Blisters. Aaaaaaargh!

Prevention really is better than cure but what is the best way to go about it and what do I do when I get one?

We asked two of our staff blister experts (with some serious hillwalking and ultra-racing footcare experience between them) for their top tips……

What is a blister? 

Blisters are small pockets of fluid that usually form in the upper layers of skin after it has been damaged and can develop anywhere on the body. Fluid collects under the damaged skin, cushioning the tissue underneath. This protects the tissue from further damage and allows it to heal. Most blisters are filled with a clear fluid (serum) but may be filled with blood (blood blisters) or pus if they become inflamed or infected.

They can be caused by friction to the skin, heat – for example, from sunburn or a scald, contact with chemicals or medical conditions but whatever their cause, they are no fun at all while you are out walking or running in the hills.

Prevention

Footwear fitting is critical for blister prevention so when you are buying footwear please come into the shop where possible to ensure there is adequate toe room & minimal foot movement not just on the flat but on the slope and with weight on your back too. Why? Because your feet get longer and wider when the weight of your body is increased by the addition of a loaded rucsack. Fitting and lacing can make a very big difference to improving fit as can footbeds – don’t forget to ask about Superfeet volume adjusters and insoles!

If you have older footwear – be aware that your foot can change shape over time. Our bodies change as we age and our feet are not exempt. With every step, your body absorbs two to three times it’s weight due to gravity and that all goes through your feet. This can also mean that the shoe size you have been wearing for years and, indeed, the shoe size of High Street shoes can be different from carefully lasted footwear designed for function as opposed to fashion. If you have suddenly started getting blisters after years of comfort, then it’s worth checking older footwear for damage inside as there could be areas of wear.

Socks play a large part too. The correct weight, size and fit will make a big difference to the fit of your footwear and look carefully at the materials they are made from to ensure they are designed to transport or wick moisture away from your foot. This won’t stop your foot feeling sweaty on a long day out but will make a difference to comfort. Liner socks can work well as they reduce any friction or movement between your foot and the boot/shoe – especially when walking. Technical socks will also be woven to add cushioning and support to blister prone areas such as the heel and toe area.

Finally, a bit of skin care can work wonders for feet ravaged by the continual pounding of miles. If you are heading out on a long day a quick application of a lubricant such as UP Skin Shield or Vaseline to blister prone areas can reduce friction enough to stop one forming. Regularly moisturising feet can help as well as getting busy with a pumice stone on any hard skin or callouses. Add a trip to the Chiropodist to your personal healthcare list.

Do not attempt to harden feet/skin. This will not prevent blisters, but it will mean any blister that does develop will be much deeper, and thus more painful and harder to treat.

If you usually get a blister in a specific place then consider taping the area with KT tape before setting off. It’s very easy to get caught up in the pace of the day and think “I’ll worry about it later” but regardless of whether you are enjoying a walk or running an event; if you feel a hot spot developing – STOP. Treat it. It really will save you time later.

Treatment

If you get a blister and still have a long way to go, stop and dry your foot properly. Next, comes the big question: To lance, or not to lance? This depends very much on your situation as kept intact, the fluid will cushion the damaged tissue underneath. (That’s the NHS advice) Should you decide to drain the blister with a sterile pin/scalpel be aware you have an open wound that you will need to keep clean and cover with a sterile dressing to reduce the chance of infection. Tape the area with KT tape to keep everything in place while you finish your activity. On long endurance events Medics will often choose the lancing method.

If the skin is torn/broken/missing then after cleaning and drying the blister area, cover with moleskin dressing or second skin and tape with KT tape.

·       Compeed – warm to skin temperature before applying then leave on

·       Adventure Medical Kits have 3 good products to treat blisters

·       Blis Sox - wear under your regular socks to prevent heel blisters

·       Engo patches – go inside the shoe to reduce friction

·       Zinc Oxide/Climbing Finger Tape in first aid kit or use as prevention

·       ‘Fix Your Feet’ is a great book for advice

A note on using Compeed:

For extended trips or longer races consider avoiding Compeed or similar. This is fine for short/single day trips but can cause major problems if left on during trips/races for a long time. Firstly, the skin surrounding the Compeed will be more flexible than the Compeed itself which can cause additional blisters to occur around the perimeter of the covering. If this happens, you will need to remove the Compeed to treat these (this is not a happy experience!) As it is so sticky, it will take any loose skin off with it, making the area very raw and painful – and prone to infection.

Couldn’t see the answer to your questions above - don’t worry! There’s even more information on our podcasts. Happy listening…..