Fixing Your Feet: Injury Prevention and Treatments for Athletes

Fixing Your Feet: Injury Prevention and Treatments for Athletes

by John Vonhof

Paperback(Sixth Edition)

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Take Care of Your Feet!

Your feet take a beating with every step. Don’t wait until foot pain inhibits your speed, strength, and style. Learn the basics and the finer points of foot care before pain becomes a problem. Foot expert and ultrarunner John Vonhof shares how the interplay of anatomy, biomechanics, and footwear can lead to happy—or hurting—feet. Fixing Your Feet covers all that you need to know to care for your feet, now and hundreds of miles down the road.


  • Tried-and-true methods of foot care from numerous experts, plus tips and anecdotes about recovery and training
  • Information about hundreds of foot-care products for nearly every foot ailment
  • High-interest topics such as “Barefoot & Minimalist Footwear,” “Blister Prevention,” and “Providing Foot Care for Athletes”
  • Covers both individual foot care and team care

“From heels to toes, products to pathology, resources to rehabilitation, this book has it all. An essential guide.”
Runner’s World

“After more than 25 years of treating feet and reading about treating feet, I’ve found nothing, absolutely nothing, as helpful as Fixing Your Feet.
—Buck Tilton, MS, cofounder of the Wilderness Medicine Institute of NOLS and author of many books on outdoor health and safety

Product Details

ISBN-13: 9780899978307
Publisher: Wilderness Press
Publication date: 08/02/2016
Edition description: Sixth Edition
Pages: 384
Sales rank: 764,479
Product dimensions: 6.00(w) x 8.90(h) x 0.80(d)

About the Author

John Vonhof brings a varied background and extensive experience to “Fixing Your Feet.” This sixth edition is the synthesis of 34 years of experience as a runner, hiker, and medical professional, and a never-ending quest to learn more about foot care to help athletes in extreme events. His popular website, fixingyourfeet .com, is dedicated to providing articles, resources, links, and a blog about foot care, and it serves to inform and educate athletes about all that’s new in foot care and to provide foot-care advice. Other medical professionals recognize John’s expertise too. In 2009 he was the lead author of a chapter on foot injuries in the textbook Expedition and Wilderness Medicine (Cambridge University Press).
Over the years John has provided volunteer medical aid at numerous sporting events around the world, patching feet, training medical staff and interested athletes, and providing advice to thousands of athletes. His expertise has taken him to Chile; Costa Rica; Brazil; British Columbia, Canada; and many states to help on medical teams. He continues to be sought out for his expertise and experience in providing answers to foot-care questions, especially for multiday events.
A runner since 1982, John discovered trail running and ultras in 1984. He has completed more than 20 ultras: 50Ks, 50-milers, 100-milers, 24-hour runs, and a 72-hour run. He ran the difficult Western States 100-mile Endurance Run three times and the Santa Rosa 24-Hour and 12-Hour Track Runs 12 times. In 1987, with fellow runner Will Uher, John fast-packed the 211-mile John Muir Trail in the Sierra Nevada in 8.5 days, carrying a 30-pound pack. He still runs and rides his road bike. In 1992 John changed careers, becoming a paramedic, orthopedic technician, and emergency room technician. In 2013 he retired from a position as a prehospital care coordinator at an emergency medical services agency in the San Francisco Bay Area.

Read an Excerpt

Barefoot and Minimalist Footwear

A few years ago, no one was talking about minimalist footwear. Then Time magazine named Vibram FiveFingers one of the best inventions of 2007. A few people got on the bandwagon. In 2009 Christopher McDougall wrote the book Born to Run and the issue exploded. McDougall set off to find out why his feet hurt and shared with readers the secrets of the Tarahumara Indians—and a better way to run. Barefoot running and running in minimalist footwear have become much more acceptable, and now the testimonials abound.

Mitch Kern shares his experience with barefoot running: “I’ve been running for years but my career has always been punctuated by injuries along the way. Like so many others I read McDougall’s Born to Run and just had to buy a pair of Vibram FiveFingers. From there I transitioned into barefoot running and have been injury free ever since. I feel like I’ve learned just how to run for the first time. In the past, I was a heel striker/long strider, but now I take a very different approach—faster cadence and on the balls of the feet. I am convinced it is the way to go. People think I’m nuts, but man, oh man, what a difference.”

Talk to a few people who are wearing Vibram FiveFingers or who run barefoot and you will discover a culture has developed. This unique line of footwear has five individual toes—for your toes—and with a Vibram outsole, it is akin to going barefoot. People who were previously unable to run now can. Those who had become accustomed to discomfort and pain from bunions, heel pain, and more have discovered relief. It is worth paying attention to.

Daniel Lieberman, a prominent researcher in the barefoot and minimalist movement, has written extensively on the subject. On his website he says, “We do not know how early humans ran, but our research indicates that humans were able to run comfortably and safely when barefoot or in minimal footwear by landing with a flat foot (midfoot strike) or by landing on the ball of the foot before bringing down the heel (forefoot strike).”

Running barefoot or in minimalist shoes is different from running in the usual running shoe. Most important, you land differently. Danny Abshire, the cofounder of Newton Running, says you acquire a connection with the ground as you run. You are more agile and run with finesse. Others in the barefoot and minimalist movement echo the same thought.

For purposes of this chapter, minimalist footwear is defined as any footwear that does not have the typical high cushioned heels, stiff soles, and arch support common in today’s running shoes. The information and tips in this chapter, generally speaking, apply to someone wearing FiveFingers or other minimalist footwear, or those going barefoot. Many of those wearing minimalist footwear will also forego wearing socks.

And lest you think that going barefoot is only for walking and running, consider the group Barefoot Hikers. Barefoot Chris (his trail name), a member of Barefoot Hikers, recalls the reaction of hikers they encountered while on a weeklong barefoot backpacking trip on the Appalachian Trail. “They told stories of many other barefoot hikers, including at least two that had done the entire trail without shoes.”

A quick online search for “barefoot running clubs” finds many cities with these running clubs. There are also clubs dedicated to walking and hiking barefoot.

Shoes vs. Minimalist Footwear
For years, everyone wore shoes, or if we were hikers, boots. We could choose between neutral, flexible, stable, motion-control, cushioned, lightweight, and trail shoes. We might stick to one design or try several. Many athletes went through pair after pair trying to find the perfect shoe for their feet, often in an effort to accommodate injuries. We had choices—as long as it was a shoe the shoe companies offered.

Yes, there were always a few runners who ran barefoot. Many times they received odd looks. Others looked for ultralightweight shoes, which were few and far between. If you wanted to run, shoes were what you needed.

Kevin O’Neall shared his experience with wearing FiveFingers: “I was close to giving up running after 50-plus marathons and two dozen ultras because of chronic heel pain. My feet had developed golf ball–size lumps where the Achilles tendons insert on the heel bone. After a year and a half wearing FiveFingers exclusively, the lumps are 90% gone. There is still heel pain, but it tends to fade while I’m running. At this point I prefer them to running shoes, even though they do make me a slower runner.”

Of course, there are many arguments for and against barefoot running. Some claim that barefoot running is better for you. Others argue that barefoot running is dangerous and will lead to more injuries. And still others say that running shoes prevent injuries—or lead to injuries—depending on their point of view. Athletes will point to the few studies available to support their views—whatever they are.

The conspiracy theorists talk about the “big lie” from the shoe companies, which want you to buy their shoes. One ultrarunner, a proponent of the minimalist movement, wrote in an online forum, “They want you to buy heavy, stiff, supportive, motion-control shoes so that all the little muscles, tendons, and bones in your feet get weak, conforming to the brand you run in, so that they can upgrade you to the next model, which will invariably be heavier, stiffer, more supportive, more cushioned, more motion control, more expensive, and wear out faster.” Personally, I don’t believe that statement. I think there is room for regular shoes and minimalist shoes—and barefoot running. You have to make the choice, and in my view, it should be an educated and informed choice.

Christian Griffith, an ultrarunner, made a valuable comment in an online forum about the barefoot and FiveFingers bandwagon that so many athletes are touting. He wrote, “It’s a tool to help strengthen, lengthen, and improve flexibility in the leg muscles with the added benefit of forcing me to run what I view as ‘correctly’—meaning upright, with a stable midline, midfoot strike, and gently.” Others in the forum agreed, emphasizing it as a way to learn and maintain good running form and to keep that form when moving back to shoes. While some athletes will stick to barefoot or minimalist footwear, many rotate between a combination of trail shoes, road shoes, barefoot, and minimalist footwear.

Table of Contents

Foreword x

Introduction 1

Getting the Most out of Fixing Your Feet 4

The Best of 20 Years of Foot Care 7

Part 1 Foot Basics 19

1 Seeking Medical Treatment 20

2 You Can Have Healthy and Happy Feet 23

Think "Feet" 23

A Weekly Ritual 23

Talk to Your Doctor 24

Summer Foot-Care Basics 24

Winter Foot-Care Basics 25

Aging Feet 25

3 Sports and Your Feet 27

Sport Similarities 28

Differences in Terrain 29

Conditioning 31

Biomechanics 33

Part 2 Footwear Basics 41

5 The Magic of Fit 42

Learning from Shoe Reviews 43

Know Your Feet 45

Components of a Good Fit 48

Buying Footwear 48

Tips for Hard-to-Fit Feet 52

5 Footwear and Insoles 54

Brand Loyalty in Footwear 57

The Anatomy of Footwear 57

Running Shoes 59

Sports Shoes 62

Hiking Boots 63

Choosing Lightweight Footwear 68

Custom Shoes 69

Sandals 70

Insoles 72

6 Barefoot and Minimalist Footwear 76

Shoes vs. Minimalist Footwear 77

The Value of "Going Bare" 78

The Science on Barefoot Running 79

Function and Form 80

Barefoot Precautions 81

Minimalist Footwear Choices 85

7 Socks 93

Sock Fibers and Construction 95

Buying Socks 98

Specialty Socks 99

Going Sockless 103

Part 3 Prevention 107

8 Making Prevention Work 108

9 Blister Prevention: The New Paradigm 112

Blister Formation 113

Understanding Shear 114

Understanding the Five Factors in Blister Formation 115

The Components of Prevention 120

Finding the Right Combination 123

A Short History of Blister Studies 124

10 Compounds for the Feet 128

Powders 128

Lubricants 130

Skin-Toughening Agents and Tape Adherents 133

Antiperspiranfs for the Feet 137

11 Taping for Blisters 139

Tapes 140

Kinesiology Tape 143

Working the Tape 145

Three Taping Techniques 146

Taping the Feet 148

12 Orthotics 154

Custom-Made Orthotics 156

Over-the-Counter Orthotics 160

Using Your Orthotics 160

13 Gaiters 162

Making Your Own Gaiters 163

Repairing Gaiter Straps 164

14 Lacing Options 167

Lacing Tips 168

Lacing Methods 168

15 Self-Care for Your Feet 172

Skin Care 172

Pedicures 174

Foot Massage 177

Hydration, Dehydration, and Sodium 180

Strengthening Your Feet 182

Changing Your Shoes and Socks 182

Keeping Your Shoes Fresh 183

16 Extreme Conditions and Multiday Events 185

Aching Feet 185

Cold and Wet 188

Maceration 192

Trench Foot and Chilblains 195

Frostbite 197

Snow and Ice 197

Heat 201

Sand 202

Jungle Rot 205

Foot Care in Multiday Events 207

17 Teamwork and Crew Support 212

Teamwork 212

Planning for Foot Care 213

Team Responsibilities 214

Crew Support 214

18 Providing Foot Care for Athletes 216

Being Part of a Foot-Care Team 218

Setting Up Your Station 219

Tips on Managing Blisters 219

Modifying Footwear 221

Advising about Postevent Care 221

Your Tools 222

Mandatory Foot-Care Gear 223

Part 4 Treatments 225

19 Treating Tour Feet 226

20 Blisters 229

Hot Spots 230

Blisters 231

Types of Blisters 236

Draining Blisters 238

Preventing Infection 240

General Blister Care 241

Advanced Blister Patching 242

Extreme Blister Patching 246

Beyond Blisters 254

Fixing Blisters, Their Way or Yours 255

Postevent Blister Care 256

21 Strains and Sprains, Fractures and Dislocations 258

Strains and Sprains 258

Strengthening Exercises 264

Fractures 267

Stress Fractures 270

Dislocations 271

22 Tendon and Ligament Injuries 272

Treating Tendon Injuries 273

Achilles Tendinitis 277

Ankle Tendons 282

Bursitis 283

Plantar Fasciitis 283

23 Heel Problems 293

Heel-Pain Syndrome 293

Heel Spurs 293

Haglund's Deformity 296

24 Toe Problems 298

Strengthening Your Toes 298

The Basics: Toenail Trimming 298

Black Toenails 299

Big Toe Problems 302

Hammertoes, Claw Toes, and Mallet Toes 303

Ingrown Toenails 305

Morton's Toe 306

Overlapping Toes 307

Stubbed Toes 311

Toenail Fungus 311

Turf Toe 314

25 Forefoot Problems 316

Bunions 316

Metatarsalgia 318

Morton's Neuroma 319

Sesamoiditis 321

26 Numb Toes and Feet 323

Transient Paresthesia 323

Peripheral Neuropathy 324

Raynaud's Syndrome 325

27 Skin Disorders 326

Athlete's Foot 326

Calluses 328

Corns 331

Fissures 332

Plantar Wads 333

Rashes 335

28 Cold and Heat Therapy 337

Cold Therapy 337

Heat Therapy 339

Combination Cold and Heat Therapy 339

29 Foot-Care Kits 341

Basic Self-Care Kit for Home Use 343

Fanny Pack Kit 343

Event Kit 344

Part 5 Sources and Resources 347

Appendix A Product Sources 348

Appendix B Shoe and Gear Reviews 350

Appendix C Medical and Footwear Specialists 351

Appendix D Foot-Related Websites 352

Notes 353

Glossary 356

Bibliography 360

Index 362

About the Author 374

Customer Reviews