AMC Outdoors, July/August 2000

By Michael Lanza

We are hard on our feet. We not only expect this complex body part consisting of 38 muscles, 52 bones, 66 joints, and 224 ligaments to carry us upright — something for which it was not originally designed — but to stand up to running, jumping, hiking with a heavy pack, AND climbing, all while spending sustained periods of time in cramped footwear.

Ain't that a kick in the shins.

"We punish our feet," says Dr. Howard Palamarchuk, an international racewalking competitor, now assistant professor in the in the Department of Orthopedics and Director of Sports Medicine at the Temple University School of Podiatric Medicine, in Philadelphia. "Then we put them into all kinds of shoes. There's a price to pay for these activities."

Most outdoor enthusiasts won’t pay the price of giving up their favorite activities, so to avoid paying the price of painful foot problems we must learn how to love our feet, that they may carry us through many years of bipedal bliss. First and foremost:

• Get activity-appropriate footwear that fits.
• It's simple advice, but keep your toe nails trimmed.
• "Know your overall condition and your foot type," Palamarchuk says — meaning, don't overdo activity, and get medical advice if you suspect your feet are genetically prone to problems.
• Don't ignore pain. Acute pain is a signal to stop; chronic pain suggests a problem that requires medical attention.

Common Foot Problems
Below are common foot problems and some tips from Dr. P. on dealing with them.

Blisters are minor burns caused by friction on hardened skin and are more likely to occur on skin that's wet and warm — like a foot inside a boot. Besides having good footwear, start each day with clean, dry socks. When out for a long day, yank off your boots and socks and let them and your feet dry out whenever you stop even briefly. Wash your feet every day. Treat a blister or any "hot spot" right away. A slightly red or tender spot can be protected with an adhesive bandage, tape, or a piece of Moleskin or Second Skin. Leave the skin on a small blister. For a large, painful blister, sterilize a needle or knife in a flame, then pop and drain the blister. To prevent infection, clean around it and apply an antiseptic ointment. From the center of a piece of Moleskin large enough to overlap the blister, cut a hole as large as the blister, then place the Moleskin over it. You should be able to walk.

Overuse injuries are common among "weekend athletes," usually attributable to a sudden increase in a training schedule, or a singular devotion to one activity so that you build up only specific muscles while other muscles remain weak. The result: injury or inflammation in muscles, tendons, fascia, ligaments, bones, bursa, and joints. Avoid such injuries by increasing activity levels gradually, stretching properly, warming up before and cooling down after exercise, taking rest days, mixing physical activities — and stopping if you feel pain.

Treat inflammation with anti-inflammatories like ibuprofen, and obey the rule of RICE: Rest, Ice, Compression, and Elevation. Moisten a hand towel, stick it in the freezer for 30 minutes, then wrap it snugly around the injury for 15 minutes, repeating this at least through the first 72 hours. If pain becomes chronic, see a doctor.

Achilles tendonitis is an inflammation where the calf muscle meets the back of the heel. Common among people with shortened or tight calf muscles, it may be caused by failure to stretch before and after an activity that stresses that tendon, like running or hiking hills. Stretch by leaning toward a wall from about two feet away with your heels flat on the ground. Or sit with legs extended, wrap a towel around the ball or your foot, and pull gradually on it. Avoid radical stretching, like dropping the heel off a curb or step. Besides RICE, you may need shoe inserts to treat Achilles tendonitis — in both shoes, not just for the injured Achilles.

Arch pain, or plantar fasciitis, afflicts the plantar fascia, a ligament that extends from the heel to the ball of the foot and supports the arch. Running and jumping can strain the fascia, causing a dull ache. Good shoes with a rigid heel and cushioning will often protect against arch strain, but once it develops, you may need a shoe insole, or orthotic, for arch support. An insole should have a true arch support, rather than just be a cushioned pad; if an over-the-counter orthotic doesn't work, get one custom-made. RICE helps.