Comparison of various blister prevention methods - A podiatrist guide

[Rajy62]

There have been a number threads about the various blister prevention strategies. Not all techniques work well for everyone because of the unique "microclimate" surround our feet. For a deeper understanding of blister management, I invite you to read this podiatrist guide, by Rebecca Rushton. According to Rebecca: "Blisters are not caused by rubbing on top of the skin. They're caused by rubbing underneath the skin surface (between skin layers).

The guide analyses the cause of blisters and provides insights into the various prevention strategies based on research/tests among academics, athletes and military of course. And she ranks them in order of their effectiveness:

Basic and most important (three stars)
1. Shoe-fit / lacing- a good fitting shoe/boot a must
2. Socks, merino or synthetic with advanced moisture management properties
- long term effect relies on evaporation through the shoe upper, linking to #1 a good shoe
3. Adoption - foot hardening; Preparation training in gear and on terrain
- Average person need 3-4 weeks minimum
4. Cushioning and insoles -reduces/distributes peak pressure
- Thicker insoles are not always best, there are several popular brands e.g spenco thinsoles
5. Patching - targeted friction management with ptfe (polytetraflueroethylene) patches
- low friction patches are applied to targeted areas
- Popular brand is teflon/ENGO, unaffected by moisture, can't be used between toes
Next most important (two stars)
6. Double socks - fast wicking liner and an outer layer, optimal combination will take trial and error
7. Taping - applied to susceptible areas on the feet; More of an abrasion prevention
8. Orthotics - Professional assistance required, not relevant for all blisters
Least effective (one star)
9. Antiperspirant/powders - skin drying; short term effect, need to re-apply
- stronger preparation can cause skin irritation, messy
10. Lubricants - e.g vaseline; Popular, but eventually increases friction, messy
11. Astringents - Skin toughening; Use of alcohol, black tea, salt water, NO research

 

[Mike Savage]

Thanks for posting this very helpful guide.

 

[Fritz]

Thanks for sharing this! I'm shopping for or my next Camino, this is great timing.

 

[Texas Walker]

There have been a number threads about the various blister prevention strategies. Not all techniques work well for everyone because of the unique "microclimate" surround our feet. For a deeper understanding of blister management, I invite you to read this podiatrist guide, by Rebecca Rushton. According to Rebecca: "Blisters are not caused by rubbing on top of the skin. They're caused by rubbing underneath the skin surface (between skin layers).

The guide analyses the cause of blisters and provides insights into the various prevention strategies based on research/tests among academics, athletes and military of course. And she ranks them in order of their effectiveness:

Basic and most important (three stars)
1. Shoe-fit / lacing- a good fitting shoe/boot a must
2. Socks, merino or synthetic with advanced moisture management properties
- long term effect relies on evaporation through the shoe upper, linking to #1 a good shoe
3. Adoption - foot hardening; Preparation training in gear and on terrain
- Average person need 3-4 weeks minimum
4. Cushioning and insoles -reduces/distributes peak pressure
- Thicker insoles are not always best, there are several popular brands e.g spenco thinsoles
5. Patching - targeted friction management with ptfe (polytetraflueroethylene) patches
- low friction patches are applied to targeted areas
- Popular brand is teflon/ENGO, unaffected by moisture, can't be used between toes
Next most important (two stars)
6. Double socks - fast wicking liner and an outer layer, optimal combination will take trial and error
7. Taping - applied to susceptible areas on the feet; More of an abrasion prevention
8. Orthotics - Professional assistance required, not relevant for all blisters
Least effective (one star)
9. Antiperspirant/powders - skin drying; short term effect, need to re-apply
- stronger preparation can cause skin irritation, messy
10. Lubricants - e.g vaseline; Popular, but eventually increases friction, messy
11. Astringents - Skin toughening; Use of alcohol, black tea, salt water, NO research

Thank you for this. I will say that there are other considerations as well. In my case, I was fine until I had to walk in shoes full of water all day long. And a second day with just wet shoes. But the blisters did heal up eventually. Now if someone could put something up on the subject of athlete's foot prevention while on the trail? Please?

 

[hampshire!tim]

I had to walk in shoes full of water all day long. And a second day with just wet shoes

I was impressed by SealSkinz waterproof socks - sound rather dodgy, but actually brilliant - highly recommended

Sorry, don't know how to stop athlete's foot !

 

[Sheilajg]

Thank you for this. I will say that there are other considerations as well. In my case, I was fine until I had to walk in shoes full of water all day long. And a second day with just wet shoes. But the blisters did heal up eventually. Now if someone could put something up on the subject of athlete's foot prevention while on the trail? Please?

applying tea tree oil regularly is supposed to be effective in preventing athletes foot. I use it and haven't had a problem for a long time. I don't know if it's because of the use of the tea tree oil or good luck but the oil is great for keeping my feet feeling good while doing lots of walking. I used a foot balm with tea tree oil in it for my last long trek and my feet were very happy during and after. It smells pretty strong, though.

 

[Rajy62]

Thank you for this. I will say that there are other considerations as well. In my case, I was fine until I had to walk in shoes full of water all day long. And a second day with just wet shoes. But the blisters did heal up eventually. Now if someone could put something up on the subject of athlete's foot prevention while on the trail? Please?

Wet feet? You were asking for it. When faced with wet trails for that long, I am afraid you needed a different footware. Better off walking bear foot that day, if you ask me. Waterproofing is another can of worm altogether.

This is one reason i prefer merino wool socks now. Wet feet could not be avoided, water can seep through the top even if one uses waterproof boots. Merino make your feet feel warmer and dryer even when wet.

Isn't there anti-fungal medications for athlete's foot. I would like to know how we can keep people like you away from alberques because it is so contagious.

 

[ortemio]

I found this book called "Fixing your feet", great read with tons of links and plenty of info on how to deal with lots of the problems in the Camino.
( not sure if apropriate but here is a link : http://uploaded.net/file/qbr6xd5q/0899976387.epub )
enjoy....

 

[DMZwalker]

There have been a number threads about the various blister prevention strategies. Not all techniques work well for everyone because of the unique "microclimate" surround our feet. For a deeper understanding of blister management, I invite you to read this podiatrist guide, by Rebecca Rushton. According to Rebecca: "Blisters are not caused by rubbing on top of the skin. They're caused by rubbing underneath the skin surface (between skin layers).

The guide analyses the cause of blisters and provides insights into the various prevention strategies based on research/tests among academics, athletes and military of course. And she ranks them in order of their effectiveness:

Basic and most important (three stars)
1. Shoe-fit / lacing- a good fitting shoe/boot a must
2. Socks, merino or synthetic with advanced moisture management properties
- long term effect relies on evaporation through the shoe upper, linking to #1 a good shoe
3. Adoption - foot hardening; Preparation training in gear and on terrain
- Average person need 3-4 weeks minimum
4. Cushioning and insoles -reduces/distributes peak pressure
- Thicker insoles are not always best, there are several popular brands e.g spenco thinsoles
5. Patching - targeted friction management with ptfe (polytetraflueroethylene) patches
- low friction patches are applied to targeted areas
- Popular brand is teflon/ENGO, unaffected by moisture, can't be used between toes
Next most important (two stars)
6. Double socks - fast wicking liner and an outer layer, optimal combination will take trial and error
7. Taping - applied to susceptible areas on the feet; More of an abrasion prevention
8. Orthotics - Professional assistance required, not relevant for all blisters
Least effective (one star)
9. Antiperspirant/powders - skin drying; short term effect, need to re-apply
- stronger preparation can cause skin irritation, messy
10. Lubricants - e.g vaseline; Popular, but eventually increases friction, messy
11. Astringents - Skin toughening; Use of alcohol, black tea, salt water, NO research

What about Comped,Moleskin on a like product for blister areas? Do you agree with putting a thread through a blister to aid healing.

 

[alexwalker]

What about Comped,Moleskin on a like product for blister areas? Do you agree with putting a thread through a blister to aid healing.

First: Rajy62; thank you very much! I have read the whole guide. It is great.

DMZ: Read the guide: Thread is definitely not recommended, nor is Compeed. I would only use Compeed as a cushion on soft spots and remove it as soon as possible (each day). On blisters already formed, they make them worse by closing in moisture and keeping bacteria in place. A Spanish doctor adviced me to treat blisters with Iodine and tape a pad over it: Sterilizes and airs it.

 

[dougfitz]

Isn't there anti-fungal medications for athlete's foot. I would like to know how we can keep people like you away from alberques because it is so contagious.

Two points:

• @Texas Walker did not claim he had athlete's foot, he suggested athlete's foot prevention as a topic for discussion.
  
• I hope your suggestion that some people are kept away from albergues is humorous rather than serious. Albergues are for all pilgrims, and fungal infections are always a risk in communal shower areas. It really is up to you to take precautions. Alternatively, you could avoid albergues, although I think you would still risk fungal infection.

 

[Rajy62]

Two points:

• @Texas Walker did not claim he had athlete's foot, he suggested athlete's foot prevention as a topic for discussion.
  
• I hope your suggestion that some people are kept away from albergues is humorous rather than serious. Albergues are for all pilgrims, and fungal infections are always a risk in communal shower areas. It really is up to you to take precautions. Alternatively, you could avoid albergues, although I think you would still risk fungal infection.

Of course i was mocking about keeping people like that away. Hope Texas Walker was not offended by my humour.

 

[Rajy62]

What about Comped,Moleskin on a like product for blister areas? Do you agree with putting a thread through a blister to aid healing.

Alexwalker is correct, threading is not recommended. You can read more from this section of Rebecca's blog:

1. The blister threading method of draining a blister is fraught with infection risk.
2. Lancing a blister with a sterile scalpel blade or hypodermic needle is a better alternative.
3. Lancing a blister opens it up to infection so it should only be done if appropriate equipment is on hand. If in doubt, do not lance it. Read this article for blister treatment recommendations.

 

[JohnMcM]

[QUOTE="Rajy62, post: 282050, member: 30441"[/QUOTE]

Rajy62,
Take a gold star and sit at the front of the class for being a person who has helped many pilgrims have a great chance of a blister-free Camino

Buen Camino

 

[Sue Blue Mountains]

Thank you Alex Walker for stating that threading is a risk. As a nurse I've often wondered why anyone would recommend passing a non-sterile thread through a blister (which is sterile inside until broken) then, horror of horrors, leaving it there! A pathway for bacteria! I like the iodine and pad taped over idea. That's the sort of thing done in hospitals (although iodine only used in theatres in Oz - saline used in A&E for wounds).
About to start my first Camino and really looking forward to trying to NOT get a blister! But ready with iodine and pads should one occur.