Ankle sprains can be avoided by wearing boots that provide
good ankle support and, of course, ensuring that your
rucksack is as light as possible. If the ligament hasn’t
been torn, then it is generally sufficient to treat a
sprained ankle by applying ice to the swollen area and
resting your ankle for a day or two. It might also help to
take an anti-inflammatory medication (Neobrufen, Quiralam,
etc). With a grade II sprain (the partial or complete
tearing of the ligament) you’ve no choice but to stop the
pilgrimage and go home.
TRAUMATIC ARTHRITIS: Joint injuries caused, in this
case, by carrying too much weight. Repeated micro-traumas to
the joint finally lead to pain in the joint area which can
force you to stop walking. It most frequently occurs in the
knee after prolonged descents. Excessively long stages,
prolonged descents (Triacastela!) and an extremely heavy
rucksack all contribute to the appearance of these injuries.
You can try and avoid traumatic arthritis by planning shorter
stages and limiting the weight of your rucksack.
The injury can be treated with an anti-inflammatory
medication (Neobrufen, Quiralam) and the local application
of a cold pack.
If you don’t force yourself to do too much and
with the right treatment, this type of injury shouldn’t be
too much of a problem, although it will make walking
slightly more painful.
TENDONITIS: This refers to the inflammation of a
tendon at any point along its path. Pilgrims are
particularly susceptible to Achilles tendonitis; this injury
is characterised by pain in the back of the heel and
generally appears in the mornings when you take your first
steps, it then disappears either totally or partially as you
walk and returns more sharply during and at the end of your
physical exercise, becoming increasingly more intense. The
pain begins to last for increasingly longer periods of time
and may even not go away at all, until it finally prevents
you from carrying on.
There are several causes, however the ones of interest to us
pilgrims are: the difference in heel height (particularly
the case for women used to using high-heel shoes), the
change to flat-soled footwear obliges the tendon to stretch
in a way it is not accustomed to. The use of footwear with
an excessively soft heel area, walking up slopes also causes
the tendon to stretch excessively to the limits of its
elasticity. Finally, the direct pressure of the footwear on
the tendon, caused by ankle-high boots that are too tight at
the ankle.
Achilles tendonitis can basically be prevented by choosing
the right footwear. The
boot soles should be hard, with no soft cushioning
for the heel area and ensuring that the back of the ankle
support is lower. Almost all good boots now have a lower
ankle support at the back specifically to prevent Achilles
tendonitis. Women used to wearing high-heel shoes should do
Achilles tendon stretching exercises, progressively
increasing the exercise intensity, a few weeks before
starting to walk in the boots to be used along the Way.
If, despite everything, you do get tendonitis, you should
take an anti-inflammatory medication and apply ice locally.
Badly chosen footwear can prevent you from
continuing with the Pilgrimage!
RUBBING: foot wounds or sores caused by footwear that
is too tight or too short. Although not a serious problem,
it can be painful. Footwear that is too tight can also cause
nail problems (the famous “black nails”) which will
eventually lead to the nail dropping off. These injuries can
be prevented by selecting suitable footwear that is not too
tight. Also make sure that your nails are always cut short,
and remember to include a good nail cutter in your toiletry
bag. Keep sores caused by rubbing scrupulously clean to
prevent them from becoming infected: clean with Betadine and
protect with plasters or, better still, with a cicatrizant
like Tulgrasum that promotes the sore healing. And, of
course, throw away the footwear found to be too small! (better
late than never!)
BLISTERS: Oh those blisters! Inevitable, hateful
blisters. A pilgrim generally has a blister by the second
day of the walk, or even the first day. They are the most
common pilgrim injury and the one that is the most
bothersome.
Consider how a blister is formed: when you walk,
your footwear never fits snugly on the whole of your foot,
meaning that there are parts of your foot that move slightly
with each step. You’re not immediately aware of this and
so you start walking calmly along until you start to feel
some slight discomfort somewhere on your foot. A blister is
starting to form.
A blister consists of the accumulation of fluid between the
epidermis and the dermis as a result of the surface layer of
the skin sliding over the underlayer. This repeated sliding
finally provokes a localised inflammation which leads to the
accumulation of the fluid characteristic of a blister.
Blister prevention: every pilgrim probably has his or her
own formula or system for preventing blisters from appearing.
However, I’m now going to mention what I consider to be
the best.
1. Footwear: your foot must not be able to move around.
Footwear should fit as snugly as possible, without being too
tight at any point (risk of rubbing and sores). The best
thing is to get a good fit by using layers of socks,
generally some fine socks in contact with the skin and then
thicker socks on top. Socks can be made of cotton or, better
still, polypropylene or another synthetic fibre. There is a
very good brand of socks, called Quechua, which are
specifically “anti-blister” and are on sale in most
sports shop.
2. Before starting the stage: thoroughly clean your feet and
spread Vaseline all over them, without being stingy;
Vaseline all over your feet and between your toes. Then put
on your socks, taking care that there are no folds or
creases. If the socks have seams, then put them on inside
out so that the seams are on the outside. Put on your boots
and carefully tighten the laces, from your toe up to your
ankle, ensuring that your foot is well supported but without
the boot being too tight.
3. Along the
route. Try and stop every two hours to rest a little. Take
off your boots and socks and air your feet a little. If you
can immerse your feet in cold water, then even better.
Examine your feet carefully for any redness or incipient
blisters. Dry them thoroughly before putting your socks back
on. If these are damp, then change them for a dry pair. You
could rub your feet with rosemary oil again.
4 After the stage: As soon as you reach your lodgings, take
off your boots and socks and spend some time on foot hygiene.
It’s a good idea to immerse your feet in cold water for
some time (cold exerts an anti-inflammatory and an anti-oedema
effect) and then rub your feet well with rosemary oil. Put
on your sandals and have a rest…until the next day.
I’m now going
to deal with the first signs of a blister and what you can
do.
The first sign of a blister, when it’s starting to form,
is a slight feeling of discomfort at a specific point on
your foot. I think all of us pilgrims have felt this at one
moment or another. You get the impression that you have a
bothersome crease in your sock. This is the time to stop,
take off your boot and sock and carefully examine the area
that hurts, only to discover with horror that a blister is
forming. You need to take immediate action: if you’ve had
the foresight to buy Compeed pads, put one on the blister,
ensuring that it’s big enough to completely cover both the
blister and a small area around it. If you haven’t got any
Compeed, a wide strip of tape will perform the same function.
Normal sticking plasters are no use at all once the blister
has started to appear. The Compeed pad shouldn’t be
removed until it comes off by itself, generally after four
or five days. In other words, you can have a shower with it
on and walk perfectly easily with it on without any bother
whatsoever. If everything’s goes OK, when the pad comes
off, the blister will have disappeared. If the blister hasn’t
completely gone, then put another Compeed pad on.
OK, you get to your lodgings and find that you’ve got a
beautiful pair of blisters on your feet. So what can you do?
1. Firstly, you need to take your daily shower, paying
particular attention to washing your feet.
2. Disinfect the blister and surrounding area with a piece of
cotton wool soaked in Betadine.
3. Take a normal sewing needle, threaded with normal cotton
thread, the one used for sewing buttons on. Disinfect needle
and thread by wiping them with cotton wool soaked in
Betadine. As is logical, first wash your hands carefully
with soap and water. You don’t need to dry them.
4. Take the needle and thread and, without a second thought,
stick it through the blister from one side to the other (it
doesn’t hurt!) until you see the thread appear. Cut the
thread leaving approximately one centimetre on either side
of the blister. Disinfect the area again and Voilà! The job’s
done – you’ve now got an empty blister with a piece of
thread coming out of each side.
The blister’s gone for good, because the thread ends act as
a drain, and no more liquid will accumulate in the blister.
Now you need to be particularly careful to ensure the blister
(or rather ex-blister) doesn’t become infected. So cover
it with a dressing (a wide plaster is sufficient, provided
that it covers the whole area) and disinfect with Betadine
every day. You’ll see that you’ll be able to walk with
no problem at all, even with the threads in place. If you
remove the threads the blister will start to fill up again,
and the problem reappears.
Well, I think that’s sufficient to give you an idea of the
treatments to be applied for the different injuries and
sores and how to avoid them. If you have any doubts or need
clarification on any point, well that’s what the forum’s
here for. Ask and you’ll get a reply. Or at least we’ll
try.
In any case, let St James protect us! And ENJOY THE
PILGRIMAGE!
www.caminosantiago.com
agradece la colaboración de Manu |
