BushwalkBushwalk
Our feet take a lot of wear and tear in day to day life and even more so on a bushwalk where they are expected to support our body and backpack weight. It's easy to forget to look after our feet, but they're one of the most important things we use on a bushwalk.
Image by Maslov Dmitry
Foot Care
Helen Smith
48 | BWA August 2016
BWA April 2015 had an article “A quick guide to foot blister treatment” by Rebecca Rushton, describing how to manage blisters on walks. Following on from Rebecca’s article, here we detail ways to avoid foot infections and pain, and to help keep your feet in the best possible condition for your next bushwalking adventure.
Foot care at homeLong-term foot care starts at home, with good daily foot care routines. Here are some tips.
Check feet daily: Feet swell during the day, so inspect feet after they’ve been in shoes for several hours. Look for and monitor small cuts, bruises, scrapes, swelling, toenail infections and other skin abrasions.
Wash feet regularly: Wash with warm soapy water including between toes. Dry with a towel and use talcum powder to keep a dry environment between toes and prevent infection.
Keep toenails trimmed: When the nails are soft after showering or swimming, cut nails short. Cut directly across the top of the nail, and smooth rough edges with a nail file, thus preventing or minimising the chance of ingrown toenails.
Monitor corns and callouses: Thick patches of skin can form on the soles of the feet. Advice from a podiatrist may be needed to obtain a suitable treatment.
On a bushwalkA good foot care routine is needed on bushwalks. Here are some ideas.
Use appropriate footwear: Select shoes or boots that fit well and are suitable for the terrain and temperature conditions. Use sunscreen if wearing thongs or sandals, and warm footwear in cold conditions.
Use appropriate socks: Wear comfortable socks that help keep feet dry. Cotton holds moisture and increases friction, and should be avoided.
Fix problems as soon as they’re noticed: Remove stones or sharp objects immediately. Skin abrasion rapidly becomes uncomfortable and can lead to infection. Treat blisters early. If footwear becomes uncomfortable, try adjusting lacing.
Air and check feet at breaks: Take off footwear and allow feet to dry at breaks. Shake out any stones, rocks, sand or sticks. Do a quick check for ticks or leeches that may have gone unnoticed and treat appropriately. On overnight or longer walks, to relieve swelling or tension, consider resting and washing feet in creeks downstream from water collection points. Removing boots and elevating feet can also reduce swelling. On overnight walks, air out feet at camp by wearing sandals or thongs, and treat any issues (e.g. skin abrasions).
Take a change of socks: It’s hard to avoid socks getting saturated with sweat and this moisture may increase the chance of blisters, odour and infection. Some people find that changing socks half way through a day walk is an effective way of keeping feet dry and avoiding blisters. On overnight or longer trips, carry enough socks so that while some are drying, others are dry enough to wear.
Dry feet after river crossings: Some bushwalks require fording rivers or streams. Take a pair of sandals for river crossings and dry feet thoroughly before putting on walking footwear.
Muddy bootsRebecca Rushton
“A good foot care routine is needed on bushwalks.
BWA August 2016 | 49
Other tips
Strengthening exercises: Basic strengthening of the feet, calves and Achilles can make a big difference to reducing foot pain or strain on a bushwalk.
Lightweight Gear: Carrying a heavy pack increases the chance of foot injuries. The extra weight invariably leads to earlier and deeper fatigue and mistakes such as tripping or slipping. Consider lighter gear and sharing group items such as a tent, stove, and first aid kit.
Gaiters: Use gaiters to stop stones, sand and vegetation getting into footwear and to reduce the chance of a snake bite penetrating.
Reduce foot odour: The build-up of bacteria causes foot odour. Feet have a lot of sweat glands, and some people are very prone to sweating even without much exercise. Wash feet regularly and thoroughly, always downstream from where drinking water is being collected from. Bacteria can build up in two places: between toes and the edges of toenails. Keep these areas clean. Dry feet thoroughly and use talcum powder to keep a dry environment between toes. Talcum powder is really lightweight and works wonders for creating a dry foot environment. You don’t need much for it to be effective. Wear wicking socks to keep feet dry. If particularly odour prone, consider using an antiperspirant, and after the walk, thoroughly air footwear, and sprinkle baking soda or talcum powder onto the insoles to reduce odour. Alternatively, try some home remedies for treating smelly feet.
Use high-quality insoles: Some cheaper footwear has poor quality foam insoles that quickly wear thin, reducing support and shock absorption. High-quality replacements can make all the difference and may even outlast the shoes or boots.
Useful gearHere are some equipment ideas to help deal with any foot problems arising on a bushwalk.
Antiseptic liquid/cream: For preventing infections.
Island dressings: For protecting intact or broken blisters.
Compeed hydrocolloid dressings: For dressing de-roofed blisters (not blisters with an intact roof or torn roof).
Penknife with scissors: For cutting nails.
Tape: For taping up the blister-prone areas. Some people find this an effective way of preventing blisters.
Moisturiser: For the relief of dry or cracked skin.
Lance: For draining blisters. A lance is preferable to pins or needles.
Be prepared to experiment with a range of products to find out what works best. Also, visit Rebecca Rushton’s website for ideas on essential items for a blister prevention kit.
Gauze, ace bandage, tape, trauma shears and bandagesJim Barber
“Carrying a heavy pack increases the chance of foot injuries.
“... equipment ideas to help deal with any foot problems ... on a bushwalk
50 | BWA August 2016
Foot infectionsSkin provides a natural barrier to pathogens, however, if the skin is broken via a wound, then the area is prone to infection. Unfortunately, due to the warm and moist environment caused by sweating, feet are extremely susceptible to bacterial and fungal infections. Infected areas can turn nasty pretty quickly, particularly in hot and humid conditions - perfect for pathogens to multiply.
Here we run through prevention and treatment of two key types of foot infections, bacterial and yeast. Remember, if an infection doesn’t improve quickly or gets worse, seek medical attention.
Bacterial infectionsTypical signs of bacterial infection include increased redness, swelling, pain, warmth and tenderness around the area; pus in and around the area; and fever. The body’s inflammatory response is a way of fighting infection by sending extra blood to the affected area. That’s what causes localised redness, swelling and warmth at the site of infection.
Good foot care and maintenance can go a long way to reducing the chance of infection. Appropriate management of infections in the field is critical.
Treatment of bacterial infections in the field depends on whether or not the skin is broken. If the skin is broken, wash the area with a saline solution, or flush it out with drinking water. Apply chlorhexidine or antiseptic liquid and apply a bandage. Betadine is a popular iodine-based antiseptic, although care must be taken as some people are allergic to iodine.
Monitor the patient for signs of infection such as increased aches, pain and fever. If the condition becomes severe, seek medical attention. If infection occurs at home, regularly clean and dress the wound. Monitor and seek medical attention if the wound does not heal.
Yeast infectionsBecause shoes provide the ideal warm, moist conditions for fungi to thrive, feet are also extremely susceptible to fungal infections.
Common fungal infections include:
Athlete’s foot (red, itchy patches, white flaking skin)
Jock itch (rash, patches of redness or bumps)
Ringworm (itchy, red, scaly patches)
Athlete’s foot, jock itch and ringworm are all caused by dermatophyte fungi, although athlete's foot can occasionally be triggered by yeast (candida) infections. Fungi feed on keratin, which is a protein found in skin, hair and nails.
Here are some tips to reduce the chance of getting a fungal infection.
Develop a good foot maintenance routine.
Wear footwear and socks made from breathable materials.
Wash feet thoroughly after exercise and change socks.
Keep toenails cut short and clean them regularly (note that fungal infections can develop underneath toenails).
Air out feet as much as possible (i.e. use open shoes around the house). When feet are infected, avoid walking barefoot as this can spread fungal infection to other unwary victims.
Treatment of yeast infections on a bushwalk is tricky because it’s difficult to keep feet clean and dry. Consider soaking feet in creeks downstream from water collection points for relief, applying antifungal cream (if this is something in the first aid kit) and changing socks regularly to keep feet as dry as possible. At home, wash and dry the rash area thoroughly; apply antifungal creams and/or powders. If it hasn’t cleared up within two weeks or gets worse, seek medical attention.
“Infected areas can turn nasty pretty quickly, particularly in hot and humid conditions ...
“Fungi feed on keratin, which is a protein found in skin, hair and nails.
BWA August 2016 | 51
Foot PainFoot pain is usually caused by injury, disease, trauma, some biomechanical misalignment or a poor choice of footwear. Walking and weight bearing for extended periods in poorly fitting footwear or on an injured/inflamed foot leads to pain and tenderness, with the potential for long-term problems.
Below are some common foot complaints with short- and long-term treatments in the bush and at home, and prevention methods. Please be careful: if foot pain persists, seek medical attention as some of these conditions must be treated effectively early on to prevent long-term problems.
Heel painHeel pain refers to extreme discomfort felt through any part of the heel. It may be caused by:
Overuse, repeated impact on particular regions of the foot; and
Inflammation of tissue that runs along the bottom of the foot connecting the heel with the toes or Plantar fasciitis. It is often a result of a biomechanical problem such as flat feet.
The main way to prevent heel pain is to select footwear that has good arch support and heel height. Some people find a heel cup or orthotic helpful for absorbing shock and relieving some of the pain.
If heel pain occurs on a bushwalk, take frequent rests and consider shortening the trip. Back home, rest and recover until the pain subsides. Seek medical attention if the pain gets worse.
Achilles tendonitisThe Achilles tendon inserts into the heel from the back of the leg and controls flexing movements of the foot. Achilles tendonitis is the inflammation of the Achilles tendon, resulting in a sharp shooting burning pain. It should be treated early to prevent complications.
Achilles tendonitis may be caused by poor-fitting footwear, a short Achilles tendon, trauma to the Achilles tendon, inadequate stretching and strengthening before activity, or over-pronation.
Stretching before a walk to warm up the muscles is a great way of preventing Achilles tendonitis. Some people also find that a heel cup helps. Alternatively, an orthotic to control over-pronation and support the longitudinal arch may assist.
Manage Achilles tendonitis as you would heel pain, and reduce physical activity, apply ice and avoid walks with steep uphill climbs.
Image by Tyler Olson
“The main way to prevent heel pain is to select footwear that has good arch support and heel height.
52 | BWA August 2016