From a Medic’s point of view – Preparing for your racing season and “How to stay out of the medical tent”
Most of you will start to build the miles before our snows start to melt up here in the Tahoe area if you haven’t already. As you work toward that 50 K, 100 K, 100 mile or eventually the Tahoe 200, I would like to throw out a few points to think about from issues that have been presented to me as a volunteer medic for many endurance events over the years.
Let’s start from the bottom, up…your feet
One of the world’s largest beta testers for keeping your feet pounding away for miles and days at a time is the US Army and US Marine Corps. An army travels on it’s feet, and it is “Mission Critical” that their feet survive endless marches with an 80 pound rucksack on their backs. They have had many thousands of “testers” over the years to show what works and what does not.
1) When you consider your footwear, don’t forget that your socks are an integral part of that choice. Cotton is comfortable for short walks, but not comfortable and a terrible choice when it comes to protecting your feet over long distances. Once they become wet, they stay that way, turning your little piggies into Dim Sum and impossible to save your race from a medic’s standpoint. Wool and wool blends have been a good choice as well as synthetic socks and Injinji toe socks have worked well for many runners.
2) Keep your feet dry and change your socks often!
This point, I cannot emphasize enough. According to the American Podiatric Medical Association, your feet have about 250,000 sweat glands producing up to one pint of sweat per day. Your feet will get wet regardless, so it is best to take preemptive measures to prevent getting blisters from wet feet. Your feet need to breathe was much as your lungs…they deserve half the credit for getting you to the finish line. Oddly enough, to the best of my memory, I have never had to treat a runner that ran in sandals…for the life of me, I don’t know how they do it, but they don’t seem to develop foot problems like shoed runners.
When you stop for refueling with a energy bar or a nature break, take 5 more minutes to dry your feet, elevate them (allowing lactate and excess fluid pooling in your legs to return into circulation), put on Glide, powder, whatever works for you…get on a pair of dry socks, and get back in the fight.
Using a contractor’s safety pin from the hardware store, you can attach your wet pair of socks to your running vest to dry out until the next stop.
When stopping at an aid station, don’t just feed your face – take the time to inspect and treat your feet.
Wear gaiters. This will keep most of the grossly irritating debris out of your shoe, and you don’t need to stop as often to remove the debris. Some say it also keeps the moisture in, which is true…BUT, you’re going to be changing those socks about every 2 hours anyway, so it should not matter that much.
3) Treat yourself, get a pedicure…feet, toenails, the works. Do not go into the season with the old school of thought of building calluses…you will only develop blisters under the calluses, making it more difficult to treat. Medics prefer not to lance your blister in a very dirty environment…remember, it is sterile fluid inside the blister…it hurts, but it won’t get infected. It’s best left for you when you get home or to your hotel room to “pop” it in a cleaner environment.
4) If you feel a hot-spot coming on, don’t ignore it. It’s your early warning that a blister will be there soon if not treated now. Take your shoe off, check and see if your sock is bunching up…if not, remove the sock, look at your foot. If you brought tape with you (as you should have), place a piece of tape over it to reduce further abrasion.
Please take care of your feet before entering the race. Calluses, fissures, cracks in your skin, toenails not trimmed…is all on you. Medical staff would love to reverse all of your maladies, but it’s just not possible at an aid station, when we need to attend many runners nearly at the same time, and get you back in the race.
Nutrition and Hydration
I have written several articles before on the dangers of over hydration on the Fuel section of our newsletter. Please review that before the longer races you may enter this year. Last month, we covered GI issues that ultra runners encounter by not fueling/hydrating often enough to keep their GI tract “awake”.
Drink to thirst and don’t “over medicate” yourself with salt/electrolyte tabs. A little is good, a lot is not better. Remember, salt drives thirst…it’s an easy way to over hydrate yourself as well.
Don’t forget, a little protein at those aid stations go a long way in staving off catabolism for your body. Your muscles will break down over time throughout the race. Your body might break your muscle protein down to make glucose…ingesting a little protein throughout the day can help your body stay ahead of the curve on muscle breakdown.
Underlying medical issues
For those that suffer from asthma, this year might be a problem in the Tahoe basin. Last July at the Tahoe 100, we treated asthmatics and non-asthmatics alike with respiratory issues due to pine pollen. We even treated a young racer at our Great Ski Race event in Truckee in a blizzard! She forgot her puffer…(Albuterol) meds for her asthma…so if you have meds that you take for any reason, please remember to bring them on race day. Medics cannot medicate you without an MD to prescribe/administer it to you. You have to help us so we can help you.
Real trauma happens
Some events are grueling, and take your body to task. Sometimes we see real trauma that is more than a bug bite, a blister. Many are repetitive injuries, from constantly pounding the trail with your forefoot. If you can, take some lessons from seasoned runners like Coach Peter, about changing your gait when you start to develop forefoot pain.
I have a picture from the Tahoe 200 several years ago…it is an example of “Don’t be this guy”. Long before your foot looks like this, after changing socks and inspecting your feet, look for discolorations and areas of pain and where the tissue just does not look normal. Let’s assess it and make some decisions as to what is best for you, the race and your health for continuing on or dropping to do it again another day.
As Medics, we’re here to keep you in the fight, patch you up and move ‘em out. We’re not at the aid stations to treat runners that did not prepare their feet or themselves completely for the race. We would like to, it’s in our make up to treat people that are sick or injured. We will pass you on to Emergency Medical Services if you are in need of more serious attention. But preparing yourselves for battle is up to you trail warriors.
Please take good care of yourselves before race day, so all you see of the Med Tent peeps is a smile and a wave for good luck.
That’s all for this month…thanks for listening.