What the Sahara Taught Me About Feet, Resilience, and the Power of Podiatry
Recently, I had the opportunity to be part of the medical team at the Marathon des Sables, often described as the toughest footrace on Earth.
For those unfamiliar, it’s a multi-stage ultramarathon across the Sahara Desert. This year marked the 40th anniversary, with around 1500 competitors covering approximately 270km over 9 days. Temperatures soar, the terrain is relentless, and the physical toll is significant.
As a podiatrist and an ultramarathon runner, it was an experience I’d been curious about for a long time. But nothing quite prepares you for what it’s actually like on the ground.
Long Days, Real Work
The days were long. Really long.
Working in a bivouac setup, often in extreme heat and sand, we were seeing a constant stream of athletes. The volume alone was high, but it was the nature of the presentations that stood out.
Blisters were, unsurprisingly, the main event.
But not your standard clinic blister.
These were often large, complex, layered blisters. Some were infected. Some had been managed (or mismanaged) for days before arriving. Many looked like they should have ended someone’s race.
And yet, the goal was simple.
Get them comfortable. Get them functional. Get them back out there.
“They Probably Shouldn’t Have Finished… But Did”
One of the most striking parts of the experience was seeing just how much could be done with the right approach.
There were countless moments where you’d look at a foot and think, this shouldn’t be able to keep going.
And then, with careful debridement, drainage, protection, and offloading, you’d see that same person back on the start line the next morning.
That’s where the real reward came from.
Not just treating the condition, but being part of someone continuing their journey.
The Immediate Impact We Don’t Always See
In clinic, we often play a longer game.
We’re working through treatment plans, building capacity, addressing underlying causes. The wins are real, but they’re often gradual.
Out in the desert, the feedback loop is immediate.
You treat someone, and within hours, you know if it worked.
And when it does, you see it in a very human way. A handshake. A hug. A genuine moment of appreciation from someone who’s able to keep going because of what you’ve just done.
It’s a side of podiatry we don’t always get to experience, but it’s incredibly powerful.
More Than Just Blisters
While blisters were the headline act, the experience went beyond just skin.
We were managing:
- Fatigue-related injuries
- Soft tissue overload
- Infections
- The effects of prolonged heat and stress
All within a team of over 70 medical professionals, including emergency doctors, nurses, and specialists from around the world.
It was a great reminder of how podiatry fits into the broader medical landscape, particularly in high-performance and extreme environments.
A Reminder of What Podiatry Can Be
Experiences like this shift your perspective.
Podiatry isn’t confined to a clinic room. It has a place in sport, in adventure, in extreme environments, and in moments where the ability to keep someone moving really matters.
It reinforced something I’ve believed for a long time:
What we do has a real, tangible impact.
Sometimes it’s helping someone walk pain-free again.
Sometimes it’s helping someone finish a 270km ultramarathon in the Sahara.
Bringing It Back to the Clinic
While the environment may be very different, many of the principles carry over.
- Understanding load and tissue tolerance
- Managing skin integrity
- Preventing issues before they escalate
- Keeping people active and moving toward their goals
The scale and intensity may change, but the fundamentals remain the same.
Final Thoughts
The Marathon des Sables was challenging, humbling, and incredibly rewarding.
It was a reminder of the resilience of the human body, the importance of good care at the right time, and the unique role podiatry can play in helping people achieve things they didn’t think were possible.
And yes, there were some very memorable blisters.
Written by Andrew Maitland – Director of Melbourne Podiatry Clinic
