"Many myths continue to be propagated regarding the prevention and treatment of friction blisters... Physicians, coaches and athletic trainers continue to advocate the use of petrolatum jelly and skin powders to prevent blisters while the scientific literature suggests these measures may actually increase the chance of blistering on the feet." Doug Richie Doctor of Podiatric Medicine (2010)
Blisters are caused by too much skin stretch.
Not rubbing, not friction, not moisture or heat.
When the skin stretches (shears) too far and for too long, the connections between skin cells fatigue and break. These tiny tears under the skin surface are the start of the blister injury. Fluid fills the injured area and thats when it starts to look like a blister.
Shearing is a parallel sliding of connected tissue layers across one another. Shear happens internally where the skin/foot is fixed to the shoe surface and the bones rub on the inside, whereas rubbing happens to the surface of the skin. When skin shear is excessive and repetitive, blisters form.
The following four factors (occurring at the same time) cause foot blisters.
- High pressure and friction
- Type of skin
- Moving bone
- Repetition
High friction levels cause the skin, sock and shoe to stick together for a bit longer and because the bones continue to move inside your foot, the skin is made to stretch and the microtears happen and a blister begins.
Some people have tougher skin, some are blister prone. Skin is weaker if it’s excessively sweaty or allowed to be damp for a long time. A build-up of too much callus can reduce your skins flexibility.
A hot spot (red, warm spot) is a warning sign that a blister is on its way. You only have a very short time to change the shearing forces or you will end up with a full on blister. If it has started to sting it’s too late, the micro-tears have started.
Aim = reduce the risk of skin shearing and not get hot spots in the first place.
Our top tips:
1. Check your shoe fit and change your lacing technique to minimise excessive movement within the shoe.
2. Moisture wicking socks enable the skin to stay drier and stronger and better able to resist shearing forces. Double socks (a thin sock inside your normal sock), allows the socks to glide and not your skin. The more time your in your shoe, the more soggy your skin gets, and the risk of blistering will rise. Change your before you go for a run, or play sport (even at half time) if it’s a hot day and you are blister prone.
3. Taping can act like a second sock but must be applied carefully, (absolutely no wrinkles or gaps!) and the correct tape must be used. How long the tape is on will limit the effectiveness of this technique, eventually it becomes waterlogged which will weaken the skin and will increase the risk of blistering again.
4. ENGO blister patches are awesome.
These are a Teflon like patch that reduces shear forces. They last about 500kms, stick to the inside of your shoe, are unaffected by sweat and only .38mm thick. You can target blister prone areas on your feet with these patches to prevent “hot spots”. If you have a blister you will be able to carry on playing more comfortably as the patch on the shoe liner will allow gliding of the dressing in the shoe and not add to the shear force friction already there.
Lakeside Podiatry is a proud stockist of ENGO blister patches.
For more advice on prevention and management of blisters, taping techniques and lacing techniques book an assessment with one of our Podiatrists: click here
We would like to acknowledge Podiatrist Rebecca Rushton (the blister guru and inventor of ENGO blister patches www.blisterprevention.com.au ) as a resource for this article.