Turtle,

    My sincere apologies for not thanking you before now! I had formulated a reply to you soon after your return post, got distracted and never sent it. So please let me thank you now for your excellent reply, it was very helpful.

    I realised after I posted the question that there was a huge amount of info available online - some taping videos on the Oxfam website even which will teach me to do my research before asking a question!

    I ended up using hypafix only around the heels, medial 1st MPJ and 4/5 digits as those were sites of previous blisters. The patient reported back the week after the walk with no blisters where the taping was, only between the 1/2 digits.

    I will think seriously about volunteering next year as I found out from my patient that there seems to be a shortage of pods to help out - participants having to wait in line for ages to see someone. Plus, it sounded really interesting.

    Thanks again for your detailed reply. Have a great week.

    Regards
    Rachwadd
     
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