Incredible blisters – Healing, training, prevention

I get very bad heel blisters as well.  I do not pop them if they develop, but I’ve also developed a simple system for avoiding them.

1. Excellent-fitting shoes that minimize any and all heel slip/lift.
2. Two socks: one for a slick lining and one for padding/insulation.
3. Pre-tape my heels.

Sounds like your shoe/sock combination is not optimal for your foot, if you got blisters that bad.  I can’t advise on changing it, but the above combination has basically eliminated blistering for me.

4. what’s the wisdom about applying moleskin or other products when you develop a hot spot? how soon do you stop?

This one’s easy:  The instant you find yourself thinking, is there a bit of detritus in my shoe or was that the beginnings of a hot spot?  By the time you’re wondering, it’s almost too late.  Stop NOW.  Don’t wait for a good log to sit on, do not pass Go, do not collect $200.  Sit down on the trail and moleskin up.

As soon as I feel anything, Leukotape

^^ What those guys all said. Though I don’t do the 2 pairs socks myself. OTOH leucotape has the status of “don’t leave home without it”.  I always wear trail runners and for the last 4-5 years been through a few pairs of Solomon XA pros. I get in some miles trail running with them before hiking. Also never carry more than 20lbs since I’m old, ugly and weak.

The instant you find yourself thinking,

Is time to stop. Well said!

Deep heel blisters have rarely been my problem, but I’ve had many other blisters, so this is my experience. Much echoes what others have posted. As always, YMMV.

– At the first hint of a hot spot, clean and dry your feet, then apply Leukotape. If you even think “could that be a blister forming?” stop and check – it usually is. All the Mole… products are worthless or make things worse.

– Blisters form in reaction to heat and friction. Foot friction is tied to movement – were your heels rubbing up and down inside your shoes as you hiked? Think about how to fix that. I wear shoes a little loose – my heels move up and down, but almost no rubbing.

– Dirt increases friction. I’ve had a lot fewer blisters after wearing Dirty Girl Gaiters, to keep the dirt and other crud out. Highly recommended. Other brands might work – look for short, breathable, lightweight, simple, and stretchy, without a strap under your shoe.

– Socks make a big difference. I’ve been through many fabrics, styles, and combinations, and what works changes over time. Right now, lighter weight wool Darn Toughs are working well.

– NOLS/WMI wisdom on big blisters, backed by my own experience: clean well, puncture at the edge, squeeze out the fluid, leave the skin on, apply your antibiotic ointment of choice, and cover with a tough, dry, (ideally) padded dressing. Then suffer anyway – puncturing just lessens the pain.

– Lighter pack weight is good – up to a point. For me, dropping total pack weight below 25 pounds (~11 kg) doesn’t make much difference. But 30 to 35 pounds is into the pain range for various body parts. I might start a trip at 35, but quickly eat and drink my way below 30.

– Everybody’s feet are different. Fixing Your Feet (web site and book) has many different recommendation. I had to try a bunch of things before I found a combination that worked. Highly recommended.

Good luck.

— Rex

https://www.fixingyourfeet.com/foot-care-articles/

https://www.fixingyourfeet.com/Blister-Prevention/

Blister Prevention
Blisters are very predictable. Take three elements, moisture, friction, and heat, common to your feet when you run, and the likelihood of a blister appearing is high. The longer these elements exist on the feet, unattended to, the greater the risk. So, what can we do to reduce one or more of these elements?
The first order of business is to recognize that you, and you alone, need to find what will work on your feet. Others can give suggestions, but what works for another may not work for you. What follows is a synopsis of options you need to consider.

The First Line of Blister Defense
There are several blister reducing options that should be our first level of defense. Proper socks are a key priority. Moisture-wicking socks are available from almost every sock manufacturer, and given a choice, should always be picked before an all-cotton sock. Double layer socks offer an inner layer that moves against the outer layer, reducing friction to the skin. Try several different types of socks of various thickness’ and fabrics.
Lubricants are next on the list. Most runners grew up using a lubricant, usually the age-old standby, Vaseline. Many runners also use Bag Balm, a salve with healing properties. Newer, state-of-the-art lubricants may contain silicone, pain-relieving benzocaine, or antifriction polymers. The trick with lubricants is to reapply them frequently, being sure to clean off the old layer before another application. If your skin becomes too tender from the softening effects of the lubricant, then a powder may be in order.
Powders can help reduce friction by absorbing moisture. This reduces friction between the feet and the socks. Dry skin is more resistant to blister formation than skin that has been softened by moisture. Beware of powders that cake up and cause blisters. Good powders will absorb many times their weight in moisture.

The Second Line of Blister Defense
The second line of defense includes a variety of options. Skin tougheners, taping, orthotics, nutrition for the feet, proper hydration, anti-perspirants for the feet, gaiters, laces, and frequent sock and shoe changes each contribute to the prevention of blisters. Some of these options may be more important for your feet than for mine.
Skin tougheners work three ways. They coat the feet for protection, toughen the skin, and if using tape, help the tape or blister patches adhere better to the skin.
Taping provides a barrier between the skin and your socks to reduce friction.
Orthotics help maintain the foot in a functionally neutral position so arch and pressure problems are relieved. Small pads for the feet may also help correct foot imbalances and pressure points. Reducing these pressure points will help in reducing blisters.
The use of creams and lotions on dry and callused feet helps soften the skin and make it resistant to blisters. The skin needs nutrients, particularly in the heat of summer and the cold of winter.
Maintaining proper hydration helps reduce swelling of the feet, often common after hours of running, so the occurrence of hot spots and blisters is reduced. When you become fluid-deficient, the skin loses its normal levels of water in the skin and easily rubs or folds over on itself, leading to blisters.
Those with extra sweaty feet may find the use of anti-perspirants helpful in reducing moisture on the feet that makes them more prone to blisters.
Any runner doing trail running should wear gaiters to provide protection against dirt, rocks, and grit. These irritants cause friction and blisters as shoes and socks become dirty.
Adjusting shoelaces can relieve friction and pressure over the instep and make footwear more comfortable. Several alternatives to shoe laces are commonly found in running stores.
For those running extra long runs or ultramarathons, frequent sock changes help keep the feet in good condition. Wet or moist shoes and socks can cause problems as the skin softens, maceration occurs, and skin layers separate. Changing the socks also gives opportunity to reapply either powder or lubricant and deal with any hot spots before they become blisters.

Proactive or Reactive
You have the option of being proactive or reactive in managing blisters. The proactive runner chooses to take steps to prevent blisters before they develop. The reactive runner treats the blisters after they develop. Many reactive runners simply think blisters are a normal part of running. Wrong! Working with the blister prevention options above can help eliminate one of the most troublesome problems in running.

– NOLS/WMI wisdom on big blisters, backed by my own experience: clean well, puncture at the edge, squeeze out the fluid, leave the skin on, apply your antibiotic ointment of choice, and cover with a tough, dry, (ideally) padded dressing. Then suffer anyway – puncturing just lessens the pain.

I always pop large blisters as Rex describes.  Not only does it lessen the pain, but I like that it allows you to control how the blister pops and keep it from tearing.  I also carry a small tube of the Neosporin with pain relief and will enlarge the blister hole enough that I can squirt a small amount of Neosporin into the blister bubble.  That definitely helps with the pain and keeps things from drying out too much.

yeah, Leukotape at the first sign of a blister

Leukotape comes on a big roll.  I unroll a bunch and put it onto parchment paper – silicone coated for cooking.  The Leukotape doesn’t stick very well, which is the point.  Cut it into pieces the right size to apply on my foot.

The other day I ran out of Leukotape so I used some moleskin, which didn’t stay in place very good

This is all incredibly helpful guys, thank you!

I see a few areas where I went wrong –

-I have sweaty feet (actually, sweaty everything. I sweat like crazy) . Maybe I need 2 pairs of socks so I have an in-use pair and a spare set drying in the mesh pocket at all times and change them every hour or 2. If that doesn’t help I’ll look at limited use of antiperspirant as a last resort, as I try not to use aluminum based deodorants but in limited circumstances I’ll accept it. I like the idea of a super thin synthetic under-sock as well. I think moisture was a large reason for the severity of blisters.

– I get crud in my shoes and am not religious about cleaning it out (shame on me). I’ve been meaning to get a light set of ankle gaiters (as sand and seeds always make it in my shoes) which will help them stay much cleaner. These blisters have motivated me to pull the trigger.

– Leukotape. I didn’t know it by name but had a roll at home I use for blister mitigation when kayaking 15+ miles. Doh! I’ll definitely bring this on the next trip as a backup. That would have helped!

-time/pace management. I was pushing to get to camp on the hike in which means I didnt stop much to attend to my feet or filter water. I think I did 20 miles on only 3L of water. Being dehydrated probably didn’t help anything. And I learned a rest stop for your feet is always worth it :)

Thanks for the advice and keep it coming. Everyone’s experience is different and its good to have a full quiver of remedies!

@jshann Fixing Your Feet quotes reminded me of other stuff I do, but forgot to mention.

– Vicks VapoRub (or similar generic or more natural product) applied daily to problem foot areas for two weeks before a tough trip. Kills hidden fungus that causes skin to slough off and form blisters. Also softens calluses that can lead to blisters. Almost the opposite of “foot toughening,” but works really well for me.

– Waxy or silicone foot lubricant for use on the trail. Seems every time I need to buy more, my favorite product is gone. Apply a thin coat daily just to problem areas. Can attract dirt, so watch carefully.

To re-emphasize: everyone’s feet are different. Plan on some trial-and-error. You can find what works for you eventually.

But what works this year might not work next year, then it’s back to trial-and-error. For example, shoes are constantly changing, so next year’s model of your favorite might totally suck. If I find a pair that works, I try to buy two or three more pairs of the exact same make, model, year, and size, since I’m lucky to get a full year out of one pair.

Good luck.

— Rex

Your miles and elevation gain don’t seem that extreme to me, and only 3 days for such extreme blisters; I would have to think your shoes don’t really fit well. Your pack weight might be too much for starting out.

Like others, I also don’t find moleskin helpful at all; it’s the 1980s method. They don’t sell leukotape here where I live, but there are other products that are similar like Second Skin. Duct tape works in a pinch if you get it on before the blister forms; it’s kind of gross to remove. I also stop at the first sign of anything and check my feet, address any issues. But getting decent shoes that work for me has been the best answer. I still get black toenails though. They’re less worrisome than blisters.

I use Darn Tough socks if it’s cold out, but thinner socks like Balegas if it’s hot, full padding on the bottom. I also use Aquaphor on my feet if I know they’ll get wet a lot. Nothing wrong with carrying extra socks if it helps.

Everything everyone has said, but I’ve used 2nd skin or similar with great success if I’ve gotten a blister,  stuff is awesome!

In my experience the deep blisters, particularly on the heels, come from there being thickened skin in the area. It seems counter intuitive, that calloused skin would cause blisters, but while it seems to prevent the surface ones in our hands, the thicker skin rubs with inner layers and causes those deep and hard to heal ones. What has worked for me in the past is, leading up to a trip, working on softening and shaving off the thickened sides of the heel. One had to be careful not to take too much..

Kat, that’s an excellent point. I have troubles with dry, cracking, calloused, and built up skin on the heels exactly as you say and it seems like this contributed to the depth of the blisters.I’ve had plenty of blisters before, but never as deep as this.

the sides of my heels on both feet have been problem areas for me for my entire life and normally Im pretty good about taking care of it proactively, but a couple months ago I let the left one crack, and the left side was worse than the right, which didnt crack but has a similar issue.

I’ll use this as motivation to stay proactive with this skin as it seems it will be necessary to do long days.

Thanks again to everyone for the feedback. I feel much better equipped for next week when I think I’ll do a 10 mile / 4000 vertical hike in to Cold Spring camp on Mt Mckinnley, quick overnight and head back to test out the new Mariposa pack and see if I can hit my goal of <25lbs total pack weight with 20* gear for 2 days. Very unimpressive by BPL standards, but a 30% improvement from last trip. My weight spreadsheet says 22.5lbs with no water, so I think 25 walking away from the car is doable.

Nasty blisters that evolved into blood blisters derailed my Colorado Trail through hike some years ago.  In hindsight, the biggest contributor was footwear that was too small by 1/2 to a whole size.  I pressed on for a few days after the blisters formed, thinking that draining them and using antibiotic ointment and 2nd skin would allow me to get through, but the damage was done.

That was a valuable learning experience:  take care of your feet and your feel will try to take care of you.  Make sure your shoes are adequately sized.  When carrying a multiday backpack, I need a full size bigger boot than needed for a casual day hike.  Consider pre-taping or lubing heels with some of the products others have mentioned.  Maybe try a day trip with the load and footwear that you plan to take on a longer overnight…that should help you insure your system is dialed.   Your trip sounds fun, blisters aside.

I don’t usually get heel blisters, or blisters at all. And then I will.
As others have mentioned, stop at the first sign of friction and address the problem.

Once I do have a blister, I

–don’t pop it

–coat it with an Iodine tincture

–place a moleskin with a diamond shape cut out in the center (think donut) to allow pressure release on the blister

–wrap all that with Leucotape–all the way around my foot, so twice over the blister.

Usually, I don’t feel that much or any pain from the blister after applying all this.

I only pop the blisters that are screaming out for it. The puffy ones on the surface always feel better if I pop them. I use a needle.

It sounds like your shoes are too small or perhaps you were wearing boots which tend to be unforgiving and stiff as well as usually too small.

Your pack weight is not very light for a website called Backpacking Light. You might consider lightening your load so you can wear more comfortable shoes that won’t give you such bad blisters.

Roger’s Rule of Thumb: blisters are due to ill-fitting shoes.

In particular, ‘ill-fitting’ very often means ‘too narrow’. A lot of this is due to the smaller niche and cult shoe companies only making an ‘average’ width shoe, because they don’t have the capital to make several widths. But walkers very often have wider feet, because they have used them a lot.

Some will try you tell you that once you are an adult your feet won’t grown any more. A pity about that idea: it is blisteringly wrong. As has been attested to by many BPL members. There is also the too-common idea that the shoe size you had when you were 18 or 20 is your size for life. Ha, Ha, Ha. Your feet keep growing under load.

Just to be blatantly sexist, I will add that most women buy shoes which are too small for their feet. This is well-known in the shoe trade, but no-one warns customers because, well, $$. You might like to note the numbers of foot treatments aimed solely at women in magazines and pharmacies.

The other part of the problem is that the profit margin on leather boots is much higher than for light-weight joggers. Both the makers of leather boots and many retail outlets will loudly preach how you ‘need’ big boots for ‘big’ walks and big loads. The logic here passes me by: the bigger the boots, the clumsier they are. When you have a heavy pack on, you don’t need ‘clumsy’.

Exceptions are made for down-hill skiing and ice climbing, for obvious reasons.

Now I know that some will want to argue vociferously about this, but too many experienced BPL members are nodding their heads. We wear light joggers and good wool socks. We get our feet measured on a Brannock Device (sports stores) and never buy shoes which are smaller or more narrow than measured.

For the record, my wife and I switched from boots to joggers 20 or 30 years ago (or was it 40?), and we don’t get blisters, even on 2-month long walks in the mountains.

</sermon>
Cheers

We get our feet measured on a Brannock Device (sports stores) and never buy shoes which are smaller or more narrow than measured.

Even if you can find a sports store that has one of these devices, the likelihood that you will find a shoe that matches your size is pretty remote. Especially so if you are a woman with an EEEE width.

I used to dream of maybe one day asking for my pinky toes to be amputated just so I could fit in my shoes. I know a guy who actually did this. He had his Morton’s toes amputated so he could fit in his shoes. He’s happy with the results.

Hi Diane

A ‘good’ sports store, or at least ‘sports shoes’ store, should have a Brannock Device almost by the definition of ‘good’. It is worth while finding one.

My wife has the same size feet as me: US10, 4E (which is very convenient!). She has worn Mens shoes for decades. Womens fitting are just stupid. Anyhow, why should womens’ feet be any different?

In general, we have no trouble finding suitable shoes from the New Balance range. They do a lot of wide fittings. You can even search their web site with size and width filters. You will find a number of favorable NB reviews here on BPL from me. Please note: I have no connection with NB at all.

HTH
Cheers

I forgot to mention in my earlier thread that I sometimes use a Hydroseal blister pad after the iodine tincture and before the moleskin and leukotape wrap.

So:

–iodine tincture

–second skin type blister pad

–moleskin with a diamond cut out

-double wrap Leukotape.

that’s a lot! but it really cuts down on pain and even lets the blister start to heal. It’s said that removing wraps and letting the skin breathe is best. Sometimes I’ll do this at night when going to bed. Then, I repeat the whole wrap process in the morning. However, if my initial wrap has stopped all pain, I’ll sometimes just leave things as they are. If it ain’t broke…

There’s an excellent book called Fixing Your Feet that delves into blisters and all things feet related. One big take away is that everyone’s different and what works for one elite athlete doesn’t work for another.

Of course it’s best not to get blisters in the first place, but sometimes it happens despite due diligence.  I hate them and they can ruin a trip. I come prepared.

@book

What does the iodine tincture do?

“What does the iodine tincture do?”

it’s tacky so makes for a good seal for moleskin etc. It’s also an antiseptic. Supposedly it ‘toughens the skin”. Actually tincture of Benzoin may be better for all this–I’m really old school. Don’t use iodine on a popped blister! Too harsh on delicate skin.

REI used to sell this stuff in bottles for blister treatment.

Tincture of Iodine and Tincture of Benzoin are two completely different things.

Benzoin is sticky and will stay stuck to skin once applied.

This thread is a classic BPL salad of useful, useless and outright wrong information.

As suggested above I’d consult John Vonhof’s excellent “Fixing your feet” book and website; he has a LOT of experience with a range of foot issues and the use of Benzoin etc