Pain in Feet.

[Anghiker]

I recently did a 50+ mile hike on the AT. We did this in about 6 days, slackpacking. After the first day I started to get pain in the ball of my feet and especially in the 3rd & 4th toe area. I used one of those pads that's suppose to help that and it did for about 3 miles and then it would start in again. It did get worse but we were down there so we kept going. It's not like I was in extreme pain it just hurt. I was using my Merrill Moabs that are great to start with but also I had been wearing them for about 6 months. I also started to find blisters on the sides of my heels and the side of each big toe. I was very discourage but we kept going. Before I was done I had blisters on my blisters! Not a good thing. I don't know if the pain in the ball and toe area caused me to walk differently but I would like this not to happen again.
If anyone can give me some advise if this has happened to them and what they did, I would appreciate it.
I do have an appointment with a podiatrist but they can't take me for 3 months!

[Train Wreck]

I recently did a 50+ mile hike on the AT. We did this in about 6 days, slackpacking. After the first day I started to get pain in the ball of my feet and especially in the 3rd & 4th toe area. I used one of those pads that's suppose to help that and it did for about 3 miles and then it would start in again. It did get worse but we were down there so we kept going. It's not like I was in extreme pain it just hurt. I was using my Merrill Moabs that are great to start with but also I had been wearing them for about 6 months. I also started to find blisters on the sides of my heels and the side of each big toe. I was very discourage but we kept going. Before I was done I had blisters on my blisters! Not a good thing. I don't know if the pain in the ball and toe area caused me to walk differently but I would like this not to happen again.
If anyone can give me some advise if this has happened to them and what they did, I would appreciate it.
I do have an appointment with a podiatrist but they can't take me for 3 months!

Find another podiatrist, to start with. 3 months? Is he podiatrist to the stars or something?
I had a similar problem until I got custom orthotics designed for high arched feet. I would start out section hikes where the first day went ok, the second, the balls of my feet started hurting after about 5 or 6 miles, by day 3 it started after 2-3 miles. It was really quite painful and felt like I was stepping on a large bruise every time I put my foot down.
The orthotics helped to take the weight off the balls of my feet, which is where my podiatrist said most of my weight was resting due to the arch. It pretty much solved my foot pain problem (except for long hikes on the PA rocks, which is another story entirely).

[Wise Old Owl]

Guerra Michael DPM Podiatrist
195 Hospital Loop #4, Berlin, VT (802) 223-6155 ‎ · burlingtonpodiatry.com

Gifford Health Center at Berlin Podiatrist
82 East View Lane, Berlin, VT (802) 229-2325 ‎ · giffordmed.org

Central Vermont Foot Clinic
195 Hospital Loop, Berlin, VT (802) 223-6155 ‎ · burlingtonpodiatry.com
Category: Podiatrist

Green Mountain Orthopaedic Srg: Aros Brian C MD
130 Fisher Rd, Berlin, VT (802) 229-2663

Prevention on the trip
1. Keep your feet and your socks as clean and dry as possible. Wash your feet every evening and don't wear your socks for more than one or two days before washing them. If your socks become stiff they have a greater tendency to chafe the skin. Clean socks also help prevent other foot ailments such as bacteria growth. Dry socks inside wet boots are better than wet socks. If your feet are wet during the day it is important to dry them at night and either air them out with no socks while you sleep or use clean dry socks. Foot powder can be a boon to people with sweaty feet. I always carry at least 2 pairs, wearing one and drying out the other. In a very wet environment, I take 3 pairs.
2. Say hello to your feet every morning and evening. Sit down and really look at them. Know what your feet look like when they are healthy. Are there red places or sore spots? If there are, of if there are spots you know you are prone to developing blisters, put duct tape over that spot.
3. Socks should fit well. Avoid having wrinkles or lumps inside your boot, and if you feel wrinkles, stop and smooth your socks out.
3. Soak your feet in cold water. If you're walking by a stream, take the time to pull your boots off. Not only will it feel delightful, it actually helps to prevent blisters by reducing swelling. Putting your feet up when you take a break does the same thing.
4. If you feel a hotspot, stop and treat it immediately. A hotspot is a place where the skin is being chafed and can quickly develop into a blister if not cared for. A simple piece of duct tape is often all you need. If the area is quite sore or red, a piece of moleskin with a hole cut out of the middle is more effective. The hole should be placed over the hotspot - this decreases the friction over that area.
5. Change what you're wearing on your feet. If you wear liner socks and you're getting lots of hotspots, take them off. If you're not wearing liners and you're getting lots of hotspots, try wearing some.


Blister treatment
Sometimes no matter what you do, you get blisters. This is not a moral failing. However, they should be treated immediately.
1. Decide if the blister needs to be popped. It is less likely to develop infection if it is left intact. However, if it more than 3/4 inch in diameter, if it is likely to pop anyway because of it's location (which it usually is), or if the fluid is hazy, it is better to pop it in a controlled fashion that leaves a covering of skin. Typically I don't cover or pop blisters in the evening - I wait to see what they look like the next morning.
2. If you don't need to pop the blister: Cover the blister with a piece of mole skin cut to a size larger than the blister itself. It should have rounded edges to avoid being lifted when it is back inside you boot. Then cut a hole slightly larger than the blister itself and place it over the blister. If the blister is particularly tall, another piece of mole skin with a hole in it may be placed over the first. Cover the blister and mole skin with a dressing and an adhesive bandage.
3. If you do need to pop the blister:

• With flame-sterilized nail clippers or small scissors make a small “V” cut in the side of the blister. Make the cut at the edges of the blister where ongoing foot pressure will push out additional fluid. This allows better drainage than needle holes. Push all the fluid out with your fingers.
• Apply a small dab of antibiotic ointment or zinc oxide to the top of the blister.
• Directly over the blister, apply a blister patch like Spenco’s Sports Blister Pads, or a large duct tape patch with a piece of toilet paper in the middle to keep the tape from sticking to the roof of the blister.
• After applying a patch, roll socks on and off to avoid disturbing the patch, and use a shoe horn to ease the heel into the shoe.

Like many things, over time you will learn what works best for you!

[litefoot2000]

Go on Roadrunners.com and find out what type foot you have.

[Anghiker]

As for the podiatrist, 3 months is common here. We're rural and because I am a new patient. They do have me on a cancellation list, maybe that will make it sooner. My sister has been the gamut of the podiatrist in the area and has told me which one not to bother to go to. So that cut our 3 or so dr's in the area down to one!
Train Wreck your feet sound just like what happen to mine. I'm thinking I will need orthotics as well.
Wise Old Owl, Thanks for the prevention tips. I do most of those tips. The moleskin worked great on the blisters but after a few hours even that would bunch up so I started to put duct tape on the moleskin to hold it and that worked great to keep the moleskin on.
Thanks everyone for your advice and input.
Happy Hiking and Happy feet!

[Wise Old Owl]

Yea the bulk of their business is folks with Diabetes.... When I visit I have a list of questions and let them know about my years of standing on a salesfloor and years of hiking... there has to be give and take... Orthopaedic's is a serious step up and also a professional who can help.

[Chair-man]

I also started to find blisters on the sides of my heels and the side of each big toe. I was very discourage but we kept going. Before I was done I had blisters on my blisters!

I can't address your foot pain but as far as the blisters go I'll say this.
Loose fitting socks = blisters
As you might have guessed, blisters are caused by friction. When you wear loose socks the socks become part of the shoe and rubs against your skin. When you wear snug fitting socks the socks become part of your feet and the friction goes between the sock and the shoe.
Also, try wearing toesocks to eliminate any blisters on your toes, they worked for me. Injinji and Smartwool both sell toesocks.

[bflorac]

Had similar problem. Waited 3 months to see podiatrist. Of course the pain was gone by then. He prescribed custom in soles. They helped the balls of my feet but the elevated heal caused LT band issues with my knee. Tossed them out.

1) Got shoes that fit. This took forever because I have wide feet with high arches. This rules out 99% of the boots. Ended up with New Balance.
2) Switched to SuperFeet (green). Not perfect due to my wide feet but better then original. I wish I could get them wider to support by wide heels.
3) Stretch. Yes, stretch you feet. Every time you take your boots off or put them on stretch your toes, arches and ankles.
4) Rest often. Every break, take you boots off (and stretch) Let them air out. Stick them in cool water if you can.
5) Take Advil, Ok perhaps that is just me getting old. But I pretreat my with a dose of Advil at night to keep any swelling down.

[bflorac]

"Got shoes that fit."
Just because a shoe is the correct length (and it should be 1/2 longer because you feet will strech) it does not mean it fits. Try different styles, manufacturers. Two shoes of the same length but different styles, even from the same manufacturer are not the same it. Look for shoes leave lots of room for your toes to move. Use the upper laces (of a ankle high boot) to keep your foot to the rear going down hill. Loosen them a bit going up. Use poles to help going down hill so you down cram your toes into your boots. When going down hill, think "heal-toe" so your foot rolls thru the normal motion. Often it helps to walk like a penguin. Don't run down the hill, take steps, even if you have to zig-zag back and forth across the trial.

[MuddyWaters]

I dont have anything to add.
Except to reiterate that pain and blisters, hiking low miles without a pack, is not exactly "normal". That would ruin anyones time, and it doesnt have to be that way. Please do yourself a favor and do seek some resolution on the problems.

Without any additional information, I would only expect those issues from someone that fairly overweight, not used to doing much walking at all, and wearing poorly fitting boots. with heavy socks. Or that has some unusual foot problem.

My feet hurt a bit at the end of 20 mile days on a lot of rocks. But thats carrying a pack, and they are always 100% the next morning. I also wear fairly minimal footwear.

Blisters are caused by pressure. By pressure forces that pushes on the skin , literally tearing it away from the underlying tissues.
Less pressure = less blisters. Lighter pack, lighter body, = less blisters. Slower pace, less impact forces = less blisters. Lower miles = less blisters.

Liner socks, allow the two socks to slip, reducing the friction between shoe and skin, so the force transmitted by the pressure to the skin is less. This works to some extent, in some cases where the forces are not perpendicular, where they are transmitted to the skin at an angle. I would think for that reason that liners do less for blisters that occur on bottoms of feet from impacts. I used to have to tape my feet when I ran every day to prevent blisters under my arch and balls of feet. This spread the impact forces out over a larger area of the foot. However, I dont ever get any blisters hiking with thin socks and trail running shoes. I keep my shoes fairly loose and my feet can slide around a bit too. No problems.

[shelb]

... moleskin with a hole cut out of the middle is more effective. The hole should be placed over the hotspot - .... Cover the blister with a piece of mole skin cut to a size larger than the blister itself. It should have rounded edges to avoid being lifted when it is back inside you boot. Then cut a hole slightly larger than the blister itself and place it over the blister. If the blister is particularly tall, another piece of mole skin with a hole in it may be placed over the first. Cover the blister and mole skin with a dressing and an adhesive bandage.

Suggestion: Ditch the moleskin. Pack duct tape. In my experience, moleskin will bunch up and I still pop the blister or rub off the protective cover of an already popped blister. Several Thru-hikers suggested duct-tape, and since then, I have been told speed-skaters use it also. Put the duct tape on a "hot spot" or a blister.

My experience? Duct tape on a blister remained on all day and easily peeled off at night, leaving the blister (larger than the size of a quarter) INTACT for 3 days of 10-15 mpd hiking in SNP.

For the last two years, we have had much better luck having our Scouts pack duct tape for hot spot/blister issues than the old mole skin.

However, that is just our experience.... If the other works for you, go for it (it didn't work for us!)

[bflorac]

FYI - not all duct tape is the same. There are all sorts of tape qualities and tape adhesives. I've had some that fell off as soon as it rained and others that actually pulled my skin off with it as I removed it (ouch). That said, I still use it in a pinch. I have also had good luck with Leukotape P Sportstape. It it thinner and smoother than most duct tapes and stays on even when wet.

If you really want duct tape that sticks, avoid the cheap **** at walmart. Get what is referred to as "gaffers tape" like "Permicel/Shurtape P-672"

[perrymk]

2) Switched to SuperFeet (green). Not perfect due to my wide feet but better then original. I wish I could get them wider to support by wide heels.

http://www.superfeet.com/store/wide_green.aspx

[Blissful]

Ball of the pain foot is a metatarsal issue. Correct shoes and insoles will help the problem. Be sure to get fitted by someone who knows foot types. SUperfeet insoles help - if you have high arches you need the green, lower arches, blue. Meanwhile roll a bottle of ice under your foot.

[Larry Vaughn]

A npain in that area could be a neuroma. I had trouble with this even before I got on the trail last year. I found that superfeet gave me some relief from the pain after an extended period of time.
the pain would feel like the toe was out of joint and would be accompanied with sharp pains and a noticeable "click" on the joint of the 4th toe. This is a common occurrence for late 30's and 40's, they offer a couple of treatment options including steroid injections and surgery. Also you can get orthotic inserts to raise the bones and help align the metatarsals (foot bones ).
Without having the Pod Doc do something I highly recommend the superfeet. Also be sure your shoes are wide enough to allow expansion of the foot while hiking, if it is neoroma then a tight fitting shoe only exacerbates the problem.

[shelb]

FYI - not all duct tape is the same.

If you really want duct tape that sticks, avoid the cheap **** at walmart. "

This is VERY true! We use around 10 rolls of duct tape on a theatrical set every fall. On occassion, someone has purchased the cheap kind and it DOES NOT WORK! We do not go for a certain brand; however, we do make sure that it is the more expensive type sold by Meijer, Walmart, or whatever hardware store we are going to.