San Francisco Podiatry Video


Friday, July 25, 2014

What is a Real Runner?

A couple of days ago I had an interesting conversation with a woman. We were talking about exercise, not just for fitness sake, but for enjoyment. About fitness as a lifestyle worth living. I asked her how much she runs, and she explained that she “only runs a few miles several days per week.”

“You seem like a real runner,” she said.

I remember feeling an involuntary wrinkle in my brow and being taken aback for a moment. 

Because even though I started running as a kid and I still run a lot today, I don't actually didn’t think I ever perceived myself to be “a real runner.” 

When I think of a real runner I picture Karen Gaucher, Ryan Hall, Deena Castor and Meb Keflezighi. I tend to conjure mental images of people who have dedicated their lives to running in ways that I never could. In someway, I think I had classified a real runner as somebody who could consistently run 100 miles per week during their training periods or win races.

A real runner, I had always thought, never loses that focus on the future. Keeps her eye on the goal. She visualizes achieving her aim. Always thinks about finishing, and how it will feel.

But as I thought about that, I started to think about my friends who I think of as “real runners.” And I immediately came up with several that don't run outrageous distances. None of them run for paychecks. All of them truly love running.

John Hunt, Anjulee Johnson, Phủỏng Mai N, Sarah Graham, Mimi Jacobson-Kwok, Brynn Ewen, Laura Duplantis. These are my friends, normal people, and they are all “real runners.” In one way or another each one of them has impressed me. I have seen pictures of their runs and have been inspired. The way they have described a specific run, the way they felt, what they get from running has made me smile. 

What I realized is that their stories, their reasons for running and how their descriptions of running touches me is always about being in the moment.

It's about rows of palm trees on the Stanford campus. The smell of running through the redwoods. The beauty of oaks and pine trees passing overhead. It is about sunshine and fog and feeling alive. It's about being grateful to be fit, and able to run. It is about enjoying movement in a beautiful place, right now.

Its not about pace or distance. Its not about how many finisher medals hang on the wall. Its not about being a Kenyan. And its certainly not about how the next marathon finish will feel, tomorrow, next month or next year.

Its about gratitude. An instagram pic of a beautiful setting or a genuine smile in the middle of a long run. Its about now. The way it feels to run 47 blocks in Oakland, one way, today.

And then she asked me what my last run was like.

I didn’t think about how the run fit into my Ironman training plan. I didn’t think about the pace I kept. I described the feeling of warm sun on my shoulders, strength in my legs, 7 deer quietly feeding on the side of the trail, the amazing blue of Crystal Springs set a against a sea of green trees hugged gently by a thin blanket of clouds under a clear blue sky. I though about how that run made me feel so alive, in that moment. 

And I thought, “maybe I am a real runner.”  

Dr. Christopher Segler is a 12-time Ironman Triathlon Finisher, but more importably he is a real runner.  His podiatric sports medicine practice caters to athletes who think that there has to be way to stay fit, keep training, yet still heal an injury. He often lectures at medical conferences on the treatment of complicated running injuries, running biomechanics, and subtle fracture patterns of the foot and ankle. If you have a question about a running injury you can call him directly at 415-308-0833.  You can also learn more about running injuries at and

Thursday, January 16, 2014

Can I play basketball with these blisters?

Hi MyRunningDoc!

I have a basketball game tomorrow. Can I play basketball with these blisters without causing any problems?   What can put on it while I play?


Blisters under the ball of the foot can be painful. In the images above you can see that JM has developed some large blister that cover the entire big toe joint area. The blister may have started draining, or maybe he simply decided to pop and de-roof (meaning cut the blistered skin off) the blister in order to relieve the pressure. With large blisters, it is often necessary to drain blisters ton keep them from getting bigger. Yet doing so can make them more painful and take longer to heal.

In this case the raw pinkish area is going to be painful when running. Suddenly stopping or changing direction will also put a lot of stress on the blistered area and aggravate the raw skin under the big toe joint.

When you run, about 50% of you body weight is transmitted through this area. There are really only two ways to decrease the pressure to the ball of the foot at the big toe joint.

1. Decrease your activity (as in no basketball, walk less, etc.).
2. Move the pressure somewhere else. 

It is a simply rule of physics: you cannot remove pressure, but you can transfer it. It is possible to create a pad that moves the pressure from the big toe joint to the rest of the ball of the foot. By moving much of the pressure and irritation to the little toe joints, it may possible to play with less discomfort.

You can purchase pads at any drugstore that are designed for the ball of the foot. The idea is to hold the pad on the foot and identify the painful area. Clear pads obviously make this easier.

 The painful area is outlined on the pad.

The outlined area over the blister is cut away.

The pad now can put more pressure on healthy skin under the ball of the foot. The pad may stay in place well with a sock on. If not it can be taped in place to secure it. If properly placed, there will be less pressure on the blistered area. 

Even if properly offloaded, there is a risk that continuing to play will further erode the skin and cause more discomfort. In the end, if continuing to play on a de-roofed blister, it will take longer to heal. The increased mechanical irritation of running increases the chance of the blistered area becoming infected.

With any de-roofed blister (or other open wound) it is always best to seek an evaluation from your own physician before attempting treatment. You should speak with a sports medicine podiatrist to make sure that the blisters heal properly. You also need to identify the cause so that it doesn't happen again.

Dr. Christopher Segler, DPM is a podiatrist, Board Certified, American Board of Podiatric Medicine. He is also a 12-time Ironman Triathlon finisher. His sports medicine practice caters to athletes He sees patients in person in San Francisco, Houston, and Hawaii. He also offers remote consultations via webcam to athletes living abroad. If you have a sports injury question and are trying to figure out how to keep running, you can reach him directly at 415-308-0833. You can also learn more about blister causes and treatment at and