by Bob Longworth MSc DPodM
It’s not every day that a patient says: “I’m off to walk across the Antarctic and I need insoles to stop my feet from blistering.” She then threw in “I’m off in 2 weeks and won’t be able to try them out until I’m there.”
Steph is part of ‘Inspire22’ – a multi-disciplinary team expedition to cross the Antarctic by foot. 50 days of pulling everything behind you on a sleigh for 10–15 miles a day with guides to keep you on the right path (as there are no real landmarks to speak of) and stop you falling down hidden crevasses. No baths, maybe one change of clothes, not leaving anything behind (poo bags at the ready) and the same boots all day every day.
She brought in the boots she would be wearing, which were unlike anything I’d seen before, and talked me through the gait technique she would be adopting on the ice, which again was new to me.
The problem she usually has with her feet when doing ultramarathons (she’s quite a lass!) is blistering where she overloads her forefoot, a consequence of a high arched profile to her feet. I knew I could sort her out in regular footwear with regular gait but this… this was very different.
What to do?
Well, thankfully the treatment protocols we adopt at ‘Podiatry Clinics Yorkshire Ltd’ mean that you don’t need to have seen a certain set of criteria before in order to successfully treat. If you allow your patient to tell their side of the story (a good history), can identify the injured tissue (a diagnosis) and work out what’s happening to cause that particular tissue to be stressed too much (a mechanism of injury), then assuming the problem is mechanical and not a systemic issue, we should be able to help.
I used these principles with Steph and produced some insoles designed to off-load where she gets blisters and even out the pressures under her foot. I did wonder if there was enough room in the boots for them, so my parting advice was “Comfort is king — if they don’t feel right, don’t wear them!”
I have been following the expedition blogs on Instagram and Facebook with bated breath, wondering how she is getting on.
Today she posted:
Blog by @spinster_steph
‘One foot in front of the other: A muscle-powered journey of 900km requires, amongst many other things, a pair of robust and reliable feet. Unfortunately, the genetic lottery didn’t furnish me with these. I have been burdened with very high foot arches which have seen podiatrists coo and cluck with excitement over the past 25 years and me limp and wince from blisters, impressive toenail loss and pain on the balls of my feet whilst lumbering around with an ‘unusual’ gait.
This is all manageable during my usual training for (ultra)marathons, with access to running water, clean socks every day and any amount of blister plasters, soft shoes and the opportunity for rest. However, a more serious solution was required for this expedition.
Enter stage left the podiatry whizz Bob Longworth, of Podiatry Clinics Yorkshire @podiatry_clinics. Bob was intrigued by the possible issues presented by INSPIRE 22 in terms of my feet. He set about creating custom-built insoles based off the insoles from the trainers I had worn to the appointment. My heels have been raised and my feet effectively now have contact with much more of the ground, significantly reducing the degree of pressure I used to feel through a very small surface area. Feet are not glamorous and are often overlooked but, for me, the happiness and health of these downtrodden poor souls was essential to my expedition success. Thank you, Bob, for your patience, expertise and interest in our challenge!’
— Steph
What a relief!
The only literature I’ve been able to find about foot orthoses and skiing has been limited to Alpine and Downhill skiers. Perhaps the next Antarctic trip could take along a Podiatrist to research what’s really going on in those boots. As he loves snowboarding, can I nominate Lee…?
Book an appointment or make an enquiry → — Leeds, York, Wetherby and Wharfedale.
Bob Longworth MSc DPodM is a director and senior podiatrist at Podiatry Clinics (Yorkshire) Ltd.