How to Prevent and Treat 7 Common Thru-Hiking Foot Problems
Have you ever noticed that thru-hikers have an awful lot in common with zombies? Both are prone to shuffling glassy-eyed through the woods at strange hours. Both have large appetites and—cough—unusual diets. And there’s no denying that both zombies and thru-hikers have similarly disgusting feet, complete with gnarled toenails, off-color skin, and a putrid odor.
From blisters to trench foot, lost toenails to plantar fasciitis, all hikers will experience foot problems at some point. By taking action to prevent and treat these common issues, you can save yourself a lot of discomfort and avert hike-ending injuries. Read on to find out how you can avoid getting zombie feet on the trail—and how to deal with it if you do.
Ed. Note: We are hikers, not doctors. This advice is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of a qualified health care provider with any questions you may have regarding a medical condition.
1) Plantar Fasciitis
Zombie level: Low. Your feet probably look normal on the outside even though they’re screaming on the inside.
Do your heels feel like they’re about to explode with every step? If so, you might have plantar fasciitis, an inflammation of the connective tissue in your arches. Stretch and massage your arches once or twice a day to prevent and treat this condition, and invest in a good pair of insoles such as Superfeet. Try massaging your arches with a golf ball on the trail. You can also buy special sleeping socks designed keep your plantar fascia moderately extended all night long.
2) Heel Spurs
Zombie level: Low, though the pain might give you the zombie shuffle.
Heel spurs are bony growths on the underside of the heel that sometimes cause pain and inflammation. They’re caused by repeated strain on the foot muscles and are often associated with plantar fasciitis. To help prevent this, be sure to stretch and massage your feet frequently. Choose good shoes and insoles for hiking. If you develop heel spurs, your doctor may recommend custom orthotics, over the counter pain relievers, or cortisone injections.
Zombie level: Low to moderate. Your feet are more intriguing than horrifying.
A bunion is a lump of bone or tissue on the side of your big toe joint that can cause the toe to be pushed out of alignment. Bunions are usually caused by too-narrow shoes and by gait issues that put excessive pressure on your big toe joint when you walk. Custom orthotics, bunion pads, toe separators for overnight wear, and toe socks can alleviate pressure on the bunion and keep your toes properly aligned.
Look for a hiking shoe that feels comfortable and has a wide toe box. You don’t want the side of your shoe putting pressure on the bunion. For the ladies: if you’re having a hard time finding a wide enough hiking shoe, consider looking at men’s shoes instead, as they tend to be wider. If you’re still experiencing pain, talk to your doctor about getting cortisone shots or having the bunion surgically removed (though this is typically a last resort).
Zombie level: Moderately to severely disgusting feet.
Wet feet and poorly fitted shoes cause blisters. Pack spare socks on your next trip so that you can change into a clean, dry pair if your feet get wet. And before you hit the trail, take the time to find a pair of hiking shoes that fit you well. You may need to try out several different styles and sizes before you find the perfect pair. Some hikers also swear by liner socks from a brand like Injinji for blister prevention. They’ll give your feet a little extra cushioning and protection, especially around the toes.
Carry supplies for blister treatment in your first aid kit in case your preventive measures fail. I like Leukotape for this purpose. It’s an extremely sticky athletic tape that gives your skin just enough added protection to prevent blisters. When you feel a hot spot starting to form, stop and tape the affected area before it becomes a full-on blister. This stuff is adhesive enough to last several weeks, so it’s perfect for long trips.
If a blister does develop, it’s better (in my nonmedical opinion) to pop it intentionally rather than have it burst in your already-nasty socks during the day and risk infection. Sterilize a needle or the tip of a knife with rubbing alcohol and carefully pierce the blister. Apply antiseptic to the site after draining and cover it with a Band-Aid. Keep your feet as dry as possible during the day to reduce the risk of infection.
Zombie level: Textbook zombie feet.
Abrasions are closely related to blisters. Sometimes when you’ve been hiking in dirty water, fine sand and silt can wash into your socks. This essentially turns them into sandpaper, rubbing your poor tootsies raw with each agonizing step. Again, clean, dry socks are the best way to prevent this from happening. If your feet are already abraded, clean them, sterilize with alcohol or antiseptic, and cover them up with gauze and Leukotape.
Zombie level: The sight of your feet could make a grown man cry.
We’ve all heard stories about hikers experiencing the dreaded loss of some or all of their toenails on the trail. Lost toenails are actually entirely preventable in most cases, even if you plan to hike a long distance. Not to brag, but I didn’t lose a single toenail on my thru-hike. Granted, my pinky toenails did become weirdly gelatinous and bendy, and some of the others were temporarily reduced to crushed, blackened shadows of their former selves, but that still counts, right? Right?
Toenails become a problem when they’re constantly bumping up against the front of your shoe. This probably means your shoe doesn’t fit quite right. Make sure your shoe fits well and your foot doesn’t slide around on inclines. Look for a style with plenty of room in the toe box. If you’re still having trouble keeping your toes from bumping the front of your shoe, try the heel lock method when lacing.
Once your toenails have died and fallen off, there’s nothing to do but wait for them to grow back on their own. You may feel a pang of loss each time you see that tragically empty nail bed. If it’s any comfort, know that your nails should eventually grow back after you finish hiking.
7) Trench foot
Zombie level: * Barf *
If your feet have been cold, wet, and dirty for a prolonged period, you’re at risk of developing trench foot. You’ll know that’s what it is because your feet will feel like they’re on fire and full of broken glass with every step you take. Another clue is that the soles may start to look like cottage cheese that’s been sitting in the back of your fridge for the past six months. Thick chunks of skin may slough off altogether. Yes, I’m speaking from personal experience.
If you suspect that you have trench foot, it would be wise to get yourself to an urgent care. Trench foot can become extremely serious—amputation serious—in its advanced stages. That said, there are steps you can take to treat mild cases yourself, even on the trail.
First, keep your feet as dry as possible at all times. Take breaks throughout the day to remove your shoes and socks and let your feet air out. Next time you’re in town, buy enough spare socks that you can change into a clean, dry pair at least once a day. Don’t wear socks to bed. Let your feet breathe overnight.
It’s important to keep your feet clean when you have trench foot, because your risk of infection is higher than normal. Wash them every night with soap and water. If you can, heat the water up on your stove first, as you want to keep your feet as warm as possible. As an added measure, wipe them down with rubbing alcohol to further sanitize them. Finally, take ibuprofen to reduce any swelling you might be experiencing.
Your feet are arguably your most valuable possessions as a hiker. They’re capable of carrying you thousands of miles through all kinds of conditions, and all they ask in exchange is a little TLC. Don’t find yourself hobbling zombie-like down the trail, wincing in pain with each step. Take good care of your feet and they’ll look after you in return.
What actions have you taken to prevent and treat foot problems on the trail? We’d love to hear about them in the comments.
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