The Runner’s Guide To Preventing and Treating Blisters

As the most commonly reported running injury, blisters can mean the difference between a great day out, an awesome race or incredible discomfort.

It should go without saying that road runners, trail runners and hikers should know how to manage their feet, whether doing an endurance race or heading out for a day on the trails. When competing in a race, counting on race volunteers or medical staff to patch up your feet assumes that they know what your feet need, and know how to treat and patch blisters. Just as you train with miles on your legs, you need to learn to care for your most important asset, your feet.

Brian Krabak, MD and Louis Davenport, MD have attended and treated ultra-marathon and trail runners all over the world. Here we share their advice and guidance on the key steps you can take to prevent blisters, care for your feet during a day on the trails, and how to treat your feet once you have crossed the finish line or reached your final destination. We have also added a few tips we have picked up from our customers and research team along the way.

Understanding the Causes

Blisters typically develop due to friction on the skin. This can occur from the rubbing of clothing, shoes or other sports equipment on the surface layer of the skin and is made worse by moist and warm conditions. Over time, continued friction can cause the upper layer of skin, the epidermis, to separate from the middle layer, the dermis. Fluid then fills the gap and a blister is formed. In most instances this fluid is sterile and harmless; however, infected blisters might become filled with pus while traumatic blisters could contain blood. Blisters are actually formed to protect an area; the pain encourages you to stop whatever is causing the injury while the fluid creates a cushion. However, too often we must continue what we are doing and treatment is required.

Prevention is the Best Cure

The best tactic to deal with blisters is to never get them. To prevent blisters you have to minimize friction on the skin. Strategies for preventing blisters include:

• Inspect your feet daily and identify any "hot spots." If you develop any hot spots during activity, it's important to treat them right away to prevent the blister from forming. Compeed have a range of products suitable for protecting and soothing your feet. With specialized plasters for every part of the foot, it’s really useful to keep some in your pocket for immediate treatment of hot spots or blisters during a run.
• Break in" your footwear. Competing in new shoes that have not been previously worn will lead to blisters. Make sure the shoe fits properly to avoid excessive movement and can adapt to any swelling that might occur over the course of a race.
• Use moisture-wicking socks to reduce friction and moisture on the skin of the feet. Toe socks like Injinji provide an added layer of protection for the toes and are designed to provide superior moisture management when compared to normal socks. Another brand to consider is Drymax which, as their name suggest, has developed a range of socks specifically designed to keep your feet as dry as possible whilst running. With a range of features to stop dirt getting inside your socks and flat toe seams, they are very popular amongst runners.
• Consider using a lubricant every day. Lubricants can reduce friction and limit moisture that can lead to skin breakdown. An example would be Bodyglide, an easy to apply balm that is resistant to perspiration and water. These products stand-up to heat, humidity and cold. They help lubricate dry skin, prevent hotspots and can last for hours, making a big difference in preventing blisters when it comes to race day.
• Tape your feet or toes. A thin paper tape, such as hydropore, around each toe can last for days. However, make sure you avoid taping between the toes, as this is likely to cause friction. Stronger tape, such as moleskin and Elasticon, along the base of the foot or heel can also come in handy.

We recommend buying The Rough Country Blister Kit to get all the products you need to care for your feet. The kit provides everything you need including detailed instructions on how to care for your feet whilst in the outdoors.

Advice for Treating Blisters

If you do get a blister, the goal becomes to prevent it from enlarging and to prevent infection. There are a variety of treatment options:

• Small unbroken blisters that don't cause discomfort should be left to heal on their own; the best protection against infection is your own skin.
• The effects of many early or small blisters, as well as significant hot spots, can be diminished by adding a layer of tape over the area or surrounding them with a donut-shaped piece of moleskin to help relieve local pressure.
• Large, painful blisters that are not bloody can be drained with every effort made to preserve the top layer of skin covering the blister. To safely drain a blister, clean the blister and the surrounding area with rubbing alcohol or antibiotic soap and water. Next, sterilize a needle over a flame until the tip glows red and allow it to cool. Finally, puncture a very small hole at the base edge of the blister and drain the fluid by applying gentle pressure. Once drained, cover with a bandage. If it looks potentially infected, you could use an antibiotic ointment. Seek medical attention if there is progressive redness or foul smelling discharge from the blister.

Our Top Tips for Preventing / Dealing with Blisters Before, During and After a Trail Race

Pre-Race

1. Reduce your calluses. Soft skin is better than skin with hard calluses. Common callus areas are under toes, on the heels, and on the bottom and side of the forefoot. Getting a blister under a callus can end your race. They are almost impossible to drain and because of that, can be very painful. Get a callus file and lotion to control the build-up of calluses.

2. Learn how to treat blisters and tape your feet before you head out on the trails.

During the Race

1. Wear socks designed to reduce moisture around your feet. If conditions are going to be sandy, avoid double-layer socks as sand can build up between sock layers.

2. Carry and know how to use a small blister kit, like The Essential Blister Kit from The Rough Country. The kit provides everything you need in a plastic Zip-Lock bag to keep it dry and easy to find when out on the trails. The Rough Country Essential Blister Kit comes with a step-by-step instruction guide on how to care for your feet during the race. It has everything you need and nothing you don’t, to avoid carrying excess weight in your pack.

After the Race

1. If you’re racing the next day you need to air your feet, look for and treat any hot spots or blisters, and clean your shoes.

2. If the race is over, soak your feet up to four times a day in Epsom Salts and warm water. The salts dry out the skin, helping blisters to heal faster.

Too many runners and athletes forget about getting their feet ready for a competition. Whether it’s an endurance race where you’re in contention to win, or a day on the trails with friends, make sure you give consideration to your most important asset, your feet!