Immersion Foot Strikes Again – Advice?

[Nick Smolinske]

So one year ago I had a New Year’s hike in the Grand Canyon where I ended up giving my self trench/immersion foot.  We had cold temperatures and wind-driven snow, and my feet were wet and numb for pretty much the entire day of hiking.  We got to camp early (4 pm), and I got into my sleeping bag right away, but my feet were still a little numb when I went to bed 5 hours later.

If I knew then what I knew now I would’ve put hot water in a bottle and warmed my feet up right away.  I probably could’ve prevented any long term damage.  But alas, I had some lasting effects (red swollen toes) for a few months.  It finally went away sometime in March.

Fast forward to yesterday when I had a very cold night of car camping and the symptoms came back – swelling in the same toes as before (all of the left foot, outside of the right).  My feet weren’t wet at all, just cold for a couple of hours in the morning.  So it seems the nerve damage is still around, and that cold is activating the symptoms.  It’s not as bad as before, but the swelling still makes hiking less comfortable.

My question is, what should I do now to treat the symptoms while hiking?  Most of the resources I can find online just talk about prevention, and I think a doctor would probably just tell me to not let my feet get cold.  So far I’ve tried Aleve to help with the swelling and it seemed to work, but I also slept inside last night so that’s not very conclusive.  So far my plan is to bring Aleve and some warm sleeping socks on my next hike, and if we have a very cold and wet day put a hot water bottle in the foot of my sleeping bag.

 

So, has anyone experienced this before?  Any other ideas?

[Paul S.]

Not letting your feet get cold is a great idea. Why is that something you deem not possible?

[Jerry Adams]

and not letting your feet get wet?

[todd]

Well,

If your trip takes you into conditions where you’ll be wet no matter what (like hiking through water), then so be it.

The hot water bottle should work well.  But if I had it as uncomfortable as it sounds, while in camp I think I would take some small pocket toe warmers/handwarmers, and wear them inside my loose sleep socks, but over a pair of dry hiking socks.  You can maintain a “normal” routine and still hang out in camp this way (won’t have to get in your bag right away), by loosening your shoes a good bit.

I don’t know if it’s practical to do so, but periodic light jogging in place would increase bloodflow to the area as well.  Upon arriving in camp and prior to bed, this should help a good bit.  Concentrate on flexing the toes with each step if it doesn’t hurt too much.

OH!  and what about bread bags / produce bags between sock layers in camp?

If these don’t work, I honestly think I would stay home :(

[David Thomas]

Yeah, those hand- or toe-warmers that last 4-5 hours would be a big help. Not a lot of weight. I wait till STP has them and there’s a 30% off coupon and stock up. That gets them below a dollar a pair.

The kids’ Nordic ski lessons only go down to 0F and Nordic ski meets to -10F, but we’ll go Alpine skiing somewhat colder. And I end up handing them out to other skiers with inadequate gloves or cold feet due to minimal socks or over-tight boots.

[David Thomas]

But to back up to some basics: thick wool or wool-synthetic blend socks?  A big enough boot to allow for those socks without compressing your feet and reducing circulation?  Well hydrated (can be hard in winter) so you’ve got enough blood volume to circulate in your peripheria (hands and feet)?  Well-hydrated = you peed a decent volume in the 2 hours.

[Nick Smolinske]

Some good advice here, thanks!  Mostly I’m worried about the long Grand Canyon hike I’ll be leaving for in a couple of days.  On that one I should be able to avoid getting my feet wet.  Avoiding cold feet is another story, particularly if there’s a big snowstorm.  I’ve always just gotten cold feet on winter mornings and accepted it as a fact of life, so I’m not sure it’s 100% avoidable for me (tall and skinny body type).  At least not while wearing any kind of shoe I’d like to hike in.  But I’m open to ideas.

I’m definitely bringing thicker wool socks with liners, and I do have some of those chemical hand warmers that I can throw in the pack.  I’ll have to try going up half a shoe size as well.  The bread bags are a great idea if we do get a storm, might as well keep my feet dry.

I also hadn’t realized that being better hydrated might help.  Good to know!

[todd]

Nick,

The bread bags don’t only work if you’re wet!

With a liner under and warm sock over you will be toasty (perhaps too toasty in this case but that might be a good thing :)  )   They work great in camp and in your bag.  Just use a bandana or pack towel to dry off your feet before moving on for the day.

 

 

[Jeremy and Angela]

Yep, keeping your feet warm and dry seems best.  I’d pack spare socks for that purpose.  Keep in mind that re-injury is will be easier, and it doesn’t need to get that cold for it to happen.  Dane over at Cold Thistle wrote a brief post on this topic back in 2010, it’s worth a skim over.

-J

[Mark]

If you are on a hike where you can resupply after a couple of days disposable babies nappies do a great job of drying out shoes during the night.

About 40g a pop dry so you wouldn’t want to be lugging them about for days, but if you want dry (or drier) shoes in the morning they work great.

[David R.]

Here is an article that Ryan Jordan shared on my “Overboots and More” thread which seems quite applicable.

http://backpackinglight.com/spring_footwear/

Body Glide has anti blister / chaff products which can also help keep away trench foot (rather than Hydropel which is no longer available):

https://www.bodyglide.com/

And I agree, buy shoes / boots 1/2 to 1 size larger so that you can fit layers of socks – VBs to keep your feet warm. And you may want to look at the Forty Below Overflow Supergaiters. They seem a like they may be a good option if you want to keep your feet warm and your not in snow using snow shoes / crampons.

https://www.40below.com/products_detail.php?ProductID=69

And don’t underestimate the effectiveness of massage. Massaging your feet with your warm hands will help bring back blood flow, reduce inflammation, and improve function / feeling. You can warm you hands in your armpits and then get to work on your feet (unless your a yogi and can warm your feet in your armpits…).

[Roger Caffin]

I do remember someone moaning at great length about his cold feet, which puzzled me a bit because under those conditions my feet were OK. It turned out he was a dedicated wearer of shorts. With all that exposed flesh in wind and rain, the blood going to his feet was stone cold before it got there. No wonder he had cold feet!

There’s a lesson here somewhere.

Cheers

 

[Jerry Adams]

if your feet are cold, put on a hat?

that is, if you have a marginal amount of insulation for the cold, blood flow to feet will be restricted to keep your torso from cooling and killing yourself

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