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The cold world of alpine climbing.

The cold world of alpine climbing.

Sunday, July 24, 2011

Your feet!



This is likely one of the most important blogs I will write on Cold Thistle.

I figure if you are reading this blog you are into climbing.  All sorts of climbing, rock, ice and snow.  That means being out 12 months of the year on you feet besides just the climbing.

If you are like me, enough miles and you eventually get injured.  Major or minor injuries have a way of adding up.   Something I didn't really believe when i was 18 and now realise just how wrong I was on that myopic perspective.

"The human foot is one of the best-engineered parts of the body.

Each foot has 33 joints, eight arches, 26 bones, more than a hundred muscles, ligaments, and tendons that all work together to distribute body weight and allow movement. Unfortunately, many people pay no attention to their feet – until they start to hurt.

Foot disorders must be diagnosed and treated early, before they become very painful and incapacitating. In some cases, some painful foot abnormalities are already warning signs of even more serious ailments such as diabetes, circulatory disorders, and nerve problems.  Do a self-check while it’s early.."


It looks like this pair of feet will be loosing 5 out of 10 toe nails. Likely the result of a combination of running and climbing abuse?



Few things will really slow you down in the mountains.  Knees will.  But everyone who has had a bad blister on their foot will acknowledge just how disabled you can be when you feet start hurting.

Staying mobile will keep you climbing in one fashion or another.  There are other joints that will slow you down but the ones that seem to most easily effect us are the feet, and knees.

If you look the first set of feet with the taped toe, pictured above with the title, the thing most obvious is the over size joint at the ball of the foot, base of the big toe.  It is called a Bunion.  Sad as it seems , your feet change over time and generally get bigger. Bunions can be hereditary, but for climbers it can exacerbated by abuse of long walks, tight rock shoes, or rigid soled boots.

I replaced several pairs of perfectly good winter boots last year for just those reasons. Capsulitis of the second toe, Hallux Abducto Valgus (bunions) and a few other issues of simply wear, tear and age means bigger boots and prescription orthotics to slow the progression. If left unattended you will end up with some seriously damaged feet and a long term loss of mobility.  Below is a good sized bunion on the left foot and hammer toes on the right foot.. 



Here is a look at just a few of the common foot issues climbers (or anyone might) have.  Do your self a favor and take a look at your own feet.  Address the issues sooner than later.




"Plantar Fasciitis
When there is increased stress on the arch, microscopic tears can occur within the plantar fascia, usually at its attachment on the heel. This results in inflammation and pain with standing and walking and sometimes at rest. It usually causes pain and stiffness on the bottom of your heel.

Bunion



An enlargement on the side of the foot near the base of the big toe (hallux). The enlargement is made up of a bursa (fluid filled sac) under the skin. The term bunion is also commonly used to describe a structural (bony) deformity called hallux abducto valgus (HAV). Bunions can be painful and can be aggravated by activity and wearing tight shoes.

Neuroma

In the foot, a neuroma is a nerve that becomes irritated and swells up. If the nerve stays irritated, it can become thickened which makes the nerve larger and causes more irritation. Pain from a neuroma is usually felt on the ball of your foot.

Corns & Callouses

Corns and callouses are areas of thick, hard skin. They usually develop due to rubbing or irritation over a boney prominence. The hard, thick skin is called a corn if it is on your toe and it is called a callous if it is somewhere else on your foot.

Toenail Fungus (onychomycosis)

Fungi like a warm, moist and dark environment (like inside a shoe). A fungal infection in your toenails may cause the nails to become discolored, thickened, crumbly or loose. There are different causes and it is difficult to treat due to the hardness of the toenail.

Ingrown Toenail (onychocryptosis)



An ingrown toenail can occur for various reasons. The sides or corners of the toenail usually curve down and put pressure on the skin. Sometimes the toenail pierces the skin and then continues to grow into the skin. This may cause redness, swelling, pain and sometimes infection.

Hammer Toes

A hammer toe is also sometimes referred to as a claw toe or mallet toe. It involves a deformity of the toe where there is an imbalance in the pull of the tendons. Either the tendon on top of the toe pulls harder or the tendon on the bottom of the toe pulls harder. This results in a curling up of the toe.

Plantar Warts (plantar verucca)

Plantar warts are caused by a virus. Plantar means bottom of the foot, but warts can occur other places on the foot and toes as well. Plantar warts can be painful depending on where they are located. Sometimes they are mistaken for callouses because layers of hard skin can build up on top of the wart.

Flat Feet (pes planus)

Just because you have flat feet does not mean you will have problems or pain. If you do have pain, there are various treatment options available. If you only have one foot that has a flat arch, it may be due to another problem and you should get it checked out.

Athlete's Foot (tinea pedis)

Athlete's foot is a common skin condition that can affect everyone, not just athletes. It is caused by a fungus. It may cause redness, itchiness, tiny bumps filled with fluid or peeling skin. It is most commonly located between the toes or on the bottom of the feet.

Achilles Tendonitis

Achilles tendonitis involves inflammation of the Achilles tendon. If the tendon stays inflamed long enough, it can lead to thickening of the tendon. Sometimes nodules or bumps can form in the tendon. Achilles tendonitis can become a long term problem or can lead to rupture of the tendon."










Capsulitis of the second toe, (or any toe)


 Hallux Abducto Valgus (bunions), hammer toe, onychocryptosis, and Plantar Fasciitis have all plague this pair of feet.  Much of the damage is a given from hereditary.   But much of the damage could have been mitigated by the use of a prescription orthotic early on ( or even a well fitted off the shelf orthodic) and more carefully picking the approach and climbing footwear to be used.

Foot injuries and broken bones from martial arts, accidents, cold injuries while working, skiing and climbing, the use of overly tight rock shoes, and rigid soled alpine boots all add to the long term damage.  And slow recovery.   But as much as anything your genes, your heredity, will have much to do with how your feet fair over time.  That is luck of the draw.   A good Podiatrist may be able to limit the damage or fix what you have been given. 

More here on what to look for and avoid:



Mountain boots?



I think there should be much more concern with several issues on mtn boots.  First is the low quality generally worthless, insoles boots are delivered with today.  I have $700 and $1000 production boots that come with insoles that sell for less than .10 cents a pair.   Come on!

The other concern in recent boots is a super rigid sole and a very flexible ankle.  Our feet don't work that way.  You are bound to have feet  issues with a bad insole and a dead rigid sole.

11 comments:

Anonymous said...

How about avoiding injuries by strengthening your foot with barefoot/minimalist shoes running ? I had all kind of pains in my feet for the last 5 years and cured them all in 3 months running once a week for 15 minutes in minimalist shoes(will do 2 times a week starting next month). It also increased my calves endurance so going uphill is much easier now.

Alex

Dane said...

Alex,
Good question. I am a minimalist myself and have never (well seldom) ran in anything but racing flats (up to marathon distances) or the newer Nike Free, style shoes. No question in my mind you get stronger feet, ankle and calf muscles from doing so.

The issues I am talking about in this blog post have nothing to do with avoiding injuries but protecting what you do have, not sure that minimalist or bare foot running will do anything for them beyond, limiting hammer toes and Plantar Fasciitis. Actually I would bet barefoot/minimalist shoes make all the rest of the issues mentioned worse. I certainly suspect in has in my case. My running has gotten better/easier over the years with no injuries but my foot issues have increased and climbing footware and fit more problematic every year.


If you look at Native peoples who go bare foot a lot, bunions obvious and everywhere. One reason that many times they aren't capable of wearing shoes.

marcello said...

you should do a post on knee safety. These are so informative and useful.

Anonymous said...

Dane,
Racing flats are too narrow and have a sole that's not flexible enough and Nike Free are just cushioned shoes, both far from being truly minimalist. Have you tried Merrel Trail Glove or New Balance Minimus? The trick here is getting a shoe with a lot of flexibility and enough toe room so that when you press your forefoot into the ground there is little to no contact with the sides of the shoe(went a full size larger for this reason). You had me worried with the thing you said about barefoot tribes having bunions but I'll just take the risk , there is no way I'm going back to padded shoes and orthotics.

Alex

Dane said...

Alex,
I still think you are missing the point. Lots of different "flats" available, in sole size and patterns. Different amounts of flex available within tha group as well. Like anything wear what works best for you. I do.

But I don't suggest to anyone else what works for me will work for you.

Bunions and most foot issues are generally heritary, or over use, or ill fititng shoes not a running shoe issue.

Foot and lower leg, and ankle *injuries* can easily be the wrong running shoe if you are putting on miles.

One more time...I am not talking injuries or running shoes.

The current fad of running bare foot is myoptic imo. Although I never run in even a medium weight shoe. Just takes a few days living with people that don't have shoes and live their entire lives walking every where to see the kinds of foot issues common in third world countries.

All of the feet pictured in the blog are climbers I know. Few of us climb with feet that are totally pain free. I use to, now I don't. If you do..great. Hopefully that will continue for a long time.

I have never and would not suggest a heavily paded running shoe or the general "orthotic" some might suggest for running. Simply doesn't work for me. But someone else might require an othotic to be able to walk let alone run pain free. Everyone is different.

CT is not a running blog. It is a alpine climbing blog. If you want to be able to continue to wear mtn boots you need to take care of your feet. If that requires an orthotic or even surgery then so be it. But the sooner you figure that out the better off you will be and the more fun you'll have in the mtns.

If you think bunions are scary, take a look at crimpergirls feet here:

http://www.supertopo.com/climbers-forum/1562190/Feet

Anonymous said...

Dane,

I got your point but I was just trying to convert you to this myoptic fad of running barefoot as gratitude for all the information I got from your blog. And I still disagree that flats are minimalist shoes ;)

Alex

Anonymous said...

Two points: the barefoot running craze will be over when people overdo it and begin to realize a wide range of injury. We do a lot of trail running here in Bozeman and I don't know of anyone doing serious trails with the minimal shoes. Lightweight yes, but not things like the Vibram or Free. Like most things, people to not take the time to learn how to use the tool. They are at best a short distance training tool.

Second, the best investment is custom insoles. If you have any shoe without them you wasted your money on the boot. There are lots of options including some self thermal forming you can do at home.

Stretching and foot exercies will help.

Dane said...

Alex, now that was funny. If you are going to preach, you should know the choir better :)

Anon?

"the best investment is custom insoles. If you have any shoe without them you wasted your money on the boot. There are lots of options"

I agree that boots require a decent insole and there are lots of options. But like bare foot running, home molded insoles aren't for everyone or the uneducated.

Actual foot issues should be diagnosed by a doctor and treated accordingly.

Anonymous said...

Anon,
Just to give you a bit of perspective, in the ex Soviet countries people used to run in flat soled replicas of Chuck Taylors and Adidas, really bad shoes, but it was the only thing available(my father ran marathons in them). Forefoot strike was the only way you could run in these shoes and many chose to go barefoot. We only got "real" running shoes in the mid 90's so for us cushioned soles are a fad for which I fell and paid with serious pain, going minimalist is just running normally by our standards.

Alex

Dane said...

Alex I'll let you guess what pair of feet pictured in my blog comes from a Soviet country.

Until very recently all the US military ran in some pretty dismal boots as well.

But your point is well taken.."going minimalist is just running normally by our standards." My standards as well.

Anonymous said...

Try SmartToes Toe Stretchers, I tried a number of products for hammer toe relief, and this one is by far the most effective. SmartToes is great for hammer toe treatment and bunion treatment.