Toe blisters at the TransRockies were a huge problem. We saw many of the same runners day after day during the six-day race. One lady kept coming in every day after her run. She finally told me she was removing all the tape from her toes before running the next day. Bad idea. I informed her tape would act as a skin protector for the day’s run and not to take the tape off.
Every day we saw all kinds of toe blisters. Big ones and little ones. Ones filled with clear fluid and others filled with blood.
Most had the usual blisters between toes and after draining these were patched with Kinesio Tex tape first wrapped from bottom to top and then a second strip from side the side. The second strip going side to side prevents there being a seam hitting on the neighboring toe.
Blisters under the toenails were very common. Many were blood filled. In the photo you can see the thin edge of a blister at the forward edge of a toenail. When possible, I drain the blister there. Since the lifted skin is dead, there is no pain associated with this method. I always use a scalpel or needle and give a test ople to make sure the runner can’t feel the point. If the can’t, it is safe to make the drain hole there. If they can, I have to go through the nail.
Drilling through a nail is pretty straightforward. I use a nail drill but you can also use a needle or even, in a pinch, a paper clip. Hold pressure on the drill or needle as you spin it back and forth until the nail is penetrated. At the TransRockies I drained four or five blisters with my nail drill.
Once the hole is through the nail or a hole is made in the skin, pressure will expel the fluid and the pain and inside pressure will be gone.
Covering the tip of the nail with a strip of tape will help prevent it from catching on socks.
Toe Blister Causes
In my experience, toe blisters are typically caused by too long or rough toenails, and poorly fitting shoes. When toenails are too long, the socks catch on the long nail, or on a rough nail, and are pushed into the quick of the nailbed. A blister forms underneath the nail and pain starts. The answer is to trim nails short and then file them smooth so when you run your finger over the tip of the toe, no edge of a nail is felt.
Of course, toe blisters can also be caused by shoes that are too narrow or too short in the forefoot, overlapping toes, old and worn socks, downhills, and rough fabric on insoles. At the TransRockies there were long steep downhills.
With a bit of forethought and planning, you can avoid painful toe blisters. The best way to start is to do good toenail care.