The 4 Day Nijmegen March and how to accomplish it.

~Footcare~

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Winning the Medal =
Managing and preventing injuries.

In the above photo, which was taken minutes after completing the 120 mile march, there are no new injuries. I completed the 4 days of Nijmegen without 1 single new blister. The skin damage on the heels were the reminants of past blisters left as a natural bio barrier.

Even with moisture wicking socks, athlete tape and shiny slick decal applications to the insole to reduce friction, heat and moisture can still build to create blisters.

Humidity, temperature, rain, heat, cold, cleanliness of your socks and footwear; uphill, downhill or uneven paths; asphalt, concrete, dirt or cobblestones can all contribute to blistering. You must be
educated in first aid blister draining and patching in order to pass this training. Faulty can care result in sidelining foot infections. There is no sure fire way to totally prevent them, the best you can do is address every hot spot before it becomes a blister and change socks hourly letting your feet cool down so you can feel them.

The worst thing you can do is 'tough it out' and soldier on. While this might work the last part of the last day...doing this to finish day 1-3 may create a sidelining injury, such as no skin left on your heel. (which happened to me in 1984)
Blisters will happen at some point during the training or event.

The dance at the end of the march is even called "The Blister Ball."

http://www.fixingyourfeet.com/  is the web site belonging to John Vonhof,
http://www.fixingyourfeet.com/blog is John Vonhof's blog.
The answer guy you can trust to guide you to your solution.

His book "Fix your feet" was the one source of information that made my completion of the 200 kilometer march possible. His book will answer every question and he even mentions Nijmegen in it. While his book is primarily for runners it is equally valuable for marchers, hikers and walkers for fixing your feet till they are happy.

Toe nail loss as a result of under the nail blistering, 1 or more.

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Every time I practice for hundreds of miles, I end up losing my 2nd toe nail on only the left foot. (drilled to drain blister)

It hits the shoe in a microtrauma fashion in as many as 75,000 footsteps a day to do 30 miles and an estimated 660,000 footsteps, 330,000 per foot to complete the event. (add 8 more miles walking to and from the starting line daily.)  

Any tissue you hit 75K in one day is not going to like it. While it may seem wrong to buy shoes 1.5 sizes too big in length and width, you'll need it because your feet will swell walking for 12 hours a day on concrete/bricks/cobblestones/gravel x4 days.

~Foot care products/procedures~

Antiseptic applications, what you'll need to prevent infection from blisters.

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Hydrogen peroxide gets in there and burns out any existing problems, Betadine kills any remaining germs in the surrounding area and alcohol wipes insure adhesives stick and stay on by removing sweat or oil.

Dealing with blisters...they will happen. A blister is an open wound and should be treated as such.

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Cut away dead hanging skin if need be but leave attached skin as a natural barrier.

Alcohol wipes clean the entire area...
(watch out getting it in the blister...Hydrogen Peroxide hurts less.)

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You'll need to remove all the surrounding dirt and bacteria and change your socks to reduce infection risk before you get home and can soak your feet in Epsom Salts. A blister is not a sidelining injury unless it hits a blood vessel or creates pain beyond your threshold. Motrin helps with minor blisters. Don't keep going if it keeps worsening. Trim the rough edge in your shoe that created the problem or place an Engo Guard (anti-friction) patch in your shoe or on the insole. Let the blister tell you what to correct so it doesn't happen on your next training walk. Blisters can also occur based on how you hold your feet when you step...step with exacting bio-mechanics since rolling your foot outward to avaoid big toe soreness will create blisters on the opposite side of your foot.*
(* When walking distances of 25-30 miles in 80-100 degree weather.)

Hydrogen Peroxide gets in and kills whatever may cause an infection.

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Use this with a Q-Tip and scrub if needed to abrade the area and get everything out. Discovering you have an infection the following weekend will cancel your training march plans.

Before bandaging it's best to disinfect the surrounding area completely with Betadine.

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Put it all around the wounded area and work it into the wound.

Infection prevention must be done, endure a few minutes of pain to prevent days of it...or worse.

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Be careful not to miss anything and don't rush...you want it to heal properly. I usually allow it to air dry so it heals faster. If you must get on your feet fast, use Neosporin and a Band Aid to seal it off sterile.

Post training infection management, protect it and seal the blister.

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Apply the Neosporin directly from the tube dabbing it on, not touching the wound with anything but the product.
 Then carefully unwrap the Band Aid as not to touch the sterile surface.

(flexible water restistant fabric band aids work best.)
You can then go enjoy a huge dinner in town as you heal up for tomorrow.

~Distance Taping~

Pre-cut all the tape, measure out a pattern that works from the outside in, layered towards center.

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Kinesio Text tape is cut out to fit the foot exactly (4 sets, 1 per day) and applied in a pattern from the distal outer to medial center.

Tincture of Benzoine is used on the tape edges and on surrounding skin.
The tape job is secured on the edges with flexible clear tape to prevent any distracting 'roll up.'

Wipe your feet down with alcohol wipes to insure tape adhesion, rolling/sliding tape may occur with oily skin and that doesn't work.

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The alcohol wipes will remove all dust, dirt, sweat and oil allowing tape to stick the best it can. (some people didn't need tape at the event...I did. It's all based on your skin type.)

Apply the blister plaster to the heel to add extra support and prevention.

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The heel should be smooth (sanded earlier) and completely clean. Any particles trapped under the adhesive will soon become very noticable to you and force you to undo everything to remove it...possibly even requiring a full re-do, that would mean wasted time and materials. Do your prep work the night before bed...then put your socks on and sleep. In the morning you will just need to slip your shoes on. Wouldn't it be awful to push snooze too much and then be late because you had to do the prep work? Prep work done while tired waking may not be very good anyway. I did it all before bed in 2009.




A) Arrive home from marching
B) Peel tape and soak feet in epsom salt
C) Let feet dry by walking in flip flops (air feet out, but don't get stepped on or stub a toe!) go find dinner in town
D) When back, follow these steps on this page to prepare for marching the next day
E) Socks on, lights out...@ 8-9PM (5-6 hours sleep)
F) Have your host wake you at 02:15-02:30 for a relaxed start to the day - no rush...breakfast & coffee provided.
G) Go for it! Get to Wedron by 04:00AM (50km crowd)

Heel protection blister plaster attached, clear and slightly padded.

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These blister plasters (thin) are preventative in nature against injury. Better to prevent it ahead of time,

Apply the tape to the heel first.

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This tape stretches, but do not stretch it on while applying it. Allow the tape to flex with you when moving. Apply it directly and contour it to your heel.

Second piece of tape holds heel tape down.

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Same application technique, contour it to your foot, but do not stretch it on.

Third piece of tape.

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The method is to overlap the tape as you work towards the center...holds the other pieces down.

To fix rub spots, cut out a nickle sized plastic sheet from your blister plaster package.

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This is to place within the tape wherever it rubs and allows the area to slide around instead of being 'gripped' and furthering damage. Very effective and saved many training days.

Tape number four, ball of foot...frequent trouble zone. Apply 'Sports Slick' to the rub point plastic patch to allow for zero friction, then seal it down.

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This embedded slip zone will take the heat and friction off of developing blisters, which will be appreciated in the next 40-50,000 footsteps over several hours.

Last tape number five. Now you are ready to seal the job to prevent tape from rolling up.

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Take Tincture of Benzoine and apply it to your skin along the borders of the tape job. It is a medical grade adhesive.

This flexible medical tape is used to seal the edges of the tape job, Tincture of Benzoine holds it tight.

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This tape should have no overhang as it is needed to hold the other tape from rolling up. If this tape is cut too long, it may roll up too, forcing you to stop to fix it.

Completed tape job, with experience preparing and cutting tape, it will take 10 minutes per foot to prepare for 10 hours of walking.

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Lightly run your hand over the tape...nothing should roll up...all should be secured. Sand off rough nails that may cut into neighboring toes and socks. Now is when you 'secure and de-bur' to put socks on.

Foot powder to the toes, will allow them to slip and reduce wear and possibly prevent blistering.

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Use a quality foot powder to keep your toes covered, prevents moisture and rubbing from creating blisters.

With toes powdered, ready for socks. The tape secure, edges smooth and no bunches in the tape.

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Now you are ready for putting on your socks. This series of steps from bare feet goes pretty fast in less then 15 min per foot and will last 15 hours from when you leave till you get home.

The right socks make all the difference, I had to try many kinds till I found the right ones.

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Drymax trail running socks proved to be the reliable and best socks, causing limited cappilaritis (skin reddening) and keeping my feet much cooler and dryer.

Turn all your socks inside out before putting them on, roll them on or it will lift the tape off sliding it.

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As soon as you are about to sock change, roll the sweaty ones off and prepare to roll a fresh pair on by turning the new ones inside out and create a 'toe pocket' to be ready to wear them.

Leave the worn ones completely inside out so you do not mix them up on the next sock change.

Place the sock over the toe, then roll it up...you don't want your toes crammed inside the end.

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Each sock change, examine your toes for blisters forming...many times you will not feel them till your feet cool off. I usually take 5 min cool down breaks, with no socks for this reason. Catch the problems early.

Continue to roll the sock on, checking everything as you go to make sure all loose tape is fixed.

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If tape is starting to loosen from heat or moisture, dab more Tincture of Benzoine on and let dry a few minutes. Then re-apply same tape carefully.

Roll over heel area. This is where I have the worst problems, if a blister is forming, treat it now.

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General soreness and fatigue is different than hot spots turning to blisters. If you feel a sharp pain in one local spot, chances are it is a blister developing.

Unwrap it and treat it now, before it gets bigger.
Roll the tape back...dont remove it completely and wash the area with an alcohol wipe, then use Swiss Army Knife scizzors cleaned with an alcohol wipe to snip the edge, drain it and apply neosporin antiseptic. (this is going to hurt...but not more than an hour)
Then dab Tincture of Benzoin on your skin to re-attach the tape, let dry and re-apply your original tape.
Tape it back on and roll your sock the rest of the way on.


*Be careful splashing Tincture of Benzoine and Alcohol around open blisters...it may make you jump out of your chair!

Put the sock all the way on and even out the tension in the fabric, tension makes friction.

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Your socks should be the right size first, and then put on so the fabric is not twisted or straining on the toes. While this sounds like its being too careful, it's not. In normal every day life, it wouldn't matter but when you walk 4AM -4PM, 4 days in a row...you will want to avoid any situation that contributes to an injury over a span of as much as 50 hours.

Every hour or two, take a 5 min shoes off break and feel your feet to catch blisters early.

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In Nijmegen I did a shoes off break every 2 hours minimum, except the rain pouring day. I checked my feet in dry conditions six times a day and changed socks all six times. This is how I prevented any injuries. I used Engo guard shields and athlete foot powder at the first sign of any hot spot and prevented the problem in the first place.

~Rainy days~
 soaking wet conditions all day walking...the effect on feet.
(amazingly when they dried overnight, they went back to normal appearance.)

Right foot after walking in soaking shoes and socks for over 7 hours, still another 30 mile day tomorrow.

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This is the result of walking in the rain for the distance of a marathon. Every thick bit of skin you built up becomes soft and at risk for damage. It dried overnight no problem.

The end of day #3, 9 hours of wearing soaking shoes, legs chafed raw by a knee brace.

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Not pretty...here's how you know if you really want to finish. In this condition: waterlogged and bleeding...and still 1 more 30 mile, 12 hour day to go. Earlier on...blisters primarily occured on the bottom of the heel, none on the sides.

My worst injury prone area, the heel.

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"Awe comon...that's just walking...it's not hard...it's not fitness!'   This is my heel after day 3.
A picture is worth a thousand words. What do you think?

Trauma endured after 600 miles of preparation march training in Rochester Hills, Michigan; and nearly 100 miles of event walking in Nijmegen, Holland. A day in the rain is no fun - ouch!

After 600 miles rain, heat or cold....

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You still want to do this after seeing what can happen to your feet? Then you are ready.
Looks like 'trench foot' huh? This is from only 13 hours immersion in wet footwear.
Have no fear...inside one month, my feet were nearly healed completely, except for the 2 lost nails which grew back within 6 months. In 8 months my feet were completely healed like nothing happened.

~2010 training, same distance as 2009, 600 kilometers~

~Each year you train, your feet and the equipment will change~
You have to start over every time companies change their footwear designs.
The 2 pair of new running shoes that will last 500+ miles will run you about $300.00

...Anyone still wonder why you earn an Army Medal for doing this?

Right foot, heel blisters formed after 60 mile training weekend.

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The side of the foot gets most of the trauma, unlike last year...last year the bottom of my feet got it.

I never had any side of foot blisters last year, my feet got wider.

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After walking over 1,000 miles on concrete, my feet got wider and the blister pattern shows that after walking 90 miles in one week training the last part of the program for this years event. This happens with as little as 3 millimeters in increased width.

Center of foot blister from bursitis, behind 3rd toe.

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I made the mistake of doing push-ups bare foot, jumping into position and this damaged the bottom of my foot for 3 weeks, it was then further damaged my mis-stepping on a poorly maintained stair case, causing a condition known as 'turf-toe' which happens when forcing the big toe back, iced it for another 3 weeks.
Blisters happen every year and heal fast and can be prevented with proper prevention.
The only way a blister is a sidelining injury is if it is allowed to get worse and worse getting deeper.
Bursitis and 'turf-toe' is a sidelining injury. If these injuries occur, ice them immediately and elevate them...do not train until they heal. If you train with these joint pains, it will force you to take weight off the affected area, causing knee pain and new blisters you never had before on the outside edge of your foot.

You say to yourself..."Hopefully they will heal in time before the event."
In my case they did because I was following all the proper care techniques...
R.I.C.E. (R -rest, I -ice, C -compression, E -elevation.)

Medal Award #2:
The second time you finish the marches you will be awarded medal #2, which has a crown on top of the cross. While it has the same award value as medal one, the crown signifys that you have completed the marches two times successfully.

I was to be marcher # 50-D-474 in 2010 in line for medal #2,
but the overall price of travel expenses forced me to cancel this year.

Next year I would be going for Medal #3, but it will be #2 again since I missed this year.
DON'T LET THIS HAPPEN TO YOU.
UNDERSTAND YOU NEED ALL THE MONEY TO TRAVEL WELL AHEAD OF TIME. IT TAKES TOO LONG TO TRAIN AND IS TOO MUCH EFFORT TO ORGANIZE - TO LET IT GET AWAY.

Injuries:
(Originally I had turf toe and bursitis, which ended up healing in time and I passed all training goals.)
Bursitis - from doing calisthenics & push ups without shoes on, no support and I weigh 185 pounds.
Turf toe - from stumbling on a poorly maintained, crooked concrete stairway wearing 'flip flops.'
I was impressed that using ibuprofin and ice could successfully heal turf toe and bursitis in 6 weeks.

And even if you heal up and are strong and ready...one more SNAFU...$$$

Travel expenses:
(cost me to cancel the event in 2010)
It will cost you minimum $2,400 to cover all your:
Gas (to/from airport), flights, airport taxes, baggage fees, tips, local Nijmegen room with family, train to/from, buses to/from start/finish, taxis, lunches & dinners and airport parking for 1 week.
To go to Nijmegen Holland and complete this event, you must be able to afford it.
[Regardless of how well trained or prepared you are, not enough money = not going.]

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williamjh2008@aol.com