February 15 2018
In this excerpt from Running Rewired, author Jay Dicharry describes what your body feels every time you take it for a run.
Adapted with permission of VeloPress from Training Essentials for Ultrarunning by Jason Koop, coach to elite ultramarathoners. In his book, Koop reveals his highly effective ultramarathon training methods for ultrarunners of all abilities.
Training is the first level of prevention in blister formation. Your skin adapts to stress just like any other organ in your body. Many studies, primarily involving the military, have demonstrated that gradual exposure to frictional forces on the foot (through hikes and marches) decreases the skin’s susceptibility to blisters (Allan 1964; Hodges, DuClos, and Schnitzer 1975; Knapik et al. 1995). As you train, your epidermal skin cells become thicker and in theory more cohesive, making them more resistant to blistering. How does this happen? As you run, you slough off skin cells faster than normal. These are rapidly replaced by new skin cells, but these young cells don’t get the chance to differentiate into layer-specific cells (epidermis, dermis) before they are stressed by another run (S. H. Kim et al. 2010). When this happens frequently over a relatively short time, it results in overthickened skin (i.e., the callus).
Still, you’ve got a great chance of getting blisters during an ultramarathon. Whenever you stress an organ or a structure in your body beyond its capabilities, you cause damage. Ultramarathons normally represent a longer, more difficult run than your day-to-day training, complicated by the fact most ultramarathon events occur in areas away from your home training grounds. The trail surface, camber, dirt, dust, and debris your feet encounter are undoubtedly different during the race than at home. Furthermore, your biomechanics are different depending on the properties of the trails, placing stresses on different areas of the skin of the foot. Therefore, the shoe/sock/powder/tape/lubricant/insole combination that worked in training may not always work during the race. Just as training on flat ground will not completely prepare you for a mountainous ultra, training on your home trails might not fully prepare your feet for the rigors of race day. Therefore, a combination of education, preventive measures, and wound care skills offers the most comprehensive way to ensure that your hard-earned training does not come undone by the unraveling of your feet on race day.
If you do get a blister (or the precursor, which is referred to as a “hot spot”), you have a decision to make: You can save some time and continue running, or stop and lose some time treating your feet. In making this decision, you need to balance your race-day goals, performance expectations, safety, and race situation. Generally speaking, the more time you have left to run and the bigger the problem could become, the more it is worth your while to take a few minutes and fix what is wrong. Don’t let little problems become big problems. My advice is to always err on the side of caution and fix problems early, particularly at the 100K and 100-mile distances, where there is a lot of ground to cover. Blisters come in a variety of shapes, sizes, and levels of discomfort. Treatments also come in many shapes and forms. Unless you are a medical professional with many years of blister management experience, a simple solution is always best.
I have found success with the following nine-step plan:
If you are particularly blister prone, practice various techniques at home. Cutting and placing the patch on the surface of the skin can be the most frustrating part of the process during a race. The tape is sticky and adheres to itself and to your fingers. You’re in a hurry. You’re sweaty and dirty. And you’re working in a dirty, dusty environment. Finding a routine and learning some simple skills goes a long way to making the process smoother and faster in race conditions. As with any other skill, practice makes perfect!
Jason Koop is the Director of Coaching for CTS, coach to elite ultrarunners, and an elite ultramarathoner. Koop’s book Training Essentials for Ultrarunning reveals his highly effective ultramarathon training methods for ultrarunners of all abilities. Learn more at velopress.com/koop.