An Introduction to Shear and Blister Formation
This is a guest post by podiatrist Rebecca Rushton from Australia. She has looked at blisters, how they are formed, what causes them, and how to prevent them. For years, the common thinking about blister causes has been friction, heat, and moisture. Rebecca’s research has led her to identify shear as a leading cause of blisters. Read the article and then check out her website. Over the next months, Rebecca and I will take an in-depth look into blisters, their formation, and treatments. Her website Blister Prevention has a lot of valuable information on blisters (more on that at the end of this post). Here’s Rebecca’s article.
An Introduction to Shear and Blister Formation
Foot blisters continue to wreak havoc with endurance athletes’ feet in spite of their best preventative efforts.
Poor blister prevention outcomes are due in no small part to the misunderstanding of the cause of this obstinate injury.
The force that causes ‘friction’ blisters is not friction. And it’s not rubbing. It’s shear. But if you ask 100 people the question “what causes blisters”, nobody would answer “shear”.
Shear is the sliding of layers across one another – internal layers that are structurally connected. Those connections can break and when fluid fills that cavity, you have a blister!
What Does Shear Look Like? Try this …
Step 1: Place the tip of your right index finger on the back of your left hand.
Step 2: Wobble it back and forth but keep it stuck to the same bit of skin. Notice how your skin stretches? This is shear and this is what causes blisters.
Shear might look like rubbing but it’s not. Notice how your finger tip has not moved relative to the skin of the back of your hand? But your hand skin has moved relative to the underlying bone. This is shear. Your skin doesn’t need anything to rub over it for blisters to form. It just needs shear (this stretching of the internal tissue layers) to be excessive and repetitive.
Rubbing Causes Abrasions
Most of us use the term rubbing to mean two surfaces moving across one another – like when you rub your hands together. The type of skin injury that rubbing causes is abrasions. An abrasion is where the top layers of skin are rubbed off – you end up with a red raw sore. Blisters (from shear) and abrasions (from rubbing) are completely different entities – they have different mechanisms of injury and affect different layers of the skin. Here’s a video on blisters versus abrasions on the feet.
Is the distinction important? Yes it is. The lack of understanding of blister causation is at the heart of why foot blisters continue to plague athletes.
Achieving True Blister Prevention Success
There are 3 factors that influence shear. Impacting on these is how we can minimise shear and prevent blisters.
1) Type of skin
Thinner and more mobile skin (like we saw earlier on the back of the hand) will abrade before it blisters. In contrast, thicker and less mobile skin (like on the palm of your hand) is the type of skin more likely to form and maintain a blister. Do the same experiment we did before but with your index finger on your palm – the skin is noticeably thicker and less mobile in comparison. (This is why blisters are most common on the soles and palms)!
Apart from the thickness and mobility characteristics which determine the ability to blister (and which you can’t do an awful lot about), shear is influenced by two other factors: friction and bone movement. You need both, not just one, to create skin shear. The good news is that these things we really can change! Change one or more of these, in one of many ways, and you can successfully prevent foot blisters.
The cause and influencing factors of foot blisters
2) Friction
Friction is the force that resists the movement of one surface against another. It’s the degree of slip or grip between surfaces. Low friction (slippery) is when two surfaces glide easily against each other. High friction (sticky) is when the two surfaces tend to grip together.
The moist in-shoe environment during exercise causes high friction levels between the shoe, sock and skin. This causes these materials to stick together … yes the shoe sticks to the sock and the sock sticks to the skin … for longer. They all stick together for longer because of high friction.
3) Bone Movement
Meanwhile, as we run the bones move back and forth. With the skin remaining stationary (for longer) and the bones moving back and forth as far as they can go, the soft tissue in between stretches – that’s what shear is.
This concept of friction and bone movement leading to shear is depicted in the diagram below and in this video demonstrating shear.
- Orange = shoe | White = sock | Brown = skin | Purple = section of soft tissue undergoing shear
The purple area is a section soft tissue between the skin surface and its underlying bone. Although the heel itself has not lifted within the shoe due to high friction levels, the bone has moved up relative to the skin surface causing shear to the soft tissues in between.
About Rebecca
Rebecca’s website Blister Prevention has a lot of valuable tips and techniques, and information on blisters. Take some time and explore the site, subscribe to updates and receive a copy of her ebook, Blister Prevention for Active People. Rebecca is a podiatrist in Australia.
Next Up? More on Shear and Blister Treatments
Over the next month or two, we will talk more about shear and common blister treatments – including what works and doesn’t work. Make sure you are a subscriber to this blog to receive each post. You can do that at the box at the upper right side of this page.
Blister Treatment or Prevention?
Filed under: blister care, Foot Care, Footwear, Health, Sports, toenails
Which is more important, blister prevention or blister treatment?
For more than 17 years, I’ve taught foot care techniques to anyone who will listen. I have taught classes at running stores, REI stores, events, and more. In addition, I have worked medical at many races, helping provide foot care to participants. These races have been in Death Valley, Chile, Costa Rica, BC Canada, Colorado and Washington, and many in California. This year I will be at Western States 100, Badwater, the Gold Rush Adventure Race, the Jungle Marathon in the Amazon, and hopefully at races in Colorado and Namibia.
I have never counted the feet I have worked on but I would put the number well over 3000. I remember one race in Colorado in 2010 when I saw the same lady 10 times. It was a six-day stage race and she’d come in every evening and morning! I’d patch her feet in the evening and she’d take it off when she went to bed in her tent. She had foot wear issues that gave her blisters on top of blisters. She was never into prevention mode – only treatments.
In this picture, taken from the cover of the 5th edition of Fixing Your Feet, we see treatment taking place. I love the picture. I even know whose foot it is. What I can’t tell you is what he did for prevention. I wish I knew.
FYF Cover Image
My question in this blog post is what should we spend more time on, blister prevention or blister treatment?
Prevention can take many forms: good choices in footwear, the right socks, lubricants and powders, toenail care, skin care, taping, Engo patches, correct lacing, the right insoles, and training and conditioning.
Treatments likewise offers many options: blister draining, many different types of patches, taping, ointments and salves, a multitude of tapes, wraps and straps, silicone pads, Engo patches, toe caps, and lubricants and powders.
So here are a few questions:
- Does prevention last only until the race starts?
- What are your best prevention options?
- How much do you count on aid station personnel to manage treatments?
- Do you know how to treat your feet?
- Do you carry materials to treat your feet?
- What are your best treatment options?
- How well do you understand blister formation and prevention?
For 17 years, athletes have had Fixing Your Feet as a resource to learn important information about foot care. As I patch feet at races, I try to educate the athletes about what I am doing and why, and what could have helped in their feet. If crews come to me for advice, I try to help them too. I have watched athletes and crews work on feet with materials and using techniques I have long preached.
In general, foot care has advanced over the years. Shoes, socks and insoles have become light years better. Lubricants, powders, blister patches, and our tools are better. People interested in foot care are trying new blister patching techniques.
All this is good because every day there are new athletes coming into running, adventure racing, hiking and thru-hiking, walking, and other feet stressing sports. Let’s make sure they understand the importance of prevention before treatment.
Zederna Insoles
Filed under: Foot Care, Foot Care Products, Footwear, Footwear Products, Health
Generally foot odor and athlete’s foot do not come from sweat, which surrounds your feet. It comes from bacteria on the skin, which is decomposed by the sweat. The waste product of this decomposition leaves a very unpleasant smell and is an ideal breeding climate for athlete’s foot and nail fungus.
Zederna Insoles
The Zederna Insole is a 100% natural product from thin cedarwood. The back consists of a stabilizing cotton layer. The sole is flexible and adapts to your foot form after a few steps. It gives you a very comfortable feeling (even if you carry orthopedic inserts). Your feet can take a deep breath nearly as liberating as walking barefoot.
Here’s how Zederna Insoles work:
- The natural suction force of Zederna cedarwood absorbs the sweat effectively
- The Zederna Insole and its antibacterial effect work where foot odor and athlete’s foot develop
- Smell and fungus creating bacteria are eliminated
The Zederna Effect
Here’s my take on the insoles. I wore a pair in my work shoes for months. My old insoles were a regular stock style and I used them because they were already in the shoes. I immediately liked the Zederna Insoles. I felt my feet were cooler and more comfortable. I liked the wood feel – my feet were not stuck to a fabric synthetic insole, but could move around on the cedarwood. Between my commute and work, I had my shoes on for 12 hours straight. The insoles were pleasant. They are perfect to use in your shoes after training.
Because they are thin, I think they could easily be used in running shoes or boots. I would wear them in training, and then, depending on the feel, I’d make the decision to wear then in a race or not.
Zederna Insole Advantages:
- Foot odor disappears immediately!
- Athlete’s foot disappears after a few days.
- The new formation of athlete’s foot is permanently prevented.
- The treatment of existing nail fungus with conventional methods is accelerated by more than 50%, because of the dry and antibacterial foot climate.
- The new formation of toenail fungus is permanently prevented.
- Plug & play: Just insert the insole in your shoes and start. Annoying treatments with gels and powder belongs to the past.
- Naturopathic treatment: The effect is purely based on natural power. No chemistry.
- As a result of the polished surface and the flexibility of the Zederna Insole, pleasant feeling arises also when wearing without socks.
- The Zederna inserts provide a pleasant and dry climate in your shoes. Comparable to walking in a forest: in summer it is relatively cool and in winter it is always warmer.
- Long durability of the Zederna Insoles.
- Reliable quality – Made in Germany.
- Comfortable subscription available.
- Fast delivery within a few days.
- More than 9.500 satisfied customers.
- Money back guarantee, if you are not satisfied with our product.
Disclaimer: I received a pair of Zederna Insoles to try. Beyond that, I have no financial investment in Zederna.
Training With Wet Feet
For years, the norm has been to avoid getting your feet wet. When feet get wet for extended periods, usually the feet have skin that is soft and macerated. In long events, and especially in multi-day events, that can lead to trouble. Taping or patching wet feet, or macerated feet, is very difficult. So it is best to keep your feet as dry as possible.
This has always been the rule.
In the past few years, adventure style races have become popular, which puts runners in conditions where wet feet are the daily norm. Most often, these races are six to seven days in length. The race often includes running through the jungle or mountains with stream crossings, wet foliage, wet trails, mud, and extremely humid conditions. In these conditions, your feet are always wet.
If you think this doesn’t apply to you because you are doing a “dry” race, please consider this. Even dry races with no water crossing can produce wet feet. Dumping water over your head at aid stations to cool off will get water in your shoes. Plus our feet naturally sweat and this buildup can result in wet feet.
Shirley Thompson, the Race Director of the Jungle Marathon told me, “We always advise runners to train with wet feet so that they can focus on a strategy before they get to the jungle. As far as footwear is concerned, we always emphasize trail shoes with good grip, and that comfort is the main factor.”
So how can we do that? For training runs, soak your shoes and socks before heading out. Step in puddles or use a hose if they dry out. Try to keep them wet as long as possible. If you feel a hot spot or blister start, stop and adjust your shoes and add tape, lube or your favorite blister prevention product. Take time to find the best shoe and sock combination for your feet when wet.
Personal Foot Care of Wet Feet
Because your feet will be wet, often at the start of each stage, it makes sense to do some of your training with wet feet. Use the same shoe and sock combination that you plan to use for the race – and get them wet. Walk and run in them. Not just a 30-minute run, but hours! Put some distance on your wet feet that is the same you expect to do during the race. Try to also to do back to back wet feet training days. It’s that simple.
As said earlier, stop and deal with any hot spots as soon as you feel them. Check for folds in your socks, friction from dirt or sand, pressure inside your shoes – and get rid of these irritants. Lube the area or apply a piece of tape or blister prevention patch to help. This may seem like common sense, but many people ignore this simple step.
At the end of each day’s stage, remove your wet shoes and socks, dry your feet and air them as much as possible. If your feet have tape on them, remove the tape to dry the skin underneath. Wear sandals or Crocs around camp to keep your feet away from the wet ground and dirt and sand. Walking around barefoot will often aggravate wet, cold, and soft macerated skin. Later in the day or the next morning, re-tape your feet and patch any blisters.
Because you cannot count on medical people patching your feet the way you want them patched or that they will be available, you must learn how to patch your own feet. I have helped at events where I have patched feet all afternoon and evening, and then had people line up in the morning for more work. Sometimes the medical staff is stretched thin or cannot get to everyone. Be prepared to do your own patching and have your own equipment. Better safe than sorry.
Many times at races, I have seen athletes who have not trained their feet for the event. They enter a race and don’t put the necessary miles on their feet, don’t have the right shoes, don’t know how to manage and patch their feet. I encourage you to take the time to train with wet feet and condition them for the extremes of your race.
More on Blisters and Foot Care
Lisa de Speville, who lives in Johannesburg, South Africa, is a close friend who often emails with insights on blisters and foot care. Yesterday I received the following email and asked whether I could share it with my readers. Her email contains insights on little toe blisters, issues with minimalist shoes, and fit of shoes modified with gaiters.
Here’s her email.
Last week I ran in the 5th edition of the Namib Desert Challenge. I had the pleasure of running in their inaugural event back in 2009 and so it really was a treat to return. Great event, well-organized, wonderful region of Namibia and a lovely warmth and hospitality from the organizers.
Since about June last year I’ve been running in more minimalist shoes. I’ve always enjoyed a softer, more tactile shoe and I took to the pair of Asics Gel Fuji Racers that I won at a race immediately. I liked them so much that I was even running them on road. I like to keep trail shoes for trail and road shoes for road so in about August I bought a pair of Inov-8s. The brand is relatively new in SA so I thought I’d give them a try (my road shoes have been Addias Response or Supernova for more than 10 years). Let’s see… I’m in the Men’s Road X 255 (6mm lift), which is not flat as a pancake. Both the Asics and Inov-8 are quite roomy and my feet enjoy this.
Certainly over the past three months I’ve felt a change in my soles – more firm and muscular, which stands to reason if they’re strengthening and working harder. It is muscle after all. Before I started adventure racing and running ultras my feet were 1.5 shoe sizes smaller and I have a feeling that my feet are another half-size bigger in recent months.
So, the time comes for the Namib Desert Challenge and I get my favorite race shoes stitched with Velcro for my desert gaiters. Everything is ready. I hadn’t worn these shoes for a while. They were still relatively new – perfect for going into a multi-day race - as I’d bought two pairs of the same at an end-of-range special many months ago. I’d flattened the first pair so they were in no condition for this race.
When I put my foot into the shoes in the days before the race to get a feel for them again they felt a little tight, especially across the width of my forefoot. And more than just newness. This is why I figure my feet are a certainly a half-size bigger. Nothing that some lace-loosening wouldn’t sort out.
I started to develop what I call ‘triangle toes’ almost immediately. This is the one thing I avoid like the plague because I hate having sore little piggies. Triangle toes is where the underside of the little toe – and sometimes the neighbor next door – becomes pointed. A blister forms here and can result in a ‘toe sock’ – where the skin of the whole toe comes off, almost like a sock. It’s nasty and I not very fondly recall some incidents of almost toe sock about 10 years ago in adventure races. Since then I take special care pre-race to make sure my little toes stay ’rounded’ and that any harder, potentially triangular skin, is filed off regularly.
I dealt with the resulting blisters – stage 2 or 3 they came up on both little toes - by draining, leaving overnight to dry and then added some tape for the stages. I tried to flatten the triangle under the tape, but it ended up triangular again at the end of the stage. For the most part they gave me little trouble.
At the start of the 55km ultra stage on Day 4, I was debating whether to remove the inner soles for give my feet more room so that the little toes would have more width. It felt odd so I started with them in and my laces not too tight. By the first waterpoint I needed to change something so I took out my innersoles. I had to re-tape a toe a little way further because the change in space altered something. After this, no problem.
I’ve never run in shoes without innersoles and it really changes the feel of the shoe. The Adidas Response TR shoes really suit my feet – I’ve been running in them for 13 years! Taking out the innersole changes them to the Inov-8 feel. Flat and bland inside, which isn’t a bad thing – just different. It also makes the sole feel so much more flat and less cushioned – I felt like I was running in a non-cushioned shoe… for 47km!
Fortunately I was none the worse for wear but, for sure, if my feet hadn’t been conditioned from 10 months of running in ‘flat’ shoes my feet would have felt it. I ran the 5th and final stage without the innersoles too.
Aside from the triangle toes, my only other foot ailments included an injured big toenail on my left (not sure why? perhaps from a kicked stone?). The toenail developed a blister underneath, which was easily solved by drilling into the nail to relieve the pressure. I only discovered this one after the second stage when inspecting my feet. The other blister came up on the long stage under the ‘joint’ of my left big toe, where it connects to the foot. I have some scar tissue there from when I sliced my toe open many, many years ago. It occasionally twinges and at this race, on the long day, I caught exactly this spot so many times on rocks – prodding in. I couldn’t have purposefully aimed as many times in that exact spot! Again, not a bother (fortunately!) and easily solved by draining. On the final stage I didn’t hit it once and so it didn’t flare up again. For the rest, beautiful feet after 230km.
As I haven’t had triangle toes for years, this confirmed for me that width-ways just-that-little-too-tight squeezing of the forefoot is almost guaranteed to cause triangle toes and the resulting underside blisters, with the potential for toe sock, somewhere you do not want to go. In fitting shoes we tend to focus on the amount of space at the front of the shoe but definitely need to pay attention to left-right wiggle room.
Finally… one of the runners had really badly injured toenails (most of them) and the tops of his toes. The reason… too small desert gaiters for his shoes! I don’t know what kind they were (not mine) but they were Velcro attached (around the shoe) and pulling at the top and front of his shoe and causing toe injury. Live and learn.
Lisa de Speville
Johannesburg, South Africa
Adventure Racing: www.ar.co.za
FEAT: www.featsa.co.za
Blog: www.adventurelisa.blogspot.com
Silk Feet – a New Callus Product
I love new products that promote healthy feet. And, as many of you know, I don’t like calluses. So I was happy to get a chance to test a new callus reduction product.
First, I need to say that I am not a fan of pumice stones and most of the callus files I see most commonly advertised as tools to help you reduce your calluses. In my opinion, they tend to tear the skin, leaving it rough and scaly. While they reduce callus, I don’t like the after effects on the skin. I have tried the Pedi-Egg and while a bit better, it still leaves a lot to be desired.
Silk Feet
There’s always room for improvement. The nice folks at Silk Feet sent me a sample of their product. Here’s a bit of text from their website.
Silk Feet is the first ever Bladeless Exfoliating Microscreen. It’s designed to quickly remove dry, callused skin revealing smooth, healthy skin beneath. The oval shape and flexible design adapt to the contours of the foot for professional results in minutes.
Silk Feet is a new generation of foot care products designed to provide fast, effective treatment to eliminate dry, dead skin cells from an individual’s foot; producing the most effective smoothing results available in a single application.
The product’s oval shape and flexible design adapt to the contours of your foot and allow the abrasive to maintain continuous contact with your skin for professional results in minutes.
The oval shape is easy to use
I found the oval shape to be pliable and easily shaped to my heels and the balls of my feet. I could hold it in the palm of my hand and rub it over the skin with as much pressure as I wanted to apply. It worked very well. In just two short sessions, my wintertime calluses were reduced dramatically. I used it on one heel and not the other so I could compare. While a bit tricky because of its size, it can also be used on toes. The oval is the same coarseness on both sides, so it can be reversed when one side starts to wear down. Wash it under running water after use.
My recommendation is to use it over a wastebasket or the side of your tub as the fine skin dust has to go somewhere – or just use it outside. It’s small enough to pack in a travel bag to take on the road. I’d suggest putting it in a baggie to keep it from snagging on other things.
At a price point of $6, I think Silk Feet is a great buy. Their website lists stores that are supposed to carry it. If you can’t find it at a local store, it’s easy to order it from their website.
A Foot Care Success Story
Filed under: blister care, Foot Care, Foot Care Products, Health, Sports
Every so often I hear a foot care story from an athlete that intrigues me. It’s fun to read their story about their issues with their feet and then the steps they took to find answers.
One of the best examples of this is Nathan’s story on page four in the 5th edition of Fixing Your Feet. He told the story of how he studied foot care techniques and learned hot to manage his feet – and successfully finished Racing the Planet’s Australia race.
Then the other day I received an email from Karen. I liked her story and asked if I could share it with my readers. She agreed. Here is what she wrote.
First, I am extremely prone to blisters. Initially I thought it was friction. I tried Hydropel, but its sticky nature attracted dirt but did nothing to calm my problem. At Fruita one year, Lisa and Jay (Smith) Batchen shared their knowledge in a presentation about the three primary causes and the light bulb went off. Hydration is my primary issue – specifically bloating. The bloating happens because I’m no longer processing fluids.
After working thru formulas and cause and effect for several years on my own, I finally solicited help from Scott Jurek -I knew him from Coyote events. Mutual friends had helped me focus on running nutrition, but I wasn’t making progress on my own. Scott helped me maintain my ability to process fluids and enabled me to delay bloating and blisters.
When I get blisters, they’ll either start as a hot spot on my pads or a painful toenail. I get them under my toenails (which I keep extremely short) or the entire pad of my foot/feet will get it. Over New Years with a very low mileage base, I went to California and ran/hiked 34 miles. Had a hot spot early that I actually taped, and a blister on a toe but that was it – a sign that I was on the right track!
I’ve also become smarter on dealing with my blisters. I still get them, but they aren’t crippling. Once after my first attempt at the Leanhorse 100, they were so bad they caused me to miss the cutoff, and they got dangerously infected. Two years later, I went back and finished – it was my first 100. I still got blisters but they didn’t prevent me from meeting my goals.
Here’s what I do now for my feet other than monkey with hydration:
- Work on my calluses and keep my toenails trimmed
- Get my orthotics re-surfaced at least a couple months before event
- Keep my shoes and socks current too and only use Smartwool socks
- Train on the exact terrain I expect and work on the plan for my feet – it’s just as important as my physical and nutritional race plans
- My starting feet recipe is to use BodyGlide on my feet before putting on socks. Then change my socks every 20 miles if I’m running anything over 50K.
- Carry a foot kit on my back at all times with a couple Engo Pads for hot spots on my orthotics, a couple of alcohol wipes, blister pads and a safety pin, and duct tape for real emergencies on a pencil or on my water bottle
- A full fledged foot kit for crew or in a later drop bag with new supplies for my carry kit, Desitin if it’s wet conditions, and tape/scissors/tincture for the next defense. An injection devise and zinc oxide and Second Skin/New Skin as final defense. I had to do all three lines of defense to actually finish Leanhorse, but we did it.
Thank you Karen for sharing your foot care plan.
New Running Barefoot Findings
The Washington Post article caught my eye, “Minimalist running style may be undermined by new findings from Kenya.” The January 21 article by Lenny Bernstein on the web was about a new study published at PLOS One.
Bernstein starts the article with a figure that catches your attention, Americans spent $59 million on “minimalist” running shoes last year, on the premise that the most healthful way to run is the way people have done it for thousands of years: barefoot.
Years after runners everywhere were introduce to running barefoot in 2009 in Born to Run and a 2010 study of Kenya’s famous Kalenjin distance runners, the new study may cause some to rethink how they run.
In the new study, a group of George Washington University researchers tested a different population of barefoot African runners and determined that most of them naturally strike the ground with their heels.
The study at PLOS One is Variation in Foot Strike Patterns during Running among Habitually Barefoot Populations.
The study measured subjects running along a trackway at least three times at their self-selected (comfortable) endurance running pace, and three more times at a faster pace. The track had a plantar pressure pad placed midway along its length.
Close-up images of subjects using a rearfoot strike (A) and a midfoot strike (B).
The article quotes Kevin Hatala, a doctoral student in anthropology at GWU, and how they expected the group’s study of 38 Daasanach subjects of northern Kenya to support Harvard researcher’s Daniel Lieberman’s conclusions about the Kalenjin. Hatala said, “Instead, we found the opposite to be true. In the group we were looking at, the majority of them were rear-foot striking at their preferred endurance running speed.”
Bernstein wrote, At higher speeds, some of the Daasanach switched from a heel strike to a forefoot strike, but even then, heel-striking was more typical. Hatala was reluctant to speculate why his findings differed from the prevailing wisdom. In addition to the effect of speed, running style could be the result of information that is culturally transmitted from generation to generation. Or it might have something to do with the predominant surface where each group lives. Hatala and Lieberman are at the early stages of comparing their data.
“I guess what we found really interesting about this is it directly shows that there is not one way to run barefoot,” Hatala said. “We have a lot more to learn about how people who are barefoot run and what might be the best way to run barefoot.”
The abstract for the study says, “Our data supports the hypothesis that a forefoot strike reduces the magnitude of impact loading, but the majority of subjects instead used a rearfoot strike at endurance running speeds. Their percentages of midfoot and forefoot strikes increased significantly with speed. These results indicate that not all habitually barefoot people prefer running with a forefoot strike, and suggest that other factors such as running speed, training level, substrate mechanical properties, running distance, and running frequency, influence the selection of foot strike patterns.”
Sales of minimalist shoes are up 303 percent between November 2010 and November 2012, compared with a 19 percent increase in running shoe sales overall in the same period.
Are you a barefoot runner? If so, what is your foot strike pattern when running – forefoot, midfoot, or rearfoot? And importantly, does your foot strike change as your pace changes?
Working Your Ankles
Filed under: Foot Care, Foot Care Products, Health, Sports
Recently a question about ankles was asked on an ultra email forum. Here’s an edited version.
“Rolling ankles seemed to be a weekly thing. So just wondering if there are any specifics to the alphabet drawing feet. Sitting, standing, flatfooted or pointed toes? One of these or all of the above? I have already been messing with it and: 1. I have very uncoordinated feet and 2. I can already feel a little “work-out” going on, so this is very promising! Any specifics would be much appreciated. Whatever that I can do to help my running while at the office is a major victory!”
Most athletes know the importance of strong ankles. Whether a runner, adventure racer, triathlete, hikers, or walker, you’ll benefit from making your ankles stronger. I responded with some basic advice.
Wobble Board
“I’d suggest a wobble board or balance board. The best ones are round. They have a rounded ball on the bottom and when you stand on them, you are forced to work your ankles as you try to keep you balance. They are very good at strengthening ankles. Keep one at home and the office. You can always alternate standing on one foot with your eyes closed and arms out. Depending on your sense of balance, that works the ankles too.”
The reference to the alphabet in the question is about using your toes and feet to write the letters of the alphabet. The motion of the writing the letters works the ankle. It’s a very effective exercise.
I also like the simple and no-cost method of working your ankles by standing on one foot, arms out to the side, and then closing your eyes. This is harder than it sounds but is also effective at strengthening your ankles.
FitterFirst has a great line of wobble boards. Here is some text from a wobble board page on their website.
Regardless of your age or ability, daily use of a balance board or wobble board is an asset to your fitness, health and well-being. Our Professional series wobble boards are made of a durable 3/4″ Baltic Birch and feature our patented Tri-Level adjustment system, which allows for a quick and easy change to any of the three difficulty levels. Simply spin the sphere and select which setting suits your balance ability and in seconds you can be working towards better S.A.M. (Stability, Agility, and Mobility). A patented dual level fulcrum allows the board to adjust from basic to advanced with a simple twist of the wrist. Try our wobble boards for daily balance maintenance at the office, while talking on the phone, or while watching television.
You will experience:
- Improved balance & coordination
- Heightened sense of body awareness
- Increased core strength & stability
Blister Prevention – The Long Version
Today’s post is long, but illustrates a valuable point. The Facebook post below started a long chain of responses – all suggestions on what the poster could do to eliminate her blister problem. There were a total of 64 responses. Let’s get right to what was initially posted.
Original Facebook Post
So some of you may remember the nasty blood blister I got during Boston in 2011. I am very unhappy to say I have another one as a result of yesterday. Today I will be doing a GREAT amount of reading on not only how to treat but prevent this from happening again. My next long run is 20 miles. I think that moleskin is going to become my new best friend for EVERY long run.
Side of the foot blister
Fifty-four Responses
I use Sportslick and only wear Wright socks (thin, double layer) for long runs. For my last Ironman I put anti-perspirant on my feet everyday for a week before the race. I got no blisters. Good luck!
Soldiers have been known to wear panty hose footies during marches. And tape every hot spot.
Going to look up mole skin because since I lost 90+, my sneakers were huge on me and I didn’t realize it so after the bursitis incident I walked a few miles and had horrible blood blisters that were UBER painful. I applied Band-Aids the next day and kept hustling… moleskin eh? Thank you and healing love to your blisters. They hurt!
May be time to re-evaluate your shoes. I got a whopper this summer after a 20 miler. My inserts in that particular pair of shoes were causing me to run a little odd.
Moleskin! I used it with any shoe that pinches or rubs, especially heels. I found cleaning my skin with alcohol first helps it adhere the best and stays even after taking showers!
If you have sweaty feet be warned moleskin can be sweated off. It is probably the best out there though to prevent blister. If it gets rolled or folded it can make the problem worse.
I use Sportslick and wear Wright socks as well. No blisters as of yet. It got me through my first marathon with no blisters and it rained that day and my feet were soaked. It didn’t do much for my bruised toe nails though lately I have been using Monkey Butt” anti-chafing powder when training for triathlons. Have had great results with this product with my bike shorts. But for feet, I would recommend Sportslick as it is a thick petroleum based ointment. Best of luck! And remember, one foot in front of the other. It doesn’t have to get any more complicated than that!
New shoes may also be the answer. I switched from running in Nike Air Pegasus years ago to Mizuno Wave Riders with little to no blistering. Turns out I needed a narrower toe box and the Nike Pegasus toe boxes would stretch a great deal over time.
Research socks and use a Bodyglide type product .
I have hyper mobility in my feet. I was using Sauconys. Horrible foot pain. Got some Mizuno. Best shoes ever! I can run without pain!
I use anti-perspirant and change my socks every 5 miles .
Try Balega dry fit socks. I NEVER get blisters anymore and I’ve completed two marathons and two Ironmans in them. Used to get blisters all of the time before I switched!
Mizunos + Bodyglide + a great fitting pair of socks = No blisters… ever again!
I get the cheap Monistat anti-chafing cream and put that on my blister prone areas, and it works perfect!
My latest blood blister peeled off the end of my toe just this week! I had a little party!
Have you ever tried Smartwool socks? They are pricey, but worth it. I haven’t had a blister since I started wearing them on my runs .
We always wore two thinner pairs of socks in high school if we had history of blisters… one pair inside and it worked like a charm.
Inside out [socks].
Here’s my 2 cents! I keep my toenails as short as I can handle- short! Smear on some Vaseline between my toes wear the same brand of sox and so far so good.
Moleskin is amazing, and glide works well too. I have heard if you’re in a pinch use deodorant where there is any friction.
In the years I have done marathons/half marathons, I find that having the right shoes, using wicking socks (I too use the Wright socks), and use talc/baby powder in between my toes I do not get blisters.
I gave up on running because of constant and ongoing blisters, I tried several shoes etc nothing helped, I loved running but those blisters were so painful, what is moleskin?
Totally agree with Smartwool socks. They rock.
Try Nuskin. I have a friend who is a marathon runner and this company is her sponsor. Supposedly very good!
Love moleskin! I get wicked blisters without it and none with it. The stuff rocks! Superb for healing blisters too!
Military uses just basic slip on panty hose/dress socks especially with long hauls when carrying 80+lbs in the desert – it works and it is cheap.
Mole Skin and my hiking boots = Love.
Panty hose and then socks over?
I swear by these don’t know if you have used/seen them – Nike Elite Anti-Blister Low-Cut Tab Running Socks.
I spray my feet with Trislide if I start getting any rubbing in my shoes. I can run barefoot and not get a blister no matter how long I go.
SUPER HELPFUL! OKAY NOW FOR TREATMENT FOR MY EXISTING BLISTER? IDEAS? I HAVE RUNS THIS WEEK.
There are lacing techniques that you can try to that help prevent this – as with some of the other comments; you may need a different shoe or sock. I’m sorry, that’s such a pain! I recently switched from Saucony to Mizuno’s & have had a really great experience so far.
Try the book Fixing Your Feet by John Vonhof. We ultra runners swear by this book.
Yeah I do believe my Saucony Kinvaras are out for this very reason. Both times I wore them – in Boston and again yesterday it happened.
The best stuff for blister is Compeed. It is now sold by Band-Aid as Blister Band-Aid and still says Compeed on the box. You can put over the blister and still run without feeling anything. I always carry with me on races. Just in case!
To heal the latest blisters I had to pop them as they were so big I couldn’t put shoes on. Then I cut the size of the blister out of the center of the moleskin and place it over/around the blister. Kept blister clean and voila, perfectly fine that night!
Yes – pantyhose and then socks over – they glide and no friction in between skin and toes.
I play hockey and some girls get the worst blisters from skates. It was actually a doctor on our team that recommended using duct tape! It does work better than moleskin and with good socks. This is at the stage where you are getting irritated in a certain spot, not of course after the blister has formed!
I second the double sock and panty hose method. I actually found ones you wear for ballet flats very helpful. Not sure how they would do on long hauls as I was a short and medium distance sprinter. Cheap and easy.
I have ran a ton of marathons and have stopped getting blisters when I purchased a good pair of socks and bought my shoes a size and a half bigger. So one good sock and big shoes = happy feet.
What you are describing sounds like poorly fitted shoes to me. Make sure you get fitted a good running shoe store, and tell them up front that you have a problem area. A good running shoe fitter should be able to fix the problem.
Knee high pantyhose along with powder maybe but the pantyhose should protect your feet from the friction.
You need to check out Incrediwear.com – they have the best socks for runners. My husband does marathons and I’ve recently started running myself. There is no question our feet don’t hurt and they wick away the sweat. They are made with bamboo charcoal and they increase blood circulation.
Wright socks!! I get them sometimes. But I wear Vibram FiveFinger shoes. And any other running shoes I have are minimalist shoes. So not socks… But if you do wear socks. Get some 2-layer Wright” socks! They are awesome. Or an old army trick. Wear nylons/knee highs under socks.
You are not supposed to pop blisters ever. If they pop on their own fine. But I would cover it up with something like the moleskin or a blister Band-Aid and wear good socks and shoes. I like the knee-high panty hose idea. Good luck & feel better!
Duct tape.
I hate to hear that girl…I run in Asics, and those socks I told you about and have never had a blister…sorry feel better girl!
I remember that blister because I had an awful one at the same time! I finally stopped getting them when I went to a actual running store, they fitted me with a pair of Sauconys with a wide toe box and laced them just from the middle of the shoe and up. In all the miles I ran after that never got another blister and my black toenails grew out and had no more problems with that either! It’s the wide toe box that saved my feet.
If the blister is open, use vitamin E oil on it at night. Air it out as much as possible. If the blisters are so large you can’t wear shoes, take a cleaned (alcohol) safety pin and drain. Don’t tear skin off. It is best not to pop but sometimes it’s needed. Motrin for the pain may seem extreme but if you r in so much pain and start altering your stride you’ll get even more blisters.
Try Second Skin. It works very good for soldiers. In two days your feet will be like new!
I never got blisters-and i used to run 65 miles a week. My trick was either Thorlo socks, or wearing two pairs of snug socks. And wearing shoes that were a full size larger. My favorites are Kswiss performance. When running distance, your feet swell so much, you need the space to be able to accommodate it.
Vibrams! They literally took away all my feet problems, including blisters. I love them.
Essential oils are helpful for treating the actual blister. Lavender and tea tree (also called Melaleuca) will help it heal. Apply 2-3 drops of each every couple hours – or when you think of it really. I hope it feels better… they are nasty.
I grease my toes and footpad down with simple cocoa butter Vaseline before any run or distance walk! Haven’t had a blister since! Took a couple times to get used to the immediate feel, but now a year later with no blisters, I hardly notice I’m doing it any more! It’s cheap & simple! And, foot fitting socks! I have my favorite kind that I own multiple pairs of, got them at the local Fred Meyer!
I do the same for long runs. And sometimes baby powder to. Helps with the moisture.
After all 54 responses, I had to weigh in. Here’s what I wrote:
As the author of Fixing Your Feet, I’ll comment that some of what has been suggested here is good but some is not what I would recommend. There is no “one right” answer to the ago-old blister problem. There are many causes and many answers. Try some and find what works for your feet. What’s important is fit, socks, trimmed and filed nails, reducing calluses, and a high-quality lube if needed to reduce friction.
Later, I emailed Jenny and based on what she described and the picture of the blister, here is my response to her.
Let’s talk treatment first. Because it’s a blood blister, I’d try to keep the roof intact. If it opens, your circulatory system is open to possible infection. I lance them, but I am used to doing that, and give the athlete a lecture on infection. Generally if you soak your foot in warm/hot water with Epson Slats, several times a day, the blood and fluid will be reabsorbed – and the blister will harden. Over time, after that, the top layer of skin may slough off but by then, the possibility of infection is over. Start there. If the blister ruptures, make sure you use an antibiotic ointment and keep it covered. Signs of infection are redness, heat, swelling, pus, pain, and streaks moving up the foot. That becomes serious. Make sure your Tetanus shot is up to date (usually about every 8-10 years).
As far a prevention goes, here are a few thoughts:
- I think I see the edge of callus at the forward edge of the blister. I don’t like calluses. Try and reduce any you might have.
- Do you have bunions? If so, that changes a few of my ideas.
- I’d guess that you have a shoe issue (meaning fit). If you have wide feet, or the shoes you wear are too narrow, you’ll have these problems. I read you wore the same shoes both time this happened. That’s a good sign you don’t have a good fit. A better fitting shoes could solve your problem. Can you get fitted at a good running store?
- Something else I see is that the bottom edge of the blister is right at the edge of where the insole hits the side of the shoe. This again gets to the issue of fit. There is pressure there, creating friction, that cayses the blister, that builds from this bottom edge upward.
- One option is to protect the area with a strip of tape. Duct tape isn’t the best, but would work. Don’t use white athletic tape. It won’t stick. I prefer Leukotape.
- You could cut a horizontal slit in the side of the shoe over the pressure point.
- I hate moleskin and never use it. It does not stick well, does not conform to the shape of the area, and is too thick. Stick to tape. The ONLY kind I would recommend is Profoot Velvetex Moleskin (available on Amazon).
- Only wear moisture wicking socks.
Something to understand, that I preach all the time, is that what works for one person will not necessarily work for another. That goes for socks, shoes, lubricants, powders, etc. We each are an experiment of one and need to determine what our feet need. Keep me posted.
Circulation