There is one running injury that is totally preventable; however, it is usually minor-to-mild on the injury scale, so it often falls low on the injury-prevention checklist. Blisters have almost become a rite of passage like a black or missing toenail — and, to a new runner, may even seem like a sign you’ve crossed into the territory of being a ‘real’ runner.
What often gets lost in all of this is that blisters are more than just a pain. Blisters are a skin lesion and, according to Dr. Howard E. Friedman, of Suffern Podiatry, are not normal.
WHAT CAUSES BLISTERS – AND ARE THEY PREVENTABLE?
Dr. Friedman shares that, in most cases, the perfect blend of excessive pressure and moisture cause a blister to form. This is why blisters form on the feet inside moist, sweaty shoes (in fact, one study of ultrarunners found the most common place for blisters to form is the toes).
“A blister is a fluid-filled area of skin formed when fluid collects and separates the top layer of skin, the epidermis,” explains Dr. Friedman, board-certified by the American Board of Foot and Ankle Surgery and a fellow of the American College of Foot and Ankle Surgeons. “The bottom layer of skin, the dermis, usually remains intact. The fluid in the blister is usually clear and sterile. However, if there was additional injury to the area that caused bleeding, then the blister may be filled with blood.”
Dr. Mark Mendeszoon, a podiatrist at Precision Orthopaedic Specialities and owner of Achilles Running Shop, the only known physician-owned specialty running store in the country, attributes blisters to wearing the wrong socks and/or having shoes that don’t fit or are worn down. This is why runners want to look for socks that wick away moisture — just as you would look for in your other running apparel — and to be professionally fit for shoes at a local running store. Once you have those shoes, you should keep track of how many miles you put on them (as well as give them frequent visual inspections) so you can replace them as needed.
“When purchasing shoes, it is always best to buy them mid-afternoon or later in the day so that your feet will be at their biggest size,” advises Dr. Mendeszoon. “Always wear a proper pair of socks and be prepared to try on a few pairs of shoes until you find the shoe that’s most comfortable for you. Lacing shoes properly is very important so your foot doesn’t slip, which can cause friction on the feet, leading to irritation and/or blisters.”
WHAT TO DO IF YOU HAVE A BLISTER
If this advice is coming too late and you have a blister, leave it alone if it’s small and isn’t causing any pain, Dr. Friedman says. “The fluid in the blister will get reabsorbed into the tissue,” he notes, “but a large blister that is painful due to its size or location can be drained.” Dr. Mendeszoon agrees, and both shared how to properly — and sterilely — do so at home:
- Clean the blister, surrounding skin and a small needle with rubbing alcohol.
- Pop the blister at the base along the side, creating a small hole for the fluid to drain.
- Gently press any remaining fluid out and allow blistered skin to stay intact.
- Apply antibiotic ointment and a bandage to the blister.
- If the blistered skin is ripping off, or when the dermis has healed and skin should be removed, sterilize some small scissors and trim the skin. Again, use an antibiotic ointment and a bandage to be safe.
- Continue to apply an antibiotic ointment and keep the blister covered with gauze or a bandage until it is fully healed.
If at any point an open wound is present — or the blister seems too large to properly manage at home — seek medical attention.
IF YOU’RE STILL GETTING BLISTERS …
So, you wear sweat-wicking socks and have been properly fit for running shoes and still find yourself with blisters? Another form of prevention, which can be easily done at home, is to apply paper tape your feet. This can either be on blisters as they heal or on areas prone to blisters. One study found paper tape prevents the incidence and frequency of blisters in long-distance runners.
If all of the above has been exhausted, it is probably time to see a podiatrist. When heading to your appointment, bring your well-worn running shoes so the wear pattern can be evaluated, as well as your foot and gait pattern.
“In general, foot pain and problems like blisters, while seemingly common, are not normal,” concludes Dr. Friedman. “If runners are developing recurrent foot problems while running, they should definitely consult with a podiatrist to resolve the issues.”