by Dr. Stephen LefflerFew things can end a hunt as quickly as foot problems. Blisters can bring an elk hunt to a stand still. Even a mild ankle sprain can prevent you from getting to your stand. Problems like ingrown toenails, calluses and corns can make hunting and hiking uncomfortable and cause you to divert your attention from hunting to your painful feet. With preseason preparation and a little thought, many foot problems can be prevented and you can get your hunt off on the right foot.(Pun intended!)
Your foot is a complex structure composed of 26 bones, 33 joints and 19 muscles. Our feet have evolved to provide balance, power, and flexibility. Two developments in human evolution have dramatically increased the incidence of foot problems. When we began walking upright we freed up our hands to do lots of other important tasks like shooting a bow. This was an unbelievably important evolutionary step, but was pretty tough on our feet. They went from supporting about half our weight to 100% and had to adjust to a different load bearing pattern. We were also able to run faster and jump higher which also increased the demands on our feet. The second development was shoes! For millions of years we basically went barefoot or covered our feet with light leather sandals. Our feet were allowed to flex, adjust to ground contours and breath. Our feet were not designed to be squeezed into rigid non breathable boxes. Shoes, particularly high heels cause many foot problems. Since most of you are not wearing heels to your stands you may think that your shoes could not be a problem. On the contrary, if you wear poor fitting shoes which rub your feet raw or don't allow them to breath and get rid of excess moisture your shoes can cause big problems. Your feet are amazing structures which are able to withstand tremendous physical forces and do incredible amounts of work. They withstand more than 100 tons of cumulative force per day and will walk more than 115,000 miles in you lifetime. They typically perform these functions with little complaint and you don't even think about them. The wear and tear does take it's toll though. More than 75% of people in the US will have foot problems at some time in their lives. Most of these problems are minor but some can be quite serious and even life threatening. Foot pain is not normal and if your feet hurt you should find out why and take steps(pun intended again!) to correct the problem. My guess is that hunters, because we walk more and are tougher on our feet, have an even higher rate of foot problems. In this article we will look at common problems, prevention and treatment.
BLISTERS
The first topic to discuss is blisters. Blisters form when the skin on your feet is subjected to friction. Blisters always begin with excess moisture. Sweaty or wet skin softens and is much more susceptible to skin breakdown and blisters. Your feet have over 250,000 sweat glands which are capable of producing a half pint of moisture each day. If all this fluid remains trapped in your shoes you are going to have problems. Typically, poorly fitting shoes will continually rub a particular spot on your foot. Moisture softens the skin and allows the outer layer of skin to actually separate from the deeper layers. Fluid fills this space to form a cushion. Your body does this to try to prevent damage to the underlying tissue. At this point you will notice pain and see a blister. Now is the time to take care of the problem. The treatment first consists of getting your feet clean and dry. A fresh pair of socks is ideal. In fact, even on backpacking hunting trips where weight is at a premium a change of socks for every hunting day should always be part of your load. I also like to keep a pair of clean dry socks in my day pack so that if I develop a hot spot on my foot 5 miles from camp I can clean and dry my feet and change my socks to a dry pair. This alone will prevent the vast majority of blisters. If you notice a painful spot on your foot take off your shoes and carefully examine your feet. If a blister has developed most experts recommend leaving it intact and covering the area with mole skin. You are trying to build a cushion over the blister to prevent any further pressure on that spot. Ideally you would clean your feet in a stream and fully dry them. You would apply the moleskin to the blister and put on your dry socks. Hopefully this would prevent further enlargement of the blister and get you back to camp. If the blister has already popped you should trim away the dead skin and cover the area with a product called Spenco Second Skin. This is a material that looks like plastic wrap which is applied over the clean blister base and provides a clean protective coating and will speed up healing. It is available in most pharmacies and many backpacking stores. It is pretty expensive, costing about 10 dollars for a small sheet but you typically will only need a small amount and it is cheap insurance for your hunt. A sheet of it is always in my first-aid kit. I also know that endurance runners have good luck covering popped blisters with duct tape so keep that in mind if you are in a pinch. The risk of infection is much higher after the blister breaks so you will need to keep a close eye on it.
Ideally we would like to prevent blisters. The first step is to buy well fitting shoes that breath. Rubber boots are great for scent control but cause lots of blisters. Leather is ideal because it breathes. Synthetics can be good but many materials will cause your feet to feel like they are in a steam bath. The shoes should be worn a lot before your big elk trip to assure that there are no painful spots. Shoes should be comfortable the day you buy them. It is a mistake to believe they will "stretch out". Also you should buy your shoes in the afternoon. Over the course of a day your feet swell. Shoes that are snug in the morning could easily be too tight by the late afternoon leading to painful blisters. The toe portion of the shoes should be loose enough that you can wiggle all your toes. Many people recommend wearing two pairs of socks when hiking. The theory is that the socks will slide over each other instead of the sock sliding against your skin. The problem is that two pairs of heavy socks can develop creases or bunch up which will guarantee the development of blisters. I personally have had mixed success with this method. Two pairs of heavy socks does not work well for me but I have had great luck wearing a thin pair of 100% polypropylene liners and a heavier cushioning pair of cotton or wool socks as my outer layer. The liners are skin tight and very slippery. They allow the outer socks to slide against them and prevent friction against my feet. As an added bonus the liners wick moisture away from the skin and help to keep my feet dry. The key is to experiment with your shoe and sock system long before opening day and figure out what is comfortable and works for you.
ANKLE SPRAINS
Next we will look at ankle sprains. Ankle sprains are very common and typically occur on the outside of your ankle. The most common mechanism is to roll your foot inward or invert it. This stretches or ruptures the lateral or outside ankle ligaments. You will quickly notice pain, swelling and a bruise. Ankle sprains range from mild, with minimal damage to the ligaments up to fractures of the ankle. Most sprains are mild. Typically if you can still walk and bear weight on the ankle soon after the injury you have a mild sprain. These can be treated with rest, ice and elevation. These maneuvers will keep the swelling down. We used to place most sprains in splints but early mobilization is in favor now and I like to get people bearing some weight on the ankle within a couple days. If the swelling or bruise is severe or you are unable to walk on the ankle you should seek medical care to get an x-ray and rule out a fracture. Most ankle sprains will recover within 2 to 3 weeks.
Now we will look at some long term foot problems that should be dealt with well before hunting season. Corns and calluses are thickenings of the outer layer of skin caused by friction. These occur in areas where your shoes constantly rub against your feet. It is sort of a chronic blister. The outer layer of skin builds up to protect the underlying structures. Corns occur on the tops of your toes. Repeated rubbing from poor fitting shoes or unusual anatomy of you toes causes you to build up a corn. A callus is a similar condition on the bottom of your foot. Corns and calluses are often quite painful and can make it tough to hike 5 miles into sheep camp. The good news is they usually respond to conservative therapy. The first step is well fitting shoes with a wide toe box and low heels. This will help to take pressure off the area. The thickened skin can be softened with medications and trimmed away. If the problem recurs or is no better after these measures your physician or podiatrist will usually obtain x-rays to rule out a bone spur or other underlying problem that may require surgery. The time to solve these problems is now. Treatment is usually successful but takes time. Seeing your doctor a week before your caribou hunt will not work.
BUNIONS
Bunions are our next topic. A bunion is a red painful bump on the joint of the big toe. With this condition the big toe typically angles in toward the other toes. Bunions are caused by poor fitting, tight shoes. The shoes literally squeeze your big toe into an abnormal position. Bunions occur gradually developing over years. This is in contrast to gout which is also a very painful lump over your great toe joint but develops very quickly. Once you have developed a bunion there are things that can minimize the pain. Well fitting shoes with a roomy toe area and anti-inflammatory medications can help. Sometimes cortisone injections or specially made insoles for your shoes may help. The final treatment and only curative one is surgery or bunionectomy. Your podiatrist will remove the painful lump and realign your great toe. This is the best long term solution although it will lay you up for a while.
HEEL SPURS
Plantar fascitis is a painful condition involving the bottom of the foot. The plantar fascia is a ligament which attaches to your heel. Abnormal stretching of this ligament caused by poor arch support, being overweight or walking abnormalities can lead to chronic inflammation and pain. Over the long term you may develop a heel spur which is a bony growth at the front of your heel which is your body's response to the chronic irritation. Typically plantar fascitis is worse in the morning or after inactivity. After walking the foot becomes less painful as the ligament stretches out. Mild cases can be treated with anti inflammatory medications. Special insoles for your shoes can improve your arch support and greatly reduce your symptoms. Physical therapy which stretches out the ligaments and muscles is also very helpful. A physician will usually obtain an x-ray to check for a bone spur. Severe cases that do not respond to the above measures may require surgery to remove the spur.
INGROWN TOENAILS
Ingrown toenails are quite common and also very painful. Ingrown toenails occur when the edge of the nail grows into the flesh of your toe causing pain and possibly infection. They are typically caused by incorrectly trimming your nails. They are also hereditary. Tight fitting shoes can also contribute to the problem. Mild ingrown nails can often be treated simply by cutting your nails straight across and leaving your nails a little longer than the end of your toe. You absolutely should not curve the ends of your nails inward. If the nail is very painful or shows any sign of infection you should seek medical care. Your physician or podiatrist will remove the offending piece of nail and treat the nail bed with a chemical to prevent recurrence. This method is highly effective.
SHIN SPLINTS
The last topic we will touch on is shin splints. This is a common problem for people who are trying to get in shape in a hurry. Inflammation and tearing of the anterior shin muscles is caused by overuse. The muscle becomes painful and irritated within days after beginning a conditioning program. It is most common in joggers. If you start gradually and slowly increase your mileage the condition can usually be prevented. If you are already suffering from shin splints, anti-inflammatories and rest will resolve the problem. Since jogging is the biggest culprit often you can ride your bike or do some other type of cross training to continue your training.
As you can see, your feet can suffer from numerous conditions that can hamper your ability to hunt effectively. Luckily with minimal care and common sense they can carry you through a lifetime of adventures. Foot pain is abnormal and should be addressed. Many foot conditions develop slowly and flare up with the increased demands of a big trip. Early attention to foot pain and preventative measures can keep you hunting effectively.
