Introduction: Preparation for Alps 2 Ocean Ultra 2019

I am the Medial Director for Alps to Ocean Ultra for 2019 having been the Medical Director for 2018. I am a General Practitioner at Central Medical in Oamaru having been in practice for over 30 years. I have a very wide range of experience including emergency medicine and trauma and experience in running marathons.

Alps Ultra 2019

At each camp there will be a medical tent for the Medical Team and Physiotherapists. We are there to help you sort your medical problems out so that you complete the run but you should start considering what supplies and kit you will need to bring and what skills you need to learn to look after your own feet and minor medical issues such as blisters and chaffing.

In 2018 the commonest drugs used during the race were Paracetamol for pain, Metoclopramide for nausea and Flucloxacillin for infected blisters. See below for further information.

Preparation for the Alps to Ocean

80-90 % of all those who did not finish (DNF) in 2018 did so because of foot problems. These were also by far the largest reason for visits to the medical tent. The aim of this article is to help you prepare yourself for this fantastic race and to not let something that is largely preventable or controllable from stopping you finish.


The biggest medical issues were:

  • Foot preparation

  • Blister

  • Dehydration

  • Nutrition

  • Chaffing

  • Heat related illnesses

  • Sunburn

  • Pain Killers

  • Nausea

  • Antibiotics

  • Have a look at the blogs by Elisabet Barnes as they are excellent. They are found at:

Foot Preparation


Prepare your feet 6 months before the race:

Toughen your skin but also keep it supple. These tips might help:

Step 1

Take your shoes off when at home. This is especially true for those who wear shoes or slippers around the house. Get used to walking barefoot.

Step 2

Walk without your shoes at the local park or beach several times a week. Stay on the grass or sandy area when barefoot. This exposes the soles of the feet to a mildly abrasive texture. Keep your walks short initially and then increase them as the feet toughen.

Step 3

Jog at the park or beach when walking becomes too easy. Increasing the speed will provide more friction to make the feet tough.

Step 4

Pat rubbing alcohol on the soles of the feet and around the edges. Alcohol is a drying agent that helps to harden skin. Do this several times a week until calluses form.

(Some runners do not like this so it is an individual choice)

Step 5

Walk around barefoot on harder surfaces such as a sidewalk once the soles thicken to keep the skin tough.

Lubricants; Products such as Gurney Goo or Trislide or even Vaseline can be used to reduce the friction on your toes and feet. In fact, it is not the friction per se that causes blisters but the shearing forces on the skin that separates the skin for the underlying attachments creating a blister. I recommend you use these at least 3 months from the race. These should be applied twice a day from a week before the race and during the race.

Toe Socks.: Some people rave about these. Injinji, Meaiguo, Habiter and other makes are available. These can help prevent the friction/shearing on your toes and feet. If anything, they can help keep toe bandages in place should you get blisters. Avoid cotton as this gets hard.

Wear a slightly larger Shoe:

During the event your feet will swell and it is likely you will need some dressings during the race which add bulk so I advise that you wear a shoe that is one half size larger than your usual size.

Tying Shoe laces:

Learn how to lace your shoe ad I advise you to look at the YouTube video ‘How To Lace Running Shoes For Your Best Fit and Improved Comfort’ as this goes through various techniques. Personally, I think the runners loop is excellent to prevent movement.

Consider a softer insole such as a memory foam. Last year a lot of runners suffered with serious bruising of the Forefoot (front of the sole of the foot) due to repetitive bruising causing a lot of pain. This is caused by repetitive sheering forces tearing the skin away from the underlying tissue.

Consider gaiters: Last year we had several problems with stones in shoes and so to keep the inside of the shoes free of damaging gravel and stones I suggest wearing these.