Whether you have been running recreationally for years or weeks, some people are more prone to developing some pesky problems that can hold up your progress. When embarking on running for the first time, you may have advice from friends or family members. Even with this, you may have sought advice from a magazine article, a blog or maybe even a youtube video. Preparing to begin a running program involves a lot of work - when you do it strategically. Researching the appropriate pace and distance to begin can be confusing. Looking into the best way to stay hydrated on a long run when you get to that point is another consideration. It is important to implement stretching and complimentary strength training to support your running. In some cases, utilizing a massage therapist or even a friendly podiatrist might be useful.
We feel like we have done our due diligence if we have a new drawer full of attire to run in and gadgets to help make our run comfortable and safe. Some of us stop there though. Some do not consider preparation for their body. Some people have amazing moisture wicking shirts and water bottle belts but haven’t though hard about their shoes/socks. And, even if you have, you could end up with blisters on your feet.
Blisters are fluid filled lesions that develop under the superficial skin as the result of friction and pressure. Blisters can occur in a variety of severities. Some are small and heal over the course of a week or two and others may be more severe. The more severe blisters tend to be defined this way based on how large the blister is and whether infection subsequently develops.
There are about as many different foot structures as there are people in the world. There aren’t as many shoes in the world as this. Instead, we rely on the shoe manufacturers to provide a wide enough range that we can get close to the best fit of shoe. And I’m not just talking about size. Shoes do, of course, need to fit your foot appropriately from tip of toe to heel. However, supporting your foot and helping it to function effectively and safely means a little more than that.
You have probably seen in the shoe store (usually a running shoe store) that some shoes are neutral, some are built for over-pronators, some are built to provide more room in the forefoot. These are all specifications that can assist you in being well protected when running and exercising. Another element which is lacking in all to many people is the actual custom fit. So are there custom fit shoes? Well yes, but these are more shoes which patients are casted for if they have a history of amputation of part of their foot or if they were born with a foot structure or deformity that cannot fit in a prefabricated shoe. So for running – we don’t get our customization through our shoes. Instead, we do the best we can to get a shoe that fits our foot size and sometimes structure and then rely on customized support inside the shoe. This comes in the form of custom orthotics.
I have LOTS of patients come into the office and respond to the recommendation of custom orthotics with a look of concern. Most of these times, these patients are imagining a large device attached to their shoe or in replacement of their shoe. A custom orthotic is not that obtrusive. In most cases, it is used in place of the liner that comes within the shoe. If you are already wearing a shoe that is correctly fit, loosening the laces is typically the only ‘adjustment’ needed. If you wear dressier shoes, a custom orthotic can be built to fit this shoe in many cases.
So why are we talking so much about orthotics and shoes when this article is about blisters? The reason is that blisters occur as a result of friction on the skin. Friction is increased in certain areas on the foot because of foot structure. By trying to reduce this friction, we should be able to negate this cause of blisters on the foot in some instances.
What else contributes to the development of blisters? The shoes you wear do affect this in some cases, when the foot structure interferes with the material on the shoe. Some people have prominences on their feet which rub against the shoe. One very common area we see this happen is at the back of the heel bone. There is a condition called a Haglund's deformity, which is a more prominent bone in the back of the foot and many shoes do not accommodate for this. Believe it or not, custom orthotics can help some people to get the foot positioned within the shoe where this prominence will not rub as much. Some shoe brands can also be built in a way that places more pressure on the skin. Nikes, for example, are a more narrow shoe generally speaking. A person with a regular size and shape of heel bone may even develop blisters because of this.
Moisture also contributes to the development of blisters. When you run and sweat, the sweat can be absorbed by the material within the shoe and this can cause blistering.
In cases where you have a prominent part of the foot and have already purchased shoes and invested in custom orthotics but still have irritation, other on-the-spot options are available. Silicone tape and body glide can provide further prevention here. Silicone tape adheres gently but effectively to the skin in areas of know irritation. It provides a buffer between the shoes’ material and your skin. Instead of your skin being rubbed, the silicone tape will and then the skin remains protected. Some silicone pads are available as well and depending on the area you are trying to protect, the tape or padding may be more effective. Body glide is one type of anti-chaffing product available. It comes in balm or cream forms and the balm is typically most effective for blisters that could result on the feet.
In cases where you experience a blister, these are essentially a lifting of the superficial layer of skin and fluid then collects underneath here. This is a protective mechanism and would be effective if activity ceases after their development. However, if the blister forms and friction continues, this superficial piece of skin will slough (or fall/tear) off, revealing a more sensitive portion of skin. Blisters can result in infections and even ulcerations of the skin that can take a long time to heal. If you develop a blister on the foot, draining it can provide relief, but it is always essential to do this properly. Extensive blistering should be evaluated and treated professionally to ensure the best outcome.
If you have completed a long run, a half marathon or a marathon and developed blisters, take the time to let your skin and body recover. Make an appointment to ensure that the blister is treated appropriately and so that you can discuss with your doctor the warning signs that may indicate a need for follow-up sooner.