Taking care of your feet on the trail is extremely important. Ultimately, they are the tool that will get you to your destination. This blog post discusses how I prevent, manage and take care of blisters out on the trail. I hope this information is useful.
Disclaimer: I am not a doctor and just have first aid training. The medical information in this blog post is just what I do, please do your own research and find what works best for you. Blisters are different for everyone and may vary from person to person.
Blisters are commonly thought to be caused by rubbing but typically are not. High friction between the skin and sock and/or the sock and shoe layers cause the skin to stick. With the bones moving inside and the skin stuck to a surface this results in skin sheer.
Taking Care of Your Feet
Taking care of your feet is paramount. Blisters are normally caused by friction, so here are some steps to take initially.
Get the right footwear. It sounds obvious, but having the right size footwear that is broken in, is a good start to blister prevention. Ignore the guy in the shop who says you need a finger distance space. You need a thumb or two fingers. On a long multi day hike your feet will swell.
Do not start a hike with new footwear, some footwear may need breaking in. Do not change the model or brand of footwear before a hike, use what you are used to.
Keep your toenails trimmed, the last thing you need is your toenails hitting the end of your footwear when you go downhill.
Keep swelling down, your feet will swell throughout the day. If you get a chance elevate your feet when you stop for a rest and at the end of the day.
Keep your feet clean and dry if possible. If you get a chance let them breathe when you stop for a rest. Try and keep them clean in camp if you have spare wet wipes.
Gaiters. It sounds obvious but having gaiters will stop dirt and small stones entering your shoes. At best having small stones or grit in your shoes is annoying, at worst it can cause a blister.
Blister Prevention
The best way to treat a blister is to not have one in the first place. Prevention is so much easier than treatment. The following are useful techniques to prevent blisters.
Sock Liners. The idea is to have a thin pair of socks inside your regular socks. This reduces friction and allows one sock to move inside the other, reduce skin sheer. They don't work for me but try them. The idea is to provide a level of slip between the 2 sock layers, thus reducing friction. Some people swear by them but they don't work for everyone.
Blister prevention pads, they work for me. These are super slippery sticky pads that you can stick to your insole. I find these prevent blisters on the balls of my feet and believe these are the most important item to prevent blisters.
Toe Protectors/Toe Sleeves. These are similar to the prevention pads above, but are designed for toes. There are open ended sleeves and sealed cap versions.
Taping/felt techniques, for ball, toes and heels. These again tend to reduce high friction. Be careful NOT to tape already macerated or blistered skin. Some options; Adhesive Orthopaedic Felt, Fixomull Stretch Tape, Mole Skin, Leukotape P.
Hotspot Management
So, you get a burning sensation in a foot. This is a hotspot and this means you could be anywhere from a few minutes to a couple of hours away from a blister. When you get a hotspot, act immediately, use some of the options above to try and stop the blister from developing. You should stop IMMEDIATELY, don't wait, take action. Typically tapes and felts would be most useful at this point, it is probably a little bit too late for other techniques. I use moleskin when I get a hotspot.
Blister Management
OK, so now you have been unfortunate enough to get a blister. You must manage it very carefully. If not managed it can become infected, painful and cause a premature end to your hike. The steps taken next will depend on the state of the blister, but primarily the steps will prevent infection, reduce friction and promote fast healing.
Draining A Blister
It is always best to try and keep a blister intact to prevent infection. Some of the reasons why you would definitely not want to pierce a blister are:
If you do not have a sterile instrument to pierce it.
You don't have antiseptic wipes.
You don't have the right dressing.
You have no way to clean your hands.
If you are likely to get your feet wet or dirty
If blood blister, these are at higher risk of infection
If you have immune issues
Small and not too painful
You have to be prepared to monitor your blister and have the supplies to keep it clean if you are on a multi day hike. Needles are NOT a good idea as they only create a small hole which easily heals over. Also do not heat a needle to sterilise it, the black carbon soot left on the needle increases the risk of infection. I recommend using a sterile scalpel blade.
Dressing A Blister
The method dressing you use will vary depending upon the state of the blister and more importantly the state of the roof.
If the roof is torn then use an antiseptic swab to clean the blister first using clean hands
Dress with an island dressing. Island dressings are simply a small non adhesive pad in the centre of an adhesive pad. This will stop the blister from sticking to the dressing. Never just use adhesive tape as this will just tear the roof of the blister off when you remove the tape. These are often called just adhesive dressings.
If you have not already done so, try and reduce friction by using one of the methods already listed above under Blister Prevention.
If the roof has gone or mainly gone, then
Use an antiseptic swab to clean the blister first using clean hands
Dress the blister with a Hydrocolloid plaster, such as Compeed.
If you have not already done so, try and reduce friction by using one of the methods already listed above under Blister Prevention.
Types of Blisters
Here are the most common types of blisters referred to in literature.
Pinch
Big Toe (and knuckle) edge blister
Heel edge
Ball of foot
Inter digital
Arch blisters
Using Hydrocolloid Plasters
Hydrocolloid plasters are a special type of plaster that are designed for deroofed blisters. They contain a gel forming agent that promotes healing. When using these types of plasters, here are some useful tips.
They DO NOT prevent blisters.
Never put hydrocolloid plasters on blisters with a roof.
Only use on a deroofed blister.
Leave them on for days up to 3-5 days, do not take them off early.
Use tape on edge of plaster to stop edges rolling back .
Do not use them on extremely weepy blisters.
My Foot Care Kits
My kit varies sometimes depending upon location, climate and duration of a hike, but generally I have 2 kits, a standard one and an extended one. I use the standard kit for day hikes and long weekends, this is normally in with my first aid kit. I use the extended one for longer multi day hikes, typically four days and upwards. Basically the extended kit just includes a couple of extra items and I typically up the quantities a little.
Standard Kit
Engo Blister Prevention Patches - I find these a great form of prevention and put a couple of these on my insoles around the ball of my feet. This is a natural hotspot for me. Should last 500km
Fixomul Tape - for prevention and hotspots.
Leukotape P - for prevention and hotspots.
Moleskin - for prevention, hotspots and reducing pressure for a blister,
Antiseptic Swabs
Gloves
Compeed Hydrocolloid plasters - only for deroofed blisters
Scissors
Adhesive Dressings
Extended Kit
Engo Blister Prevention Patches - I find these a great form of prevention and put a couple of these on my insoles around the ball of my feet. This is a natural hotspot for me. Should last 500km
Fixomull Tape - for prevention and hotspots.
Leukotape P - for prevention and hotspots.
Adhesive felt pads - great for creating doughnuts to take the pressure off balls of the foot or heel blisters or anywhere. Although it is adhesive you will still need Fixomull tape as the adhesive is not great on feet.
Moleskin - for prevention, hotspots and reducing pressure for a blister,
Silicone toe cap protectors - for prevention
Scalpel blades - for piercing blisters.
Antiseptic Swabs
Gloves
Compeed Hydrocolloid plasters - only for deroofed blisters
Scissors
Adhesive Dressings
Cotton wool balls
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