Blister Prevention

Ultra runners love nothing more than showing off their black toes, lost toenails and blisters. If you doubt me, just hang out at an aid station or finish line of a 100 mile endurance run especially one with creek crossings and swampy conditions. You are sure to see runners proudly comparing their blisters to see who has the gnarliest feet. They share photos on social media and wear their pus filled protuberances like badges of honor.

This is the last cute feet picture you will see in this post.

WARNING: GRAPHIC PICTURES BELOW. CONTINUE READING AT YOUR OWN DISCRETION.

(I knew you would continue.)

I’m fortunate that I rarely get blisters or lose toenails. Anything shorter than a 100 mile trail race and my feet are just fine minus a hot spot or two. In the 100 miler though, I’ll usually not fare as well especially if there are unavoidable creek crossings. Several times I suffered quarter-sized blisters on the outside of both heels and last year at Bighorn I had severe chafing on the tops of my feet. By the end of the race they were bleeding. In addition, the sides of both big toes were very painful especially at the end of the race and I had a huge blister on my heel. Nevertheless, I sucked it up and still finished.

My feet after the Bighorn 100. 

Following this race last summer, I began to research these issues hoping to find solutions. The first thing that came to mind was that there was too much pressure on the balls of my big toes. Could my shoes simply be too narrow? I had been wanting to try Altra Footwear for a while and decided their wide toe box may help my situation. Over the past year I bought around eight pair saving money by shopping previous models and looking for sales online. So far I’ve been through several pairs of Repetitions, a Paradigm, four pairs of Lone Peaks (2 and 2.5), and the Olympus. The results were excellent and I had little to no pain during my last hundred miler. 

Now on to the blister prevention. One of the most entertaining articles I came across recently was written by Paul Salopek, a Pulitzer Prize winning author who is currently on a seven year trek (21,000 miles) around the world. 

Follow P. Salopek’s Out of Eden Walk (National Geographic)

In his article, Blister-ology: The Art and (Pseudo) Science of Foot Care, Salopek writes about some of his walking guides who suffered severe blisters. One taped feminine napkins to his socks in hopes of preventing blisters; it didn’t work.

And constantly I beg my local walking partners to warn me when their feet begin to heat up, to get sore, to pause before real damage is done, to take preventive action. They never do. Not once. (We all know how to walk!) And so: I have applied acres of bandages. I have unspooled miles of medical tape. I have deployed hydrogen peroxide, iodine, rubbing alcohol, sheep’s fat, cooking oil, talcum powder, ice, salt water, and my own spit against a vast constellation of holes burned into peoples’ feet.

—Paul Salopek

One of the best websites I found for why blisters occur and how to prevent them is Rebecca Rushton’s Blister Prevention. She really knows her stuff and recommends Engo patches for hotspots on your feet. Treat the small problem early so it doesn't become a huge problem later. The patches actually go on your shoes and not your skin. They are small enough to carry in your pack, stay put when applied and help reduce friction. She includes treatment plans and has a bunch of other information on everything from black toenails to maceration of the feet (Trench foot). Dr Rushton, a podiatrist by profession, includes a lot of pictures of extreme blisters on her website so I hope you are not squeamish. 

 Silverheels 100 runners following the race.
Photo: Human Potential Running

One reason I rarely get blisters is because my skin is old and leathery like your grandmother's. (Try not to visualize that for very long.) I also condition my feet by logging many miles over rough terrain on a daily basis, but I get calluses on the balls of my big toes and on the bottom of my forefoot. Calluses can actually be bad according to John Vonhof of Fixing Your Feet. I've suffered from blisters under my calluses on several occasions which can be very painful. 

He recommends filing the calluses and keeping the skin on your feet as moist and supple as possible. Therefore, I grab  the microplane cheese grater from the kitchen utensils drawer and file my calluses once a week. Just kidding. I use a microplane cheese grater that is solely dedicated to my feet so my family doesn't kick me out of the house. One is actually designed especially for feet called the Microplane Sole Surfer. The last thing I do is apply heal balm to my feet to make sure my skin stays moist and doesn't crack or split.

My feet need the cheese grater. See the split?

Here's another tidbit I learned in a race recently: wear two pairs of socks to help reduce friction. I started to have chafing spots on the tops of my feet again at Silverheels 100 last month. Medical personnel at an aid station recommended I wear two pairs of socks and loosen my laces. We also applied anti-chafe balm to the affected areas and I was good to go. No more chafing and no blisters.

Another simple thing you can do to prevent blisters and black toenails is learn to tie your shoes. What? Doesn't everyone know how to tie their shoes? Many people overlook this one thing that could make all the difference in your race. Use the lace lock technique when tying your shoes to keep your heel from slipping up and down. It will also help keep your toes from slamming into the front of your shoes on steep downhills causing black toenails.

Here is a how to video from Blister Prevention:

One of the most important aspects of blister prevention is to condition your feet to the elements and terrain you will experience on race day. If possible train on the type of topography you will race on. Is your race hilly, sandy, rocky, wet, hot, on dirt or pavement?
Wear the shoes and socks that you will wear on race day as well and never try new things (shoes, socks, tape, etc) the day of your race. Everyone's feet and toes are shaped differently though, so you will need to seek out solutions for your specific problems.

Drymax socks are made in the USA

Finally I will leave you with some tips to help get you through your next race blister free.

• On longer races, stop to loosen your laces occasionally because of foot swelling. You may also want to change into larger shoes later in the day.

• Carry a small tube of anti-chafe balm and Engo patches in your first aid kit.

• Wear two pairs of moisture wicking socks; a thin one and heavier one.

• Try to keep your feet dry when crossing streams and change socks more often when it’s hot.

• Place dry socks and extra shoes in your drop bag.

• Make sure your shoes breathe and drain well when they get soaked.

• Use the lace lock technique.

• Condition your feet in advance.

• Shave calluses and keep feet moist and supple.

The only downside to blister prevention is that you won’t have any gross pictures to share with all your friends on Facebook.

I can't remember where I got this one.

 See you on the trail.