What Are Blisters?
We have all had one at some stage and not necessarily as a result of running. As if running and injury prevention wasn’t hard enough. Not all blisters cause you to stop running but when they do, nothing is more frustrating. If a blister is causing you to limp then you should stop running for a few days otherwise you risk getting a “knock-on injury” from the compensating you are doing to cope with the blister.
A blister is a fluid filled sack on the surface of the skin caused by some sort of friction between your skin and the shoes or the socks that you are running/walking in. Prevention is far better than cure but I will touch on what you can try if you have a blister later.
How do blisters form
When our skin gets damaged from friction the body reacts by filling the area between the damaged outer layers of skin and those layers underneath.
Your skin which is the body’s biggest organ consists of two main layers, the outer Epidermis and the underlying Dermis. Both your Epidermis and Dermis are themselves divided into a few layers of their own and a very active, constantly dividing and forming new cells, meaning that your entire skin surface is changed every 20-30 days which is how blisters and cuts heal.
The fluid filled sack that is a blister acts as a cushion protecting the tissue below while the skin heals. They are most commonly seen around the inside arch of the foot, the heel and the toes. Heat, moisture and friction are the three biggest enemies of the blister so the key is to keep temperature down, keep the feet dry and avoid friction. Simple!
How do I prevent blisters
1. Allow your body to get used to the new shoes and be aware if anything doesn’t feel quite right. Even though you may get the same model and brand new shoes are tougher and have less give than the old trusty pair and that can set up friction points. A shoe can take up to 4-5 hours to break in for the desired activity. The same colour and model will not be ‘worked’ to your foot, and so in the first few weeks ‘hot spots’ are common which is often a blister site. For the girls, heels can be a trap if you are going to be walking around a lot.
2. There are plenty of really good socks on the market these days which help reduce friction and prevent your feet from getting too hot and sweaty. Socks should provide protection from the shear stress. Socks can be a little bit of ‘horses for courses’, with the main trick being NEVER introduce a new sock for an event that you have not tested in comparable conditions in training. Typically the best sock will wick moisture from the foot. Some good examples are X-socks Sky Runner, Balega, Teko EV8 and Feetures.
3. Taping can be used very effectively for blister prevention, particularly on toes and arches. See a podiatrist or physio who deals with a lot of runners and they should be able to assist with this. If you are aware of a little bit of a hotspot, you can tape to prevent it developing into a blister in the first place, you could apply some Petroleum jelly to the region prior to putting on your socks.One of our personal favourites preventative measures at SSPC is – apply a barrier ointment like Bepanthen (find it the baby aisle of the supermarket) - brilliant for blisters, chaff and it helps healing to boot
4. Experiment with your laces. There are a few different ways to lace your runners to either reduce slipping around the back of the shoe or to give you more room in the front of the shoe. Most specialist running shops can help with demonstration of this otherwise ask for help when you are next with your physio or podiatrist?
5. Make sure there is no sand or dirt in your shoes or socks which might act as a friction point.
How Do I Treat Blisters?
Once you have a blister then you need to take extra care in keeping the area around the blister clean. If the blister gets infected it can become a much bigger problem. There are then two schools of thought. The first is to pop the blister, drain the fluid, and then protect the tissue. The other option is to let the body heal naturally. There are many types of blisters patches on the market which can help ease the pain while the healing happens. If one of these ensure you are not altering you running pattern then this is probably the best / safest option. Some good examples are Compeed and Spenco 2nd Skin
The size of the blister and where it is located will influence what you do. If it is small and not causing any undue problems that might make you alter your running pattern then leave it alone and it will heal naturally over a week or two. If the blister is causing you to alter your running gait and you don’t want to rest for a few days while it settles then popping it can be an option. This will require sterilising the area, sterilising a needle and using an antibiotic cream. You can then apply a plaster, or antiseptic dressing, to the area and change regularly. If you are uncertain or uncomfortable doing this, then make an appointment with your doctor or podiatrist.
In short, a blister is an alert to something not right with friction – shoe structure, shoe fit, shoe type, sock, biomechanical anomaly etc. Go through the checklist, but if you are still having difficulty, seek specialist advice, mostly these things are very easy to solve, the trick of course is identifying the cause. Try the simple (inexpensive) things first, if no luck, then usually one visit to a Podiatrist who deals more specifically with musculo–skeletal issues should be enough.
Article written by Rob O’Donnell, Physiotherapist and Director of Southern Suburbs Physiotherapy Centre and former Australian Distance running reprasentative. Southern Suburbs Physiotherapy has clinics in 3 loactions: 705 Centre Road East Bentleigh, 100 Lower Dandenong Road Parkdale and 99 Bay Street Brighton and there are physio’s with special interests in treating runners at all locations. For more details go to www.sspc.com.au