Many of us live in areas where a winter season of ice and snow can last 4-5 months of the year. Preparation for winter is necessary to make sure you can navigate safely through the ice and snow. Appropriate shoe gear is essential for your feet to stay warm and allow a good grip in slippery conditions. Proper socks and clothing are necessary to prevent hypothermia from developing as well.

The two main risks in the winter are: 

Falling on Snow or Ice

Use a snow boot or shoe with non-slip rubber soles. The Vibram arctic grip soles work well on slick ice or wet snow and Merrell has this on some of their winter boots. Columbia has an Omni grip sole for better traction. Avoid boots that have a PVC (plastic) sole, these are the worst for traction. Stiff soled boots also are more difficult to grip on slick surfaces, and I prefer a sole with some flexibility to it. Did you know, you can roughen up the rubber on the sole of the boot with a coarse piece of sandpaper, or a file for better traction? 

A boot with a good fit will give you better balance and therefore better traction. Make sure your heel is not sliding around in the boot and the boot is not too wide for your foot as well. Insoles will help improve your balance and can be helpful. The Cluffy insole improves balance and helps keep your foot in place in your boot. Having the insole contact a substantial portion of the bottom of the foot activates the nociceptors on the skin and gives you better feedback on position of the foot and allows you to have better balance.

Use ice cleats for a better grip on ice and to prevent slipping.  However, these need to be removed when going inside so you do not fall on hard floors. There are many brands of these available for a reasonable cost and worth utilizing.

Ski poles or walking sticks will give you some stability if you are going on longer walks. They may not prevent your feet from slipping but will provide you with added stability to help prevent falling.

When approaching very icy conditions; slow down, bend your knee slightly and keep your hands behind you and slightly out to your side for added stability. Certainly, keep your hands out of your pockets and off your phone. If you must answer your phone, stop walking when you are talking! Be extra cautious if you are walking your dog as they may easily pull you off balance.  Plant your foot solidly on the ground and pay attention to your balance. If possible, step on snow for better traction instead of the ice.

Freezing rain or black ice can be particularly dangerous. This is the ice you cannot see, so use caution even when the conditions are good. Also rain on top of ice or snow can create exceptionally slippery conditions. Try to find fresh snow to walk on instead of the beaten-down path that can melt and then re-freeze and be very slick. Fresh snow will give you more stability when you can find it.

Heels are an absolute no-no in ice and snow. Carry them with you to work and wear a good non-slip boot instead. Better to be safe than sorry!

Winter running shoes with an aggressive sole pattern, like a trail shoe may be a better option with snow and in harsh conditions add an ice gripper to the shoe.

Stay Warm

Keeping your feet dry is essential to staying warm. Change your socks midway through the day if needed, in a warm place, to keep the foot dry. If your feet tend to sweat a lot, use an antiperspirant on them. Dry sol is very effective. Use a boot dryer or pull out the liners to dry the boots in between use. Remember, putting your foot in a wet boot will result in cold feet quickly, regardless of the insulation level.

Make sure the boots you wear are waterproof. If they do not breathe and have a rubber or similar material covering the foot, you will have to make sure you are wearing adequate socks to wick the moisture away from your foot. One of the best ways to have dry feet is to make sure you are wearing a wicking sock of silk, polypropylene, or wool, which has natural wicking abilities. Wear a sock, or two, that is heavy for wintry conditions. Other medications and treatments are available if these things fail to keep your feet dry. Consult your physician for more information.

Use an insulated boot for prolonged outdoor exposure. The higher the insulation level, the warmer the boot will be. Many boot companies use thinsulate insulation. This is not critical when you are just going to be outdoors for a brief time, but if you will be standing outdoors in one place for more than a few minutes, you want to have a warm boot. Wool felt is also an excellent insulator, and commonly used in Pac’s or other larger boots for outdoor use.

Plan the length of your walk based on the outside temperature. If it is going to be extremely cold, reduce the time you are exposed to these temperatures if possible.

 Also, battery operated socks really do work. I wound up with frostbite on my feet when I was skiing in Vermont. For years, my feet were painfully sensitive to the cold. Battery operated socks saved me then from giving up the sport and I continue to ski today. You just need to change these batteries mid-day when needed. Also, heat packs activate with exposure to oxygen and are great. I use these also and they are convenient, effective, and inexpensive. Use in your boots, not directly on your skin. Always wear these between the boot and your sock so they will not burn your skin. Be careful with these if you are a diabetic, since most diabetics have little to no feeling, in their feet. 

If your feet are extremely cold all the time, seek the advice of your physician. Some people have a condition called Raynaud’s disease. This results in very cold toes because of a lack of blood supply when you are exposed to cold. Sores may even develop on the toes because of this disease. However, medications (calcium channel blockers) to treat this are effective, inexpensive, and very safe. Again, consult with your physician to see if this is appropriate for you as these medications may decrease your blood pressure and make you feel light-headed when bending down and then standing up quickly.

Additional tips to protect your feet

• Smoking, including vaping will make the feet colder. There are good reasons to quit smoking and medications are available to help you quit if you are serious about this.

• Avoid caffeine as this is a powerful vasoconstrictor and cuts down on the amount of blood getting to your feet. Caffeine is present in most coffee, teas, soft drinks, energy drinks, chewing gum, cocoa, and chocolate.

• Cold water fish are all high in Omega 3 fatty acids which helps to improve circulation. (Salmon, Cod and Mackerel). Also, oranges, lemons, bell peppers and strawberries are all high in Vitamin C and are good for your circulation too.

• Nuts are rich in L-Arginine and Magnesium, and both are dilators of the blood vessels, increasing blood circulation. Also, garlic is high in Allicin and beets are rich in Nitrate, converting to Nitric acid and help dilate blood vessels as well.

Disclaimer- These same foods can also cause you to get colder quicker in general and lead to a condition called hypothermia. (This is when your core body temperature falls below 95 degrees Fahrenheit).

If you have peripheral neuropathy (poor feeling in the feet) or poor circulation, peripheral vascular disease, you must be incredibly careful not to get your feet too exposed to cold temperatures. I once had a diabetic patient who walked barefooted in the snow to start his car. He developed limb threatening wounds from frostbite on both feet. He could not feel a thing and was completely unaware that he had caused a problem. While this seems incredibly neglectful, these things do unfortunately happen.

Keep your body moving in really cold temperatures, standing still is not as good for your circulation as moving around. If you must be in the cold then move your body. Ski racers are always moving around when waiting at the start of a race to stay warm. This is common sense really, but just a reminder to be aware of this, to keep warm.

Frostbite

When feet get cold, to avoid frost nip or frostbite, get them warmed up as quickly as possible. Frostbite can occur in 30 minutes when wind chills or actual temperatures fall below 31 degrees Fahrenheit. (not including wind chills) Do not stay in the cold too long or tissue damage from frostbite may occur. If being in the cold is unavoidable and you suspect frostbite, get some treatment from a doctor knowledgeable about this condition. Do not delay treatment, time is of the essence when dealing with frozen fingers or toes. Get immediate medical care if possible. If you have lost sensation to the skin, you probably have a deeper tissue injury, and may have permanent nerve damage or could potentially lose a toe or even ultimately a foot.

Winter Travel

Always bring warm clothing and warm boots when traveling in the winter. If you go off the road or break down you may not have anyone to help you for a while and running your vehicle when the exhaust pipe is blocked with snow, can cause death from carbon monoxide poisoning. Make sure your exhaust is cleared of any snow buildup and run your car for 10 minutes every hour to keep the vehicle warm if you get stranded. Carry extra food, several blankets, warm clothing, a tow rope, jumper cables, and candles and matches. Huddle together and keep your warm clothes on. Better safe than sorry, particularly if you will be in remote areas without services or cell services. A satellite emergency service to identify your location may be worth the annual fee if you travel to remote areas frequently. Notify family or friends of your travel plans, itinerary and expected arrival times so they can send for help, if you do not arrive as expected. Be a good Samaritan if you see a stranded vehicle, you may save someone’s life.

Hypothermia

Hypothermia is a serious condition when your core body temperature goes below 95 degrees Fahrenheit. If not treated quickly this can lead to death. Shivering is the first thing you will notice as the body temperature starts to drop because it is your body’s automatic defense against cold temperature — an attempt to warm itself.

Someone with hypothermia usually is not aware of their condition because the symptoms often begin gradually. Also, the confused thinking associated with hypothermia prevents self-awareness, and can also lead to risk-taking behavior.

Signs and symptoms of hypothermia include-

• shivering 
• slurred speech or mumbling 
• slow and shallow breathing
• a weak pulse
• clumsiness or lack of coordination
• drowsiness or extremely low energy
• confusion or memory loss 
• loss of consciousness
• bright red, cold skin (in infants)

Risk factors for this are:

• Extreme cold or prolonged cold exposure
• wet conditions such as immersion in icy water
• windy conditions that can produce a dangerous wind chill factor  
• young or old age
• exhaustion
• dementia
• alcohol and/or drug use 
• medical conditions that cause a loss of sensation
• poor nutrition or dehydration
• some antidepressants
• antipsychotics 
• sedatives 
• narcotic pain killers

When hypothermia occurs, you need to seek immediate medical attention and get to a warm area as quickly as possible.

Remember the homeless this time of year and help when you can to make sure they stay safe and warm. Most communities have homeless shelters or warming facilities that are happy to receive your donations. The homeless population are most vulnerable to cold injury and often must walk everywhere to get around. 

Winter is a particularly beautiful time of year and can be a fun time to be outdoors, if you know how to safely enjoy it. Just prepare well and enjoy the area that you live in. Being outdoors and getting fresh air is a good way to stay healthy and great for our mental health. Please be safe and warm this year.

About the Author

James Clough, DPM is a Podiatric Foot and Ankle Surgeon with over 37 years of experience in clinical practice. In his pursuit to help more of his patients with common foot pains, he developed the Cluffy Wedge, which has been successful in the marketplace. His customers then wanted an insole with the Cluffy Wedge in place and after many years, trying to create a best-in-class product, he developed Cluffy Insoles. This was introduced to the market in 2019. This insole is uniquely different from the other common brands of insoles sold on the market today. The need for an over the counter, affordable and simple solution was clear to him. His research indicates that Cluffy insoles are successful for most common foot pain problems, as the root cause of many of these issues has not been readily understood.

It is his goal to empower the consumer with an insole that is highly effective and inexpensive to deal with the root cause of most foot pains. This a powerful tool to let you return to your life without foot pain. Dr. Clough continues to see patients in Polson, Montana.