Blister Prevention and Management
Blister Prevention and Management
John Charles – Running Podiatrist, South Yarra Spine & Sports Medicine
Blisters on the feet can be a painful problem, particularly for those running or participating in other sports. Knowing some simple steps can make a big difference to the comfort of your feet.
Blisters are most commonly caused by excessive friction forces to an area of skin. The repetitive forces eventually cause the top layers of the skin to detach and this fills with fluid as the body responds to the trauma. If not managed, the blister can increase in size and fill with blood due to involvement of deeper layers of skin. Blisters can also form a layer of hard skin (callus) over the top when they occur in high pressure areas of the foot.
Blisters can also occur due to heat or cold exposure, sunlight exposure, allergic reactions, and other skin and health conditions.
What are the Key Causes?
When exercising, a number of factors can lead to blisters occurring. These include heat, moisture, time, pressure from footwear (at the toes, heel, arch), or pressure due to foot structure or function (i.e. bunions, heavily pronating feet).
There a number of simple steps you can take to make sure you can exercise blister free.
It’s common knowledge that feet tend to expand when exercising. The heat and activity can cause the connective tissue to loosen and thus the foot can flatten and get bigger. The increased forces when running also place more pressure on the toes when pushing off.
The simple solution is to make sure that your shoes are the right fit. Your runners should be an adequate width for your foot and have approximately a thumb’s width of space at the end of the toe. A quick test of this is draw an outline of your foot on a piece of paper. Then take the insole out from your shoes to assess areas that may be subject to high pressure. If you are not sure, a good running store or podiatrist will be able to advise you.
A good running sock should be breathable and seem free, particularly on high pressure areas of your feet. The best thickness is down to personal preference but consider this when checking shoe fit. A good tip is to take your preferred socks when buying any new runners.
Taping is a great way to further reduce the potential for friction in your feet. It’s particularly beneficial when you are doing exercise that places high demands on your feet (e.g. marathon running, bush walking).
Basic fixing tape (e.g. Hypafix, Fixomaull) can be purchased from a chemist and does a great job in reducing friction when exercising. It’s most commonly used around the toes, under the forefoot, and at the basic of the heel. Fixing tape is hypoallergenic and can be easily cut to suit any foot shape. When applying make sure that the foot is clean and dry and that the tape doesn’t crease up as this can cause irritation.
The use of lubricants such as Vaseline is a common way that people prevent chaffing or rubbing during exercise. However, I favour the use of a more specialist product like Bodyglide. I find Bodyglide to be gentler on the skin and able to withstand long periods of exercise without drying out or going grainy. It’s particularly popular amongst triathletes who wear multiple layers of clothing in various conditions.
In spite of all these steps, sometimes blisters can occur. In terms of management there are two options:
- Don’t Treat The Blister – If the blister causes minimal/no pain and is not in a high pressure area the best treatment is to leave it. Over time the skin will repair and the blister will heal by itself. You can use lubricants or dressings/tape to protect the site whilst exercising. I strongly advice against the use of blisters plasters/second skins. While they may provide some initial relief the plasters adhere to the skin and when removed can tear the skin away causing pain and delayed healing.
- Treat The Blister – If the blister is painful and is in a high pressure area, I recommend draining the fluid from it. The best way to do this is the use a sterile needle to make a small incision in the side of the blister and then push the fluid out without tearing the blistered skin on top. Removing (deroofing) the skin on top is not recommended as it will cause increased pain. Following draining the area should be covered with a simple sterile dressing. If you are uncertain about blister treatment, see a podiatrist. Incorrect management can lead to delayed healing, increased pain and possible infection.
- Hypafix or Fixomull tape (don’t forget scissors)
- A spare pair of socks (damp socks are a blister waiting to happen)
If you have any questions please contact John Charles at South Yarra Spine & Sports Medicine on 9826 2122 or firstname.lastname@example.org. I hope this article will help you to achieve comfortable and blister free exercise in future!