Footcare should become a priority to those that spend a great deal of time in the outdoors. After all, your feet are perhaps the most important part of your engine, and they carry you wherever you need to go. Here is an introduction to footcare in the field.
Rarely do I ever see a normal foot. There is no such thing, really. All feet are as individual as their “owners.” What I do see are feet that have been abused. I can usually tell when there has been a local moonwalk or charity run by the number of people who require toenails to be removed from over-blistered nail beds. Sounds lovely, doesn’t it! To be honest, I love it.
People tend to forget about their feet, only really paying attention to them when they are uncomfortable or causing them pain. The fact that people rarely walk any distance, combined with the use of motorized transport, has divorced us from ensuring our footwear is functional or even foot shaped!
As a podiatrist, I spend a lot of time encouraging people to wear shoes that are more appropriate for daily living and fit them well.
There are many conditions that affect our feet.
Warm, moist, and dark environments are ideal conditions for fungal infections to thrive. If left untreated, these can develop into open sores, which in turn could result in a more serious infection such as cellulitis, especially in people with diabetes.
There are many over-the-counter antifungal treatments available, with Terbinafine Hydrochloride 1% being the most commonly used. Keep some handy and use them as soon as the tell-tale blisters or itch between the toes starts.
For skin that has gone white and rubbery, swabbing daily between the toes with cotton wool balls soaked with rubbing alcohol can dry the skin out. Talcum powder is not recommended, as this can form balls between the toes and result in blisters or sores.
Fungal nail infections are common, but there is no need to spend money on expensive products. A daily application of tea tree oil can, over time, can cure this.
Anybody who has particularly sweaty feet will probably be familiar with the pitted “moonscape” appearance of the soles of their feet, but excessively sweaty feet can cause problems, from the feet sliding around in the shoe or boot leading to blistering to other more serious conditions.
Immersion in water or waterlogged conditions can result in serious damage to the skin. In cooler conditions, wearing wet socks and boots can lead to trench foot. This condition, common in the trenches of World War One, if left untreated, can lead to gangrene and possible amputation.
Warm water immersion foot is a condition resulting from prolonged exposure (48hrs or more) in warmer wet conditions and results in wrinkled white skin, or maceration, and thick pitted skin on the soles of the feet.
When out in the field, have a plan for water crossings, whether it’s a pair of trainers or walking sandals, if appropriate. If possible, a second pair of shoes or boots that can be worn on alternate days would be ideal to allow for wet boots to dry.
Make sure dry socks are to hand and avoid socks that don’t wick the moisture away from the skin. Cotton socks, though they are a natural fiber and absorb a degree of moisture, don’t wick moisture. Carrying plastic bags that can be worn over the top of dry socks inside wet boots is a useful backup.
Some common problems:
Many people have hard skin around the borders of their heels, across the balls of their feet, or the edge of their big toes. This can crack and, if left, can fissure deep into the lower tissues, making walking very painful. These fissures may become infected and can be difficult to heal.
Using an emery style foot file regularly on dry skin and applying a moisturizing foot cream containing urea to reduce the hard skin and maintain suppleness helps reduce the risk of this happening.
If a fissure happens while in the field, a blister plaster such as Compeed will help keep any bacteria out and hopefully stop the fissure from getting any larger.
These are usually no more than an irritant, but if left untreated, they can become wounds that can become infected. Making sure footwear fits well helps reduce the formation of corns, but if any appear, visit a podiatrist to have them removed and avoid the miracle “corn removing” plasters that can be bought in the pharmacy.
Blisters are painful, fluid-filled lesions produced by friction and pressure. They can be caused by ill-fitting shoes, new and stiff boots, socks that are wrinkled or have a thick seam running over the top of the toes, a deformity within the foot, or excessive moisture through immersion in water or sweaty feet.
The best ways to prevent blisters are keeping your feet dry, wearing properly fitting shoes or boots, and ensuring socks are seam-free. If my socks have a seam, I turn them inside out to stop rubbing over the tops of my toes. Wearing a thinner pair of socks under walking socks can help reduce the friction and prevent blistering.
If you are unfortunate enough to get a blister, don’t be tempted to burst it. Most blisters will heal naturally and require no specialist attention. The blister will dry as the body reabsorbs the fluid. The skin will dry over the top and will eventually peel off, leaving healthy, healed skin underneath.
Don’t be tempted to burst the blister as the skin over the top provides a natural barrier to infection, but allow them to heal naturally.
Cover blisters with adhesive plaster, and if the blister bursts, don’t peel the skin away, but cover the area with a padded dressing.
These happen when the tiny blood vessels in the toes constrict in cold weather and reduce the amount of blood to an area. Warming the area up causes the leakage of fluid into the surrounding tissues.
These are more likely to develop in people who have circulatory problems. It is thought that rapid changes in temperature, such as putting cold feet near the fire or onto a hot water bottle, can result in chilblains.
This is more likely to occur if wet socks and shoes are kept on in very cold conditions, resulting in significant tissue destruction. I recommend that anyone suffering from frostbite get to a warm environment as soon as possible and commence warming up the affected areas carefully.
Rewarming should not be attempted if the affected area could be re-exposed to the cold as this could cause further damage. The process is painful and should really be carried out under medical supervision.
Currently, almost 35 million people have been diagnosed with diabetes in the US. And in people suffering from Type 2 diabetes, footcare becomes an important aspect of their daily lives. Type 2 diabetes is a condition that can result in changes in the feet, with the most common being a loss of sensation or even increased or phantom sensations.
Loss of sensation to the feet can affect how a person walks. Balance can be affected, and it can result in damage to the feet that the person is unaware of.
Someone who has diabetes with a loss of feeling in their feet needs to be very careful to have properly fitting shoes as peripheral neuropathy (damage to the nerves in the feet) can mean that rubbing or pinching is not felt until there is a wound.
Essentially, adopting good footcare practices and ensuring footwear is well-fitting and appropriate to the conditions will all combine to keep your feet in tip-top condition.
Everyone should have a good pair of nail nippers and an emery foot file. If dry skin is a problem, a good foot cream with urea should be used daily, avoiding putting any cream between the toes.
Any hard skin should be filed whilst the foot is dry two or three times a week. Nails should be kept relatively short.
Ensuring you have blister plasters such as Compeed (you can get Compeed toe plasters as well), antifungal creams or gels, clean socks, and replacement shoes/boots as well as plastic bags in your kit bag will cover most eventualities that could happen “in the field.”
However, adopting good footcare practices, as a matter of course, will help to keep you comfortable and active for hopefully many more years of wilderness exploring.
Andrea Bower has written this article for Prepper’s Will.
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