Very good question.

So let's just establish this fact.

Never in the history of a blister has one ever improved by ignoring it. Welcome to the trailhead of TrailRunner Nation.

We go on Trailrun runs every single week with guests are going to help us become better runners. Happy your athletes, healthier athletes, and maybe just better human beings. Today, we're running with Dr. Kanya Olsen. We're going to talk about feet. If you use your feet during running, then this is the podcast for you. Join us. Welcome to another edition of Trail Reincarnation. My name is Don Freeman. And I'm Scott War. You know your feet carry you through every single mile that you run out there. Yet most of us only think about them when they start to fail. Why do we always wait until they fall apart and what can we be doing instead? Today's guest is Dr. Tanya Olson. She's a doctor of physical therapy, a foot care expert. She's a runner and a long time ultra running medical volunteer. In fact, we just found out she's been at Michigan Bluff Aid Station since 2008. Did you say, Tonya? Tonya, well, yeah, it would have been eight, but it got canceled. Oh, that's right. That's right. She recently, we came across her because she recently wrote an article on Ultra-Earning Magazine called Happy Feet, a modern guide to foot care. Now, foot care isn't about having a little bit of duct tape in your pack and the heroics at mile 60 or anything like that. It's about smart preparation, modern solutions which she's going to tell us about and knowing how to protect your feet before they become that problem. So, Tonya, thanks for joining us. Why do many ultra runners accept blisters and football problems or breakdowns as part of the sport? When in reality, it can be prevented. So, there's a couple of different answers, so I could give here. For one, people, it depends on, you kind of become who you hang around. If everyone around you is consistently having blisters and they don't know what to do, then that's normal for you. Plus, there's just a weird little kind of vein of thinking in the ultra world where people think destroying their body is cool and they kind of like to brag about it. There's a little of that somewhere. And yeah, I'm just gonna go with, they don't know any better. And that's my platform is to educate people that there is a better way to live. And we're excited to learn about that. We've talked about on this podcast many, many times and we've had the infamous John Vonff, who's the author of Fixing Your Feet. If you don't have a copy of it, now's the time to get a copy. If you have an old copy, you should know that Tanya joined up with John and wrote the seventh edition of the book. Why are you thinking, why is there seven editions of this book? Because

knowledge and science has changed and we're here to learn a little bit about what changes have happened. Tanya, you know, you were around and running when John first wrote his first edition, I assume, what's changed over the years? What is the most exciting thing about foot care that you could tell us about.

Oh boy.

The products that are available to use, the quality and the specificity of products that to use for foot care is just really, really advanced. Plus people like myself who have advanced training in both biomechanics and wound care, like I've, as a physical therapist, I've worked in a lot of different places. We're adding knowledge based on understanding tissue mechanics, tissue healing, sharing forces friction. So I think the short answer, which is too late, is the've got better products available and a more comprehensive understanding of the topic at large. What are the biggest mistakes we're currently making? Let me put it in this frame of mine. You're at Western States 2025. You've been there for a gazillion years, a couple decades, and a half, and you see somebody come through with foot issues, whether it's blisters or what have you. What are the biggest mistakes we're currently making? Well, the biggest mistake people make is they don't have a foot care plan. Like you said in the introduction, people don't plan on, they don't, there's not a preventive mindset just because people don't know any better. And so they don't have a foot care plan. No preventive measures have been implemented. And then stuff just goes sideways. And then all we can do if it's on the course is mitigate the damage. We can't, you know, and it's just, it's heartbreaking for me because Western states has changed so much. Like in the early days, people could, it was realistic for people to be able to get into the race again. Nowadays it's like, it's a once in a lifetime chance. And when people come into the, it's happening less nowadays. We're having less carnage at Michigan bluff because my voice is getting like people are learning and doing better. But for one, not having a plan, the basic foundation of a foot care plan is to prevent maceration. And maceration is how your skin weakens and becomes more fragile by being exposed to moisture over a prolonged period of time. So it's kind of like if you're in the hot tub or you're washing dishes and your fingers, you know, they change colors, they turn a little white and then they wrinkle. Well, that same thing happens to your foot skin, but a lot more is being demanded of the foot skin. And so preventing maceration is absolutely critical. And it's a matter of time. So no matter the longer you're out there, the higher chance of maceration. And so using a skin barrier product that's hydrophobic and creates a barrier and keeps your protection skin from moisture is absolutely essential. Now, let's talk about the cause of moisture. Each foot has 250,000 sweat glands. Holy cow. So it's not the creek. It's not the one creek you run through, a mile, 60 or whatever in your race. It's the sweat that your skin is constantly pouring out that is bathing your foot skin and not just, sweat is saltwater. And saltwater is, if anyone's done anything like with saltwater and boats and all that. It's very corrosive and damaging. And so what happens is with maceration, the skin becomes more fragile. It can actually the connection of the epidermis, which is the top layer of skin, and that's comprised solely of dead skin cells. And the dermis which is the red part underneath, like if you get a blister and it's really painful because that's where the blood vessels and nerves are housed. That connection between the epidermis and the dermis actually loosens through the process of maceration and running because you've got, you know, just kind of things are moving around in the shoe.

And that it can almost delaminate. Like if I get somebody coming in, they said, oh, I've got a big blister on the bottom of my foot. I know I've been doing this long enough by the language somebody uses. I know what their foot's gonna look like. And that once you get a delamination of that because of maceration, there's only so much you can do.

All we're gonna, you know, the main thing you can do

is tape over it and try to prevent the skin from tearing open on the bottom of the foot and then having that dermis fully exposed. But yeah, maceration. And then you need to know your feet. So you need to know your own problem areas which requires you to actually look at your feet once in a while and do a little bit of maintenance. Pay attention to your feet. Notice if there's little spots on your feet or your toes that consistently have where the tissue breaks down. And then create a preventive plan to address those issues and then then have Plan B and Plan C and all that. So kind of a long answer to a short question that that's what we got. Prevention. Look at your feet. Good. I love the topic already. Just listening. I've been talking because I have eight questions that I've written down. That's got, that is a meeting. I'm going to ask all eight right now, but sprinkled through this podcast, I hope to get a couple of these in. And the first one that came, which one of the first comments Scott made, duck tape. Does that belong in a runner's kit or does that belong to the park? Dear God in heaven, read my article from December and author running magazine I think I may have said, put down the duct tape and back away slowly. Duck tape at one point in the Ulter Running world, like in the 80s, there was not another option. That was the best option. It was the most prolific. Everyone had duct tape. There just wasn't a better option. But we used to have phones that were connected to the wall with a cord. And so we're capable of human beings to upgrade and to avail of ourselves of better options. So yeah, duct tape definitely belongs in the car, in the shop, maybe wrapped around your water bottle in case you need a splint of fracture. Tape up elaceration like butterfly stitches. No, no, there's better products for that too. Come on. But duct tape just doesn't belong. It just, it causes too many issues. There's just better products. It's, the adhesive is messy. It creates a big ol' mess. It doesn't breathe at all. It slides around and creates more skin injuries. And then if you try to take if you try to take it off and yeah, it's, there's more skin injuries, but it's a whole thing just don't even just stop it with the duct tape people to stop. So I see three major topics we can discuss here about foot care. One being foot care maintenance, one being foot care plan. And I think I want to start with that one, Tanya, is let's talk about a foot care plan because you said most people don't have one. And then the third part is repair or when the wheels fall off of the bus, when the mass release already happens. Enter. That's a good word.

We could use that word.

Can't we, Don?

Can't we?

Yeah, I'm still on question one.

I have some sub questions on my one question. So I'm not. Oh, oh, oh, sorry. I love this. You can start thinking about those categories as Don continues down his question path here. Go ahead, Don. We left the duct tape in the toolbox inside the car got it doesn't belong there

It was great for the moonshots, but now we have other products. What about the ancient time proven white cloth tape, athletic tape? No. That's bad. Leave it on the soccer field. Okay. All right. Leave it on the soccer field. It's made for short duration. You know, you need it for the game for like 45

minutes or something like that. It just don't strike strike two Freeman. I'm working. We're paying the quarters. We're going to put it down the middle of the plate. So the duct tape stays the athletic tape stays stays it stays out. Oh, stays out. Yeah, the duct tape's in the toolbox. The medical tape is in the medical kit for other stuff.

And now I have access to Amazon Prime to every product known to man. And so I'm searching through what do you suggest that I look for to get rid of the duct tape in the athletic tape? So the standard tape for most foot care issues, or most foot care interventions is kinesiology tape. And there's all different kinds. They're all basically the same. I do have some YouTube videos explaining the difference. There's nivovin and non-woven. Everyone said, you know, maybe try something that says they're waterproof. But the way that I and John have always recommended using it, it kind of, it just kind of levels the playing field. So I've all, yeah, kinesiology tape is absolutely perfect. It's breathable, stretchable, lengthwise, not widthwise. You can mold it around the toes with no problems. It's perfect. Now Scott, before you get to your three categories, I do have one follow up if I could. You mentioned the word sweat. It's just not the creeks, but it's a sweat. And then I started thinking, yeah, when we sweat and we reach up on our face and everything's white on our shirt, there are a lot of electrolytes that come out with that sweat. So now you have something very corrosive and it can cause some trauma to the skin. So it's just not water, but it's that sweat in there as well. Kind of percent, it's salt water. Yep. So that was probably- Damaging. Much more damaging than water. Was that just an observation, Freeman, or was there a question there?

Well, no, it wasn't a really question, but it was just about the patient. There was some validation. I hadn't really thought about it. So thank you for that, Dr. Olsen. I appreciate it. Go with your three categories, Scott. I love that. And I'm always happy when there's water on a course, because it's usually the one time I think people will think about their feet for God's sake.

Yeah.

Is there any stepping through that water?

Give risks. I'm always happy when there's water on a course because it's usually the one time I can get people to think about their feet for God's sake.

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