As promised, this is a continuation of the post about Foot Care Desperation – the struggle of finding a solution to problem heel blisters. Click on the link above to reread that post.
Over the years I have patched a lot of feet and see a lot of feet patched by others. When I first started, duct tape was the most commonly used tape. Along the way there has been Leukotape, Micropore, Elastikon, and finally, Kinesio-Tex. Sure, there have been others, but they have not stood the test of time.
The favorites for a long time have been duct tape and Elastikon. Duct tape is still used by some athletes. I don’t use it because it is does not shape to the contours of the foot and toes – and so can cause problems with ridges and folds of the tape. Elastikon is still favored by many. It sticks well and can be shaped to the foot. It is seen on the feet of many runners.
But as much as I have liked Elastikon in the past, I now almost exclusively use Kinesio-Tex. Let me explain what the two-tape test done by Jakob has taught me.
First, a few comparisons. Elastikon is thicker than Kinesio-Tex and its surface is rougher. When properly applied, both stick equally well. Elastikon leaves a tape residue when removed where as Kinesio-Tex comes off with no residue left on the skin. Elastikon has some stretch and conforms well but Kinesio-Tex does it better. When properly applied, both do well in wet conditions. Both come in multiple widths. Kinesio-Tex has a paper backing to remove. Elastikon does not.
I have seen several instances where runners have had Elastikon tape on their feet and have had problems. Let me share what I suspected:
- Elastikon is thicker and coarser.
- The coarser surface of the tape tends to hold the sock against the tape.
- The skin of the foot, held by the tape, is also held against the sock.
- This increases tension on the tissue under the tape.
- This leads to sore and painful tissue on the bottom of the feet.
At the past two Badwaters I attended to runners whose feet were patched with Elastikon. In each case, their complaint was sore and painful feet – to the point where they wanted to quit. In each case I removed the Elastikon, cleaned the foot, and then taped with Kinesio-Tex. In both cases, the runner went on to complete the race.
Here is why Kinesio-Tex shines. The less you add to the foot, the less chance of problems. Kinesio-Tex is thin and its surface is smooth. This allows it to be applied to toes without having to tape neighboring toes. It also means less bulk added to the foot. Extra bulk can change one’s foot strike or gait. Kinesio-Tex stretches in its length and after application and is meant to be rubbed for 30-45 seconds to bond help it bond to the skin.
In Jakob’s case, the skin under the Kinesio-Tax taped foot was in better shape and less painful then the Elistikon. I know he will continue to experiment with different methods of figuring out what works for him.
But of course, there may be other causes as well as solutions. Five readers wrote with their ideas. Read on.
Lisa de Speville commented: “There is no mention in this post at all of the type of shoe he is wearing and whether he has alternated brands and models within brands. My experience with heel blisters is that if you’re getting them, your shoes are not right. Heel cup is probably too wide. A different style of lacing can also make a big difference. This could be something to investigate?”
Imelda Fagin wrote: “I love this in depth discussion and can’t wait to hear your ‘diagnosis’. By the way, about Jakob’s original blister picture with cap of skin: the skin looked so thick. It didn’t seem like such a good idea to remove it. It looked like it could have protected the foot and was still living.”
Steve Quinne commented, “I started using Kinesio tex tape on my backpacking trips. I tape all of my toes, the balls of my feet, and my heels. I carefully do this every morning before hiking. I hiked around 50 miles with no blisters. I have peripheral neuropathy in both feet and this regimen with 3 pairs of socks and carefully fitted boots works well. Before this I was plagued by blisters, which were severe enough to put me in the wound care clinic at the hospital. I also stop every 3 or 4 miles and switch socks if they are wet. My biggest problem is sweating. If I am in good shape (like this year) I don’t sweat as much, which helps greatly in preventing blisters. Thanks for all of you help. Because of your methods here you allowed me to continue backpacking, without which I surely would not be doing so any longer. Thanks.”
Cole Hanley added: “I read the article and started wondering if the problem isn’t in the fit of the shoes. It would seem that if he could keep his heel from moving relative to the shoe then the problem could be reduced or eliminated. Are the heels of the shoes too wide or are the shoes simply too big? I haven’t needed to look at your book in a while but I seem to recall at least a few pages devoted to different lacing techniques and that’s where I’d look next since I certain there’s a lacing style designed to specifically address this issue. Any remaining friction might be reduced by using different socks and some Bodyglide.”
John Roberts-James wrote: “A very interesting set of emails from you and Jacob. May I make a comment? I am an alternative therapist, and have run the Alternative Therapy Clinic in Darlington UK since 1970. Now retired, I qualified as a Charted & State Registered Physiotherapist in 1968, have a DO in Osteopathy, and am trained as a chiropractor. The blisters, which are clearly helped by your local treatment, are in fact indications of an impaired weight distribution problem resulting from a postural (= spinal) problem coming from higher up the spine. Possibly even from the neck or C1 at the base of the skull. But more usually emanating from a mid-thoracic lesion around T3/4. In addition to your helpful local care, he needs to see a competent chiropractor or osteopath (ideally also trained in cranial therapy) to get at the root of the trouble. But tell him to keep away from Physiotherapists, who cannot be expected to know about these things. Hope this helps!”
Thanks to all my readers who contribute their suggestions.
