Don’t Do This to Your Feet!

July 17, 2016 by · Leave a Comment
Filed under: blister care, Foot Care, Footcare, Footwear, Health, Sports 

Over the next few days, over 90 ultra runners will test themselves at the Badwater Ultramarathon in California’s Death Vally. 135 miles. Extreme heat, scorching roads, sand, wind, hot winds, and then at the finish line – much colder temperatures. I’ll be there to help with runner’s foot care issues, working with Denise Jones.

I decided to rerun this blog post from 2010. It describes an issue that can harm a runner, and can happen when time is not taken to repair small blisters before they become large, and then huge.

Here’s the post from July 2010.

This was a good week. Badwater in Death Valley always is. Fit runners, great crews, fantastic scenery through the harsh reality of Death Valley – and for me, lots of feet needing care.

For the most part, things were pretty normal. Blisters and more blisters. A great case of severe capillaritis (heat rash) on one runner’s ankles. Ugly toenails. Stinky feet. And more. Lots to like for someone who does foot care.

At the closing ceremony, I noticed Monica, a runner from Brazil, was favoring her right heel. I had met her several years earlier at a previous Badwater when I patched her feet at the 40-mile mark. This year, she finished her 2nd Badwater and that was important. However, she had not come in for help.

She should have.

After the awards ceremony, Denise Jones came and told me I had to see this blister. She talked as if it was really a great find. Denise, as the Badwater Blister Queen, has seen everything and it takes quite a bit to faze her. This blister did. And yes, it was good.

What started as a small blister, one that could have been treated to prevent it from getting bigger, was now an enormous blood blister. The image shows you the size.

An enormous blood blister

An enormous blood blister

There were several issues we had to consider. First and foremost, Monica is a diabetic. This makes foot care a huge issue because any foot infection suddenly becomes a huge health issue. Secondly, the size of this blister, filled with blood, would make it difficult to patch. As always, blood-filled blisters must be managed with care.

We debated the issues and gave Monica advice on how to take care of the blister for her trip home. We advised frequent soaks in warm/hot water with Epson salts and sticking to sandals or other open heel footwear.

What I want to emphasize here is that this never should have reached the size it was and worse yet, filled with blood. For those wondering, a blood blister is bad because, once opened or torn, it can introduce infection into the circularity system if not kept clean.

I wish Monica had taken care of this earlier. She may have never mentioned it to her crew. At any rate, what could have been easily treated now became a huge issue.

It’s a good lesson on not allowing small problems to become large problems. In other words, “Don’t do this to your feet.”

Typical Heel Blister Problems

January 12, 2015 by · 4 Comments
Filed under: blister care, Foot Care, Footwear, Footwear Products 

Heel blisters are quite common – although they shouldn’t be.

Feet in the Jungle Marathon

Heels in the Jungle Marathon

Today’s post shows one participant’s feet at the 2014 Amazon Jungle Marathon.

If you look closely at this picture, you’ll see two heel blisters, both on the outside of the runner’s feet. The right foot blister is large but is not blood-filled. The blister on the left heel, however, is very large and filled with a large amount of blood.

It’s easy to think these are normal blisters – but their size makes they abnormal.

In my experience, heel blisters are caused by the constant shear when either 1) the heel is moving up and down inside the shoes’ heel, or 2) by the constant movement at the place where the shoe’s insole touches the inside of the shoe. Over the years, the majority of heel blisters have been the latter. One of the characteristics of this “insole/shoe junction” blister is that they often are flat across the bottom. The blister starts at the point where the insole’s edge at the side of the heel touches the inside of the shoe. That’s what makes the flat line at the bottom. Then the blister forms upward as the fluid forms and it grows. Given enough time and movement, you’ll get blood inside.

Patching

These are relatively simple to patch. The skin must be cleaned with alcohol wipes, and then the blister can be lanced and drained. Depending on the size of the blister, you’ll need to apply some type of blister patch. The bottom line is that you need to have something over the blister to protect the skin and prevent the top layer of skin from tearing off. For these, I would use strips of kinesiology tape (my preference is either StrengthTape or RockTape H2O) with antibiotic ointment over the blister to keep the tape from sticking to the skin. The larger the blister, the harder these are to patch but it can be done.

Prevention

You are better off to prevent these blisters in the first place.

Start with the fit. Make sure your shoes hold your heels in place with just a little movement.

Check your shoes and insoles for rough and/or thick edges at the inside and outside of each heel. Side blisters are much more common than the back of the heel. If the insole has a large thick edge, replace them. If the shoe’s fabric is worn into a hole, you are due for new shoes. Under the fabric is generally a plastic edge of the shoe’s heel counter – the plastic that curves around the heel from side to side.

Engo Blister Prevention Patches are perfect for to help prevent these types of blisters. These patches are super slick. Either the small or large oval can be applied to the inside of the shoe and cover the offending edge of the insole/shoe junction. Clean the inside of the shoe and insole first. I work the patch with my fingers to form a curve to fit with area I need to cover. Then remove the backing and apply the center of the patch first and then push the top and bottom of the patch into place. Rub it a bit to assure adherence.

Foot Problems at Western States

June 25, 2013 by · Leave a Comment
Filed under: blister care, Foot Care, Health, Sports 

This weekend close to 400 runners will start at Squaw Valley and make the trek over the Sierras towards Auburn – 100 miles away. It’s the Western States 100 Mile Endurance Race. I love the race, having completed it three times in the late 80’s. It’s tough and throws a lot at the runners. Cold, heat, extreme heat, streams running down the trail, rocks, dust and grit, water crossings, long ups and long down through numerous canyons – and for many runners, a second sunrise with renewed heat.

Toe Blister

Toe Blister

I will again be working at the Michigan Bluff aid station doing foot care. Later, I will be at the finish line taking care of feet as people finish. Having worked this race for years, I have a good idea of what foot problems to expect. Here’s what I commonly see and a few tips.

First, here are common problems:

  • Toe blisters. Under the toenail, on the tips of toes, between toes, and under toes.
  • Heel blisters. Either at the rear of the heel or at the sides.
  • Ball of the foot blisters. Either in a certain area or across the whole foot.
  • Side of the foot blisters.
  • Stubbed toes. From hitting rocks or roots.
  • Sprained ankles.
  • Sore feet.

Here are some tips:

  • Cut toenails short and them file them smooth. No rough edges to catch on socks or hit the toebox of your shoes.
  • Reduce your calluses as much as possible. This close to the race, don’t file too much off. Aim to get reduce the thickest rough patches.
  • Use Engo Blister Prevention Patches in problem areas – sides of the heels and ball of the foot. They will greatly reduce friction and shear.
  • Pretape any problem areas.
  • Check your insoles for thick edges at the sides of the heel – always a problem area. Thin these down or change insoles. Most side of the heel blisters are caused by these edges.
  • Don’t use Vaseline as a lubricant. Stick to SportSlick, BodyGlide, or a similar lube.
  • Change socks frequently and clean your feet. Today’s trails shoes often have mesh uppers, which allow sand, dirt, and trail dust inside the shoe, on and into your socks, and on your feet.
  • Know how to manage your feet and patch blisters on your own – or your crew should have these skills. You can’t count on aid station people knowing what you need or want or doing it on your time schedule. There may be other runners in front of you or they may be out of supplies.
  • If you feel something inside your shoe, stop and clean it out. Even a small rock can cause problems.
  • Wear gaiters to keep rocks and trail grit and dust out of the top of your shoes.
  • Build your own quality foot care kit. Stock it with what you need and learn to use everything.

Maybe I’ll see you at Michigan Bluff. I hope it’s just to say Hi as you run through.

Have a great race.

Types of Blisters

March 11, 2011 by · Leave a Comment
Filed under: blister care, Foot Care 

There are many types of blisters. In my experience, toe and heel blisters are the most common, followed by ball of the foot. Here is a summary of the three.

Toe Blisters

Shoes with a toe box that is too short in length and/or height often cause toe blisters. The toes rub against the toe box and blisters result. Improperly trimmed toenails are also a common cause. Socks will catch on the toenails and push them back into the cuticles, causing blisters or fluid under the nails. Blisters between the toes are commonly caused by friction from skin on skin. Blisters on the bottom of the toes can be caused by friction from the insoles. Oftentimes the pinky toe curls under the neighboring toe, leading to blisters. Shoes with a good toe box and properly trimmed toenails are important to preventing toe blisters. Injinji toe socks can help those prone to toe blisters.

A huge ball of the foot blister

A huge ball of the foot blister

Ball of the Foot Blisters

Blisters on the ball of the foot are generally caused by friction. This may be from the surface of the insole or from socks. Often a lubricant or powder will help prevent these. Trying another pair of insoles can also help because your insole coverings may be rough. An ENGO Patch placed on your insole can effectively reduce friction.

Heel Blisters

One of the more common blisters found on athletes’ feet are on the heels. Is there a reason for this? Why do so many athletes blister there? The best answer is that heels move around a lot inside shoes. Both up and down and side to side. Some shoes have plastic in the heel counters-a piece of plastic that is curved around the back of the shoe’s heel counter. This plastic piece can sometimes be an irritant and rub on your foot, causing a hot spot that turns into a blister. Another irritant is the edge of the insole where it meets the inside of the shoe. Run your fingers around the inside of your shoe. Feel for seams or the hard plastic heel counter that can cause blisters. Feel the edge of the insole. Some insoles have a thick edge, while others are thinner. Another insole may fit better and not have the problem edge. Bottom of the heel blisters can be caused by a rough surface of your insole or socks that are worn through and the weave has irritated the skin.

Of course, there are blisters on the sides of the foot, midfoot, back of the foot above the heel, and more. The above three types are the ones I have found to be the most common. If you can master getting rid of these, and patching them if they occur, you’ll know how to patch any blister.

Heel Blisters at the Gore-Tex TransRockies – Part II

December 26, 2010 by · Leave a Comment
Filed under: blister care, Foot Care 

Last week I wrote a post about the horrific heel blisters I had seen at the 2010 six-day  Gore-Tex TransRockies Race. If you have not read that post, or want to read it before going on to this Part II, here is the link.

To refresh your memory, here’s a brief description: The heel blisters covered the whole bottom of the heel side-to-side, and were 1 ½ to 2 ½ inches in length, towards the mid-foot. In most runners, the forward most edge of a blister had torn and opened up across the whole bottom of the foot. The blister’s roof is thick, at least four layers of skin. Most runners with these blisters had them on both feet.

This post will describe how I patched these deep and torn heel blisters.

As usual the first steps are to clean the blister and surrounding skin with alcohol wipes. Then drain the blister. Normally, needles holes will seal back up on themselves, so make sure you move the needle side-to-side to make a larger hole. If you use a scissors or clippers, make a V cut in the edge. Make several cuts. I would make one on each side at the forward edge and back edge. Expel as much of the fluid as possible.

In most blister patching jobs, I would then apply a dab of zinc oxide to the blister and then tape over this. The zinc oxide works to dry out the skin – just as when it used on a baby’s bottom. These deep heel blisters required more care.

Injecting zinc oxide

# 1 - Injecting zinc oxide

I filled a 5cc syringe with zinc oxide and attached an 18-gauge needle. Using the holes made to drain the blister, or the torn skin, I inserted the needle as much as possible into the center of the blister, and squeezed the zinc oxide into the blister cavity. This is shown in the first photo. Then I used my fingers to massage the zinc oxide around to fill any open space in the blister cavity. Any excess zinc oxide can be pushed out the openings. All you need is a thin layer of zinc oxide inside the blister.

After injecting the blister with zinc oxide, and pushing out any extra, I cleaned the skin with another alcohol wipe, applied a coating of Compound Tincture of Benzoin, and applied tape. I used two-inch Kinesio Tex tape.

The first strip of tape

# 2 - The first strip of tape

The first strip went around the back of the heel, side-to-side (the second photo).

The second strip of tape

# 3 - The second strip of tape

The second strip went under the foot, side-to-side, to anchor the blister’s roof to the foot (the third photo).

The last strip of tape

# 4 - The last strip of tape

I used two strips under the foot. Whether using one strip or more, the strips should be applied starting towards the mid foot, then work backwards so the last strip covers the edge of the strip going around the back of the heel (the fourth photo). Apply a slight stretch to the tape as it is applied. Round all corners of tape. Squeeze any overlaps sections of tape and use scissors to cut them flush. Kinesio Tex tape should be rubbed gently for 30 to 45 seconds to warm the tape so the adhesive bonds to the skin. At the TransRockies, I patched many runners’ feet with these heel blisters. Because they were running for six days, often times the runners came back the next day for a repatching.

I used the zinc oxide in side of the heel blisters too. I saw one runner, a lady from Germany, five of the six days. She had terrible side of the heel blisters. Her insoles were really thick in the heel and the edge rubbed her foot in the same spot every day, creating new blisters daily. These often were blood filled. After the third day, I started injecting zinc oxide into the blisters. I was amazed at how it would flow into all parts of the blister. Several times, because of the zinc oxide going into the blister, I could see blister under blister.

The zinc oxide worked well to dry the inside of the blister. It also eliminated much of the pain associated with blisters.

Blunt needles

Blunt needles

While I used an 18-gauge sharp needle, I would not recommend that for others. Typical needles, as you might imagine, have a point. Unless you are very careful, you can easily cause the point to penetrate into raw, new skin and tissue. You can purchase blunt needles that are much safer – and are easier to dispose of. Regular needles must be put into special “sharps containers” that most of us do not have access to. If you want to buy blunt needles, Amazon sells them, as well as syringes (the fifth photo). I would recommend a 16 gauge blunt needle. Because zinc oxide is like a thick substance, a large bore needle is needed to push it through. Several times I set the syringe in the sun to warm the zinc oxide so it would push easier. At night, I achieve the same results by rolling the syringe between my hands to generate warmth. If the zinc oxide is too thick (cold), no matter how hard you push on the syringe, it will not come out the needle.

There are several possible options to this extreme blister patching method. One can use Instant Krazy Glue or Gorilla Glue, or Compound Tincture of Benzoin. Be aware that these will sting as they are injected – but they seal the blister’s roof to the base.

Patching blisters using one of these options is best reserved for events where you have to run again the same day or the next day. Also, not everyone will have the syringes and needles necessary to inject blisters. If you are building a foot care kit for extreme events, these tools can help you care for the worst-case blisters.

And as usual, know and heed the signs of infection: redness, swelling, red streaks up the foot and leg, pus, fever, and pain. If any of these happen, seek medical attention.

Heel Blisters at the Gore-Tex TransRockies – Part I

December 18, 2010 by · Leave a Comment
Filed under: blister care, Foot Care 

This past August I worked on the most horrific heel blisters I have seen in over 13 years of doing foot care. The event was the running of the Gore-Tex TransRockies Race over six days in the Colorado Rockies. The daily distances ranged from 13 to 24 miles. The course was over trails and fire roads and many were steep. It was not a particularly wet course.

Heel blister with torn skin

Heel blister with torn skin

While there were many other blisters, heels and toes and ball of the foot, the heel blisters on many of the runners were impressive. In this first picture, you can see how the forward most edge of a blister has torn and opened up across the whole bottom of the foot.

Looking closely, you can see that the blister’s roof is thick, at least four layers of skin. It doesn’t mean that this is a blister under a callus. The second photo from a different angle allows you to see the blister covers the whole heel, side-to-side and to the back of the heel.

Photo showing the whole blister

Photo showing the whole blister

Up to that point, I had only seen this type of blistering on one runner. That was during the 2008 Badwater race in Death Valley. I attended to him at mile 21. He had bilateral heel blisters as shown in these photos. His history was interesting in that he had vacation in Tahiti on the beaches and just before Badwater had hiked down and back up the Grand Canyon. I theorized that the rough sand coupled with the heat on the beaches, followed by the friction of the steep ups and downs of the Grand Canyon, made his heels susceptible to blistering on the hot roads of Badwater.

Then I saw not one runner at the TransRockies, but more than 15 runners with these same blisters! The blisters were on men and women, of all body weights, and of all running speeds. They even affected a few of the race leaders.

A view of another heel blister torn on the side

A view of another heel blister torn on the side

The third photo shows a heel blister that tore on the side of the foot. I removed the torn skin because of the condition of the torn part. Leaving it on would have not provided any protection.

At the TransRockies, I talked to David Hannaford, a sports podiatrist from California who was running the race. He speculated that the footwear or the insoles could cause the heel blisters. My feeling is that the blister formed deep under several layers of skin due to a combination of steep downhill running and pressure/friction created when the runner landed on his/her heels. As the runners ran the steep downhills, with their full bodyweight landing on their heels, the added pressure and friction led to the blisters forming deeper then normal. While the coarse was not unusually wet, the feet have hundreds of sweat glands and the sweat typically generated while running could have also been a contributing factor. Many of the runners had these blisters bilaterally on both heels.

The next time I see these blisters, I will ask the runners what type of socks they were wearing. Socks with less moisture control will trap the wetness under the foot and can contribute to softened skin and blistering. I will also look at and feel the insoles. The surface fabric of some insoles is rougher than others and might be another contributing factor.

A good question is why some runners had these heel blisters and not others. It cannot be narrowed down to one thing. Here are my thoughts on possible contributing factors:

1.     The steep downhills

2.     The shorter day’s distances meant that runners could run fasted than those doing longer races, meaning the downhills were run faster

3.     The type of socks they were wearing

4.     The surface of their insoles

5.     How they landed (heels versus more on the whole foot or forefoot)

6.     How much their feet sweated

7.     Any pre-existing conditions as calluses or new skin under previous blisters

8.     The fit of their feet inside their shoes (allowing extra movement)

9.     The use of a lubricant on their feet, which can lead to softened skin

10.  A lack of training with enough miles on the feet to warrant running such distance on a back-to-back daily basis

So there the 10 factors I feel could cause such extreme blisters. As you might guess, any one, or several, of the above factors, could have caused these blisters. One person could have been affected by factors that did not affect another runner. Several of the factors, such as numbers 1 and 2, were more than likely factors in a majority of the cases.

My next post, Part II, will detail how I managed the blisters and show photos of the process of patching them, what I learned and how I would manage them the next time.

Don’t Do This to Your Feet!

July 17, 2010 by · 1 Comment
Filed under: blister care, Foot Care, Health 

This was a good week. Badwater in Death Valley always is. Fit runners, great crews, fantastic scenery through the harsh reality of Death Valley – and for me, lots of feet needing care.

For the most part, things were pretty normal. Blisters and more blisters. A great case of severe capillaritis (heat rash) on one runner’s ankles. Ugly toenails. Stinky feet. And more. Lots to like for someone who does foot care.

At the closing ceremony, I noticed Monica, a runner from Brazil, was favoring her right heel. I had met her several years earlier at a previous Badwater when I patched her feet at the 40-mile mark. This year, she finished her 2nd Badwater and that was important. However, she had not come in for help.

She should have.

After the awards ceremony, Denise Jones came and told me I had to see this blister. She talked as if it was really a great find. Denise, as the Badwater Blister Queen, has seen everything and it takes quite a bit to faze her. This blister did. And yes, it was good.

What started as a small blister, one that could have been treated to prevent it from getting bigger, was now an enormous blood blister. The image shows you the size.

An enormous blood blister

An enormous blood blister

There were several issues we had to consider. First and foremost, Monica is a diabetic. This makes foot care a huge issue because any foot infection suddenly becomes a huge health issue. Secondly, the size of this blister, filled with blood, would make it difficult to patch. As always, blood-filled blisters must be managed with care.

We debated the issues and gave Monica advice on how to take care of the blister for her trip home. We advised frequent soaks in warm/hot water with Epson salts and sticking to sandals or other open heel footwear.

What I want to emphasize here is that this never should have reached the size it was and worse yet, filled with blood. For those wondering, a blood blister is bad because, once opened or torn, it can introduce infection into the circularity system if not kept clean.

I wish Monica had taken care of this earlier. She may have never mentioned it to her crew. At any rate, what could have been easily treated now became a huge issue.

It’s a good lesson on not allowing small problems to become large problems. In other words, “Don’t do this to your feet.”

Foot Care Desperation

September 12, 2009 by · 3 Comments
Filed under: blister care, Foot Care, Health, Sports 

I get emails every week from athletes with foot care questions. Some are easy. But I love challenges and even more so when the person is dedicated to finding answers. This post is on the long side, but it is important. I hope you will read through to the end. Several months ago I received an email from Jakob Herrmann. Here is what he wrote:

The Desperate Foot Care Question

I don’t like to bug you with this question but I’m getting desperate. I’ve studied your excellent written book and have researched online but never found a true solution for my problem. If you do not want to answer this then I understand and simply delete this email.

My issues are my heels. I always had calluses on the outer-bottom sides of my heels and they became a problem when I started to run ultras 3 years ago. Especially on 100 milers I am getting blisters underneath them despite carefully taping my feet.

About a year ago I started to remove those calluses with pumice and I got them all almost gone. The skin feels very soft; however, I still get those blisters underneath them despite of the skin being much softer.

Left foot with flap of blister showing

Left foot with flap of blister showing

What I then do is to cut off all the death skin on top and remove the blister. This always leaves a deep hole in my heel. During the healing process I use pumice, Footherapy’s Apricot Walnut Foot Scrup and True Blue Spa’s “Heel of Approval” heel treatment cream. Once the skin grows back it’s again soft and nice; however, on my next 100 miler the whole process starts over and I get a blister underneath that area on my heels.

I’ve attached pictures of my last blisters, how I take care of them and how it looks once it’s fixed. The way I fix this problem feels like I’m going around a circle. Any help is great appreciated.

So, I Emailed Jakob.

John: Have you reduced the callus to soft skin?

Jakob: Before I removed my calluses on my heels the skin was hard like a crust on top of the normal skin. After I started to remove it the skin was soft; the hard crust was gone but it wasn’t as soft as the rest of the skin on my feet. I think I’ve made it better but not perfect. And yes, the same thing happens on both heels.

John: Many times with good skin care after a blister, the roof of the blister will reattach to the skin underneath. Have you given this a chance or do you simply cut off the top?

Left foot after tape is removed

Left foot after tape is removed

Jakob: When I fix my blister I cut off the whole piece including the roof. The end result is like what you see on the first picture.

John: I have seen a lot of heel blisters caused, in my opinion, by the edge of the insole where it touches the inner side of the shoe. Do your insoles have a rough or thick edge at the point where the blisters form?

Jakob: I’ve checked my shoes and their edge of the insole, where it touches the inner side of the shoe, is not too bad at all. There is a bit of an edge but nothing major.

Meeting at Badwater

We emailed back and forth several times. I asked questions and he sent photos. He was doing a great taping job. I talked to Jakob when we were both at Badwater this July. I gave him some Kinesio-Tex tape and suggested he use it on one heel, while taping his other heel as usual. What I wanted to determine is whether there would be a difference in the tapes. I had my suspicions, but knew this was a perfect opportunity for a good test.

Jakob’s Two-Tape Test

Left foot with Kinesio-Tex tape on heel

Left foot with Kinesio-Tex tape on heel

Here’s an update what happened with my feet at the Mt. Disappointment 50 mile race.

As discussed I’ve taped one foot the way I always do with the Elastikon tape and the other with your Kinesio-Tex the way you showed me.

First up, the taping with the Kinesio-Tex is so much easier. It goes on very smoothly whereas with the Elastikon tape I always have to be so careful not to have wrinkles within the tape. I had the Kinesio tape on within 5 min where it took me over 10 minutes for the Elastikon tape. I really liked that.

The Kinesio tape also feels much smoother on the skin and it more comfortable to wear.

During the race both feet felt the same. However, around mile 30 my Elastikon tapped heel started to hurt like it usually does but the Kinesio tapped heel didn’t hurt at all. I was super excited about that.

Right foot after race (taped with Elastikon)

Right foot after race (taped with Elastikon)

On the last few miles eventually both of my heels started to hurt but the Elastikon foot hurt more. Every time I hit a stone on that heel it shoot a pain through my leg whereas the other side I could feel the stone but it didn’t hurt that much at all.

Also removing the Kinesio-Tex tape was super easy. It just came off like that. The Elastikon tape is always more complicated to remove. I have to pull it very slowly not to rip open the blister.

Once both tapes were gone I saw that both heels had blisters again; however, the heel with the Kinesio tape looks so much better.

Left foot after race (taped with Kinesio-Tex)

Left foot after race (taped with Kinesio-Tex)

What this Taught Me

In my next post, I will talk about what Jakob’s two-tape test taught me.

Patching Heel Blisters

August 30, 2006 by · 9 Comments
Filed under: Footcare, Footwear, Health, Sports, Travel 

Ok, it’s time to get back to what I promised a few posts back – patching heel blisters. If you spend any amount of time with bad feet, you’ll notice that probably 80% of heel blisters are on the sides of the heel, towards the back of the foot. The exact location is easy to see. They start where the shoe’s insole connects with the shoe’s upper. From this point, they grow upward and to the sides. This was explained in my Heel Blisters post on August 5.

     Patching them is fairly easy and yet can seem complex. There are several steps basic to all blister patching.

Read more

Heel Blisters

August 5, 2006 by · Leave a Comment
Filed under: Footcare, Footwear, Health, Sports 

One of the more common blisters found on athletes’ feet are on the heels. Is there a reason for this? Why do so many athletes blister there?
     The best answer is that heels move around a lot in their shoes. Both up and down and side to side. Heel_counterSome shoes have plastic in the heel counters—a piece of plastic that is curved around the back of the heel. This plastic piece can sometimes be an irritant and rub on your foot, causing a hot spot that turns into a blister. Another irritant is the edge of the insole. The edge of the insole, where it meets the inside of the shoe, is a common blister-causing problem area. Of all the heel blsters I have treated, most have been at the point where the insole joins the shoe’s upper. Most heel blisters here start small and then expand upward to just below the ankle bone.
     Run your fingers around the inside of your shoe. Feel for seams or the hard plastic heel counter that can cause blisters. Feel the edge of the insole. Some insoles have a thick edge, while others are thinner. Another insole may fit better and not have the problem edge. Try a few at your local running or camping store. Click here for a post on insoles.
     I would love to see an insole company take the lead and make an insole that extends upward at least 3/4 to an inch higher than normal. This extra “cupping” of the heel could prevent the common problems with shorter insoles and their edges.
     As far as heel movement, the heel has to move some. One-quarter inch of movement is considered P40044b_1normal. More movement that that can lead to blisters on the side of the heel, at the back, and on the Achilles’ tendon. So the number one rule of all footwear is the shoes or boots have to fit correctly. With a well fitting shoe, the movement will be controlled and the likelihood of blisters will be reduced.
     Before we talk about how to fix heel blisters, in the next blog post, we’ll look at fit. I went looking for a post on fit and didn’t find one. So we’ll pause the blister talk to spend a few minutes on fit next time.

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