7 days in the Sahara

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Hi, I have a client who is doing the 7 days in the Sahara race-a 245km foot race across the Moroccan Sahara.

My client is prone to blistering of the toes on long marathons and he has tried injinji socks but finds them uncomfortable and gel toe covers sweaty...is there any other advice I can give him or any links?

 

Have your patient put about a teaspoon of vaseline (petroleum jelly) between all the toes of each foot, before he puts his socks on, It will feel greasy and gooey for the first 5 minutes but, in my experience of running 13 marathons, was the best thing for blister prevention. This has been a relatively reliable way of helping prevent blisters in long, warm/hot races in my patients also.

 

An old remedy is to soak your feet in tea.
I have suggested to patients that they make a strong pot of tea and, after it has cooled, use it in a foot bath for 20 minutes or so.
I have had a few Ironman Triathlon patients report that it has worked a treat. I think it is the tannin in the tea which decreases sweat and toughens the skin little.
Similar to Potassium Permanganate...
No matter what, they should try these remedies a few times before the race.

 

I worked on the medical team for a similar race in the Gobi Desert in 2005. While I have worked on and participated in single day endurence races from marathons to ironman triathlons to adventure races, I was not prepared for the ravages of these ultra endurance stage races in the sand. Many athletes had full thickness ulcers on digits and heels by day 3 and many lost toenails. I found that the most experienced athletes had their foot care routines perfected to the point where they rarely visited the medical tent.

You don't mention where on the toes he is blistering but if your patient does not like Injinji socks, or gel sleeves or a hydrophobic skin lubricant, then he might do well by wrapping his toes with paper tape. I was skeptical of this technique at first but saw it work very well. He will need to use an adhesive like tincture of benzoin first then wrap the toes individually with a single layer of tape. He should not use cloth tape, or anything other than paper tape. The paper is very thin yet durable enough to last all day on the trail. Cloth tape ends up taking too much room in the toebox. Some athletes would tape and then apply pertoleum or other lubricant over the tape before putting on their socks.

I can't emphasize how important it is that he learns while he is training what works best for him so that he has less to worry about during the event. Open sores on the feet will make for a miserable race for him.

I really admire the mental toughness of these ultra distance runners. I hope his toes don't let him down.

 

Hi

I competed in the MDS, I taped my feet with leuko tape, I also used a vaseline like gel between my toes, which helped. Once the blisters started I taped around toes. My one word of advise, is don't go to Doc Trotters for blisters, as they debride all of the dead skin, so you don't get an infection from the sand, but leaves you running on raw tissue and the guys who had this done were in agony. In our tent, we burst the blister with a needle, sterilised (as much as you can) with an alcohol wipe!!! Then ran through a piece of cotton covered with betadine, hurt like hell, then dressed it. Can't tell you how much I cringed when doing this, especially being a pod, but it really worked.

If the guy can keep his feet in good shape for as long as possible, he'll be fine.

The one thing with vaseline is that once the sand gets into it, it becomes like sand paper, so you have to be careful, its a definate no no, to use it between the legs to help prevent chaffing!!!!!!

Cheers
Esh

 

Sharon,

I dont think I have ever seen a runner following the Marathon Des Sables who didnt have blistering in some way, shape or form - even if they were not usually prone during a 'mere' individual marathon. If he is the kind of runner who is long suffering with blisters he has likely tried many different things over the years and it is important he just sticks with whatever works for him in my opinion. It may not prevent blisters but in endurance events of this proportion it is just about minimising problems and staying comfortable (relatively!).

Different things work for different runners and what one runner uses to their benefit may cause increased blistering in others. Paul makes an excellent point - they need to to this experimenting during training, and trying something new for the event may not be advisable.

I too have an immense admiration for these athletes

Let us know how he gets on

Ian

 

Hi,
I am a third year AZ podiatry student who has crewed for the hot Badwater ultramarathon, have done a couple 50ks myself, and have a close friend who has completed the MDS.

Just a couple things to add:
- Your client may want to buy running gaiters to keep the sand out of his/ her shoes.
- There's a book written by a non-Podiatrist athlete who treats feet at endurance running events, Fixing Your Feet by John Vonhof, which has practical advice on toe-taping and dealing with blisters when they pop up. It may be a good reference for your client.
- There are several toe-lube options, many of which he can find here:
http://www.zombierunner.com/store/categories/foot_care/lubricants/
The gels are just lighter/ more viscous than plain vasoline. Also, for unknown reasons some people fare better with powder in the toe area instead of p-jelly.
- When drinking or dumping water on himself during the race, make sure that the water doesn't run in to the shoes (the gaiters should help here; at other races people crewing the runner may wrap towels around the ankles when spraying down the runner)
- He probably knows this, but his feet will swell significantly in the heat so make sure he brings (and possibly breaks in) a pair of running shoes several sizes larger, as well as a knife to cut open toe areas if needed.

I agree with Dr. Langer, Dr. Kirby, and Ian that the patient needs to include gear testing as part of his training and simulate the hot, sandy environment as closely as possible.

Best of luck to him!

Jamie Mieras

 

Thanks, I have printed up all replies for info for any future patients that may be doing such sports. It's always handy to be prepared with a bit of info.