Foot Care
From WildWiki
Contents |
Foot Care
The success and enjoyment of a course can ride on the well-being of the students feet. Proper foot care is an important as sound hygiene to the welfare of the expedition without it our students can have a miserable, painful or abbreviated wilderness experience. To prevent this, students need to be motivated and disciplined about taking care of their feet.
Educational Goals:
Students need to know how to wear their socks, boots, gaiters and camp shoes properly they need to be able to identify and treat foot problems (hot spots, blisters, tendonitis) long before they become debilitating.
Key Points:
Personal Safety Concerns
Be aware of your feet. Think about where you are stepping, how your feet feel, and what their recent history is.
Avoid walking barefoot. Any cut or puncture on your feet has a high risk of infection. Keep your feet clean. Feet that are washed every day are less likely to develop skin irritations caused by salt and dirt build up. Toe nails should also be trimmed (flat and straight- not curved). Dry your feet before going to bed to promote good circulation, sensation, skin integrity, and to avoid trench foot. Don’t try to dry socks on your feet while you sleep.
Proper Foot Gear
1. Socks: two pairs of socks help provide cushioning and sweat absorption when hiking. Wrinkles should be smoothed out and the toe seam should run across the top of your toes. The socks heel should ride on your heel, not above or below it. Bunched up socks cause more blisters.
2. Boots: Boots should fit tightly enough to provide adequate ankle support, but not so tightly that they cause soft tissue problems: hot spot, blisters, or tendonitis. Loosen boots for going up hill to allow heel lift. Tighten boots for down hills to prevent toe numb.
3. Gaiters, Galoshes, and Camp Shoes: Gaiters help prevent rocks, snow and dirt from getting into your boots, thereby keeping your socks cleaner, dry, and easier to wash. During early or late season courses when there is a lot of snow, galoshes worn over booties or camp shoes help keep your feet dry and can prevent immersion foot. Galoshes are also less damaging to vegetation in soggy soil. Camp shoes are another way to reduce soil impact and erosion. They could be light and durable, should enclose your foot, and be comfortable with socks. In damp weather, dry feet in camp are a godsend: consider drying your camp shoes near a fire, or lining them with plastic bags to keep your socks dry.
Hot Spots and Blisters
Excessive friction and pressure in one location will cause a hot spot or blister. Factors which contribute to this include dirty and bunched socks, improperly laced boots, new boots, wet socks, and hot feet. Some peoples feet are more prone to blisters and may require preventative taping and mole skin.
Bruising
Though uncommon bruising is caused by high mileage on trails, inadequate cushioning, and excessive weight while hiking in camp shoes.
Tendonitis
The inflammation of the tendon or the tendon sheath is caused by tight-fitting boots or excessive pressure on the tendon.
Foot repair
• Hot spots should be covered with tape or moleskin to reduce the friction on the skin. Socks, boots and walking pattern can also be adjusted to reduce rubbing. Severe hot spots should get a molefoam donut.
• Closed blisters should be kept from enlarging or popping. Often a molefoam or ensolite donut applied around the injury will pad the area and prevent further rubbing. Tape the donut in place. Adjust the boot lacing and hiking pace at accommodate the injury. Blisters bigger than the size of a nickel should be drained with a sterile needle, dressed, and then padded with a molefoam donut.
• Open/drained blisters should be kept moist and clean. Moisture aids in the regeneration of skin, but will attract infection if you are not diligent about keeping the wound clean. Hot soaks in sterile water are soothing and aid in healing.
• Sore feet that do not have any skin breaks or tendon problems can be alleviated with rest in camp shoe, soaking in a cold stream, and foot messages. The key is getting out of the boots as soon as possible. Stiff or tight boots can be exchanged or stretched in the issue room prior to leaving for the field. Stretching and softening can also be achieved in the field be wetting the boots and having the student walk around in them until they dry.
• Tendonitis, like blisters, need to be caught early. Use the Rice method – Rest, Ice, Compression, and Elevation – and Ibuprofen to treat this problem. One can also try re-lacing the boot to relieve pressure or padding each side of the tendon with ensoite rails. If neither of these methods alleviate the pain try making heel lifts from ensolite or molefoam the lifts compress quickly so check them periodically to make sure they are still helping alleviate pressure on the tendon. Extreme methods of controlling tendonitis include cutting out the heel of the boot and or evacuation.
==Teaching Considerations:== Foot care begins on issue day. Right off the bat, encourage your students to wear shoes and see that they have the correct foot gear before departing for the field. Prior to the first hike, students benefit from seeing exactly how to put on their socks, gaiters and boots. Some instructors like to joke that for students, the first few days of a course are like early childhood all over again. During this time they learn how to dress, eat, walk, and poop. A quick lesson on how to walk with flat feet and a shorter, slower stride will help to prevent many foot problems, as well as help your students develop good hiking habits. Encourage students to find walking patterns that work for their feet and boots do not forget to include the “whys” of these techniques. The less we make our instructions sound like rules, the more likely our students will heed our suggestions.
During the first few hikes, periodically ask the students how their feet feel. Check them at breaks. It is quite common for a novice hiker not to notice a hot spot or to downplay the severity of a blister in order to avoid inconveniencing the hiking group. A foot problem can provide a valuable teachable moment on how to adjust boots or make a molefoam donut. Make sure these foot repair sessions are educational and not embarrassing for the affected student. Students also benefit from watching instructors fix their own feet. This helps them pick up different tricks for taping and moleskin, but more importantly, it shows them that all feet are susceptible.
Students are empowered when they can take care of themselves, and they are empowered as leaders for future expeditions if they can take care of others as well. Show them how to fix their feet and get them doing it as soon as possible, See that each student hiking group has its own foot repair kit.
Special Considerations for Canoe Programs
Expedition canoeing requires a different set of considerations of foot care. While participants will not spend as much time on their feet, it is likely they will have wet feet most of the time. This leaves them vulnerable to foot fungus like athlete’s foot as well as more dangerous conditions like immersion foot (trench foot). Instructors should demonstrate proper foot care with students as soon as possible on water-based programs. These include:
1) Proper foot wear while canoeing and portaging (ankle supporting boots)
2) Keeping camp shoes as dry as possible
3) Drying feet out as often as possible on breaks, in camp, and in the canoe
4) For problematic feet, lots of drying time in open air at camp can help as can the use of foot powders and rubbing alcohol. A common routine: air dry feet, then rubbing alcohol, then foot powder, then dry socks and shoes.
