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BEFORE THE RACE …

( 2 to 4 weeks before )

General : Wash your feet daily , especially in between the toes . Also dry them carefully and apply some foot powder . At this stage you should be blister free .

Foot Pathologies : Any injuries should have been treated and hopefully cured already – if you are ill or injured at this stage , then you should consider not doing the race – and all general foot ailments like corns , callouses , nail or skin issues should be professionally treated .

Cutting Nails : Cut them straight across , and not too short , then file them to make them smooth . If you have any nails that are damaged , thickened , blue , ingrown or discoloured yellow , then do not cut them yourself . If necessary , go and see a podiatrist for proper cutting and treatment of these conditions .

Running Shoes and Socks : The most important thing is to make sure your running shoes are ready to go . They should be your tried and tested shoes that you are used to , and they should be well worn in , but not old , broken and worn out . Now is not the time to be buying new shoes or experimenting with any other shoe brands or models . Also , get yourself cotton-rich , BCool or Drynamix socks – these modern materials are found in most modern running socks ( see top brands like Falke & Balega ). Importantly , if flying to the race , carry your running kit and running shoes in your hand luggage , as there is always a chance of your gear going missing in checked-in luggage .

RACE DAY …

Blisters : Try your best to avoid getting your feet wet , as this can lead to you getting blisters . A blister is a normal protective mechanism from pressure or friction , and generally they are not serious , but on a long race like the Comrades , they may become a more severe problem as the race goes on .

If you are prone to blisters , try prevent them from starting by applying a lubricant ( Vaseline or lube gel ) to your feet may help . Also , there are many plasters and dressings that may help prevent them , which can be found in your local pharmacy . Just be careful , as these plasters and dressings may come off during running , which will make the problem worse . If a blister starts with a ‘ hot spot ,’ then it is necessary to stop , remove your shoe and either apply a lubricant or a band aid , or similar dressing , to protect the area . If the blister remains small , then just manage it , but if the blister gets bigger , you may have to stop and have it drained . After draining , you must apply a dressing to protect the now raw area of the skin .

Managing Pain : During the race your feet may become painful – the longer the distance , the more chance of this happening , and there is not much you can do for the pain on the day . Resist taking analgesics or anti-inflammatory medication for the pain .

AFTER THE RACE …

Rest and recover : The damage and trauma of a long race need time to repair . Massage your feet and have a whole-body massage to relieve the stress and strain .

Treat Blisters : If a blister is small and not leaking fluid , it should be left alone to resolve itself . This blister will be reabsorbed by the body and heal on its own , but protecting it from further friction or pressure will make it more comfortable . However , if the blister is large or painful , and going to pop open by itself , then it must be treated . The area should be cleaned with an antiseptic and the blister opened with a sterile scalpel blade or needle . The roof ( top skin ) of the blister should not be removed , as it protects the raw area during healing . All the fluid should be drained , and the area dressed daily with an antiseptic dressing for a week or two until healed .

These lesions sometimes become septic because of poor cleaning and an inadequate dressing procedure . If this happens , then an antibiotic cream / ointment must be used . Sometimes oral antibiotic medication is needed . Of course , prevention of further friction and pressure is important . Always check the sports shoes for the proper fit , width and length , and Vaseline the feet well before running .

A blood blister under a nail ( subungual haematoma ) from the trauma of running is more complicated to treat . The important thing to do is to pop the blister through the nail and then drain it . You will get immediate relief ! This process is best done by a podiatrist , and a local anaesthetic can be used if necessary . Future prevention of this type of blister is needed , so check the depth of the forefoot of your running shoe .

Other injuries : Now is the time to also take care of any injuries that might have occurred on the race day . See a professional for appropriate management of the injury .

Dennis Rehbock is a podiatrist and has practiced for 40 years in Johannesburg . He has a special interest in podiatric sports medicine , wart and nail surgery , but also practices general podiatry , treating and managing foot-related injuries , disorders and deformities , as well as prescribing and manufacturing orthotic devices for various foot biomechanical conditions . He is a keen runner , having completed the Comrades Marathon and many other races . More info at www . footdoctor . co . za .

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