Monday, January 14, 2013

Saving Graces: Foot Care on El Camino de Santiago

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One of the lovely advantages of choosing a travel health care professional lifestyle is the travel!  For those of us who move between and among many locations for our life's work, the leisure/adventure side of our gigs is  a priority....and the between-assignment time opens the opportunity to pick and explore a variety of new places or events.

July is my month of international travel, a priority in my life. Five months ago, I trekked a pilgrimage called El Camino de Santiago from Leon to Santiago de Compostela, Spain.

For those of you who do not know, El Camino de Santiago means The Way of St. James. Check out this blog for info on St. James' connection to Spain:

One of the most significant challenges of El Camino (or any other long trek) becomes your relationship with and attention to your feet. Your preparation. Your equipment. Your remedies.

Me, my twin and her family - our feet! - surrounding one of the El Camino markers
(I'm wearing the colorful Smartwool socks ...   : )
Allow me to educate you on foot care on El Camino because
it will make or break you and your Camino.

1) Buy and break in hiking shoes that do not cause hot spots on your feet.  I bought Keens because my feet tend to be wider. The Keens were perfect. Some people choose Merrills, Vasque, North Face, and Salomon.

Don't order them online! Every shoe is different. It is vital to go into a shop and try them on, walk in them and wear them for the initial fitting.

I trialled a pair of Keen ankle boots, and I found after several walks at home prior to my trip that the upper back part of the shoe rubbed the heck out of my Achilles area. I would have had a super size wound had I used them.  I was really glad I opted for the regular hiking shoes. I used my poles for stability on steep downhill trekking and had no problems with my ankles turning.

2) Buy and wear hiking socks that feel comfortable with your shoes. Wear the socks for several long walks before your trip to see if you experience any toe rubbing. I brought three pairs hiking socks: Smartwool, Fits, and Cabela's. The most effective socks for me were the Smartwool socks (the ones not classified as hiking socks), which provided great compression in my midfoot, and the Fits, which were rugged wool blend and provided great cushion.  I quit hiking in the socks I bought at Cabela's after the second wear because my toes sweat and rubbed together too much. Bring three pairs of socks with you. One to wash/dry, one to wear and the third in case you accidentally get your feet wet. I will tell you that the third pair of socks will (on at least one day of your walk) be a godsend!

I found two cool websites that have a bunch of great socks:
Socks Addict:  (best prices for the quality!)
LOVE the socks at Darn Tough:
see why? GREAT colors!!

I recommend the midweight to rugged weight socks, especially if they offer compression. Don't be scared off by wool blend socks in summer. They are quite comfortable, protective, and they effectively handle the Vaseline I'm going to recommend later!

3) Learn to tie your shoes correctly to protect your feet as you go up and down steep areas.

We had the distinct pleasure of walking the Camino with an amazing priest from the Baltimore area, Ft. James. One day as we were walking, my twin was having difficulty with her feet sliding in her ankle boots. Fr. James taught her a boot-tying technique that is noteworthy for all trekkers. He had learned it from a fellow peregrino (pilgrim) earlier in his walk on El Camino. Check it out:

4) Forget the moleskin and bring a bunch of bandaids!

In addition to bandaids, I took a big bunch of moleskin thinking it would cover hot spots and protect my feet. Don't take the moleskin! It rolls and causes problems. The bandaids, however, were perfect. In fact, during the most difficult climbing days, I put bandaids around my 3rd, 4th and 5th toes to keep them from rubbing against each other into a blister. They worked perfectly. So...
  • Make sure your feet are clean and dry.
  • Apply bandaids before you slather the vaseline.

5) YEP, Vaseline.

Vaseline over clean, dry feet prior to donning socks provides a moisture barrier, a friction reducer and a skin softener. My twin and I were amazed at the end of 15 days of walking 12-18 miles per day that our feet were actually in better shape than before the trip (and we take good care of our feet!). The vaseline was the key. You may need to apply several times in a day for proper protection. Messy, but worth it.

6) Lower mileage the first two days of your trek and take frequent breaks to check skin.

Thanks, Jose, for the demonstration!

One of the smartest things you can do is start off the camino (or any long hike) slowly, especially if you are not athletic and in great shape. If you have to be a rock star by doing 30K the first day or two, or (from what I have heard) if you start in St. Jean, you are best served to check your feet frequently and make necessary adjustments before getting blisters.

7) STOP before you feel hot spots.
Every time you stop to use the bathroom (the Spanish used the term "servicio" in this area of Spain) or fill up on water, check your feet. The Camino is not a race! You'll find each stage of the Camino is much more manageable and takes only a bit longer to complete if you stop and check your feet. Most importantly, it's a lot less painful if you prevent the blisters in the first place.

8) Bring a pair of trekking poles. There are a few stages on the Camino in which you may encounter steep climbs up and down. It is during these stages that you are higher risk for sores on your feet, especially when you are trekking downhill.

I purchased women's Komperdell retractable trekking poles for half off on the Clymb website ( They were one of the best purchases I made other than my North Face Terra 45 backpack. The poles shifted a lot of force off of my feet and onto my arms, which saved my feet. My twin used only one wooden walking pole, and she ended up stubbing her toes frequently, resulting in the loss of two toenails a few weeks later (thankfully after the Camino).

9) Minimize your weight.

Take the basics only. The less you carry, the less your dogs are going to bark at the end of the day. We ran into a lot of people who went to el correo to mail items back home.

10) Treatment if you have blisters.
For your packing list:
  • A needle
  • Thread
  • Small container of betadine
  • Bandaids
Do not under any circumstance, cut the skin off a blister! You'll have an infection in no time. I met a number of seemingly educated people who did permanent damage to their feet by cutting into blisters. One ended up in the hospital; the other ended up getting a Stage IV wound all the way to her Achilles tendon.

Here's what you do if you get a blister:

After your day's walk: Shower/clean/dry your feet. Thread the needle. Run the needle and thread through a bit of Betadine. Put the needle in and out through just the skin of the blister. Don't go deeper. Cut the thread so there is a bit on each side outside the blister. You don't have to bandage it if you're going to bed. The fluid will leak out through the thread yet the thread will prevent contaminants from contacting the tissue under the blister. In the morning, the blister will be dry and healed (or close to healed).

During your walk: if you discover a blister, stop immediately and treat it as described above. The only difference is that you will need to cover it with a bandaid before you put your sock back on and start walking.

Oh, and re-slather Vaseline on the rest of your feet before you start walking again.

11) Sun screen on legs to reduce risk of heat rash.
This is not quite foot care, but an affliction that bothers numerous peregrinos - heat rash.
  • Keep legs clean and covered with sun screen.
  • When handwashing your socks, rinse them thoroughly.
  • Do not wear wet socks.
12) Shower daily and lotion up afterwards.

'nuf said.

13) LISTEN to your body.

Don't be ridiculous by "forging on" when your body tells you to rest. You'll injure yourself, and then you'll go home early from El Camino limping and in some cases, with permanent orthopedic damage. We were amazed by some of the people limping for miles. In Sarria, which is the town you must begin from to receive a Compostela (document of pilgrimage) when you reach Santiago, we saw two obese ladies with Walmart style summer sandles and thin anklets both limping. My response to this is: Be reasonable! You are not a martyr if you don't prepare physically or if you bring substandard equipment, make bad decisions, and injure yourself. You're simply ignorant.

14) Stretch daily.

Stretching was key. Up there with Vaseline. Warm up those muscles before you take off and at the end of the day if you want to stay injury free.

OK, folks, good luck on your trek. Send me a note if you have other input or tips.

Buen Camino!

1 comment:

  1. Wow, this is a very comprehensive guide about hiking and trekking. I agree that shoes and socks are great aspects for a good journey. As for me, when I hike, I often choose a good shoes and above all a good socks which I often buy online at Legs Therapy for me to have more choices. :)