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Avoiding and Treating Blisters: a Foot Care Guide for Runners

The state of runners’ feet is often something they’re a bit proud of. Missing toenails are as good as a medal to some runners and photos of gruesome blisters on social media abound. But while some minor issues can be seen as war wounds they can actually escalate quickly, end your race and even stop you running for weeks. So we went to speak to a podiatrist, Rebecca Roger from the Sidas UK podiatry clinic in Kendal, to get some authoritative advice on foot care for runners.

Blisters – avoidance and treatment

Let’s start with the obvious one – blisters. What causes them and how can we avoid the little monsters? Rebecca explained that we have two layers of skin – the dermis and the epidermis – and when there’s friction between the two a sac of fluid forms, separating the two layers, resulting in a blister. This often innocuous looking little thing can often cause pain and discomfort which is inversely proportional to its appearance. You take your sock off, thinking that at least this gruesome pain will give you an impressive photo for Facebook, only to find that it’s a teeny tiny thing. This is likely to make the modern runner quite angry.

Blister Transvulcania
‘Look, it’s huge!’ (photo by Runphoto.co.uk)

So how do we avoid blisters in the first place? Rebecca says we should be keeping our feet soft and supple all the time, moisturising and keeping on top of any dry, hard skin. Before a big event we should take particular care and show them love with moisturiser (like this moisturising Anti-Friction Cream) on a regular basis for at least a week. Maintaining your feet regularly really is the key as it makes you less susceptible to blisters.

If you do tend to get blisters, even if you take good care of your feet, then there are things you can do to protect yourself on the run. You can use a blister plaster or a ‘second skin’ silicone product or similar moleskin one to take preventative measures on spots where you get friction. If you are susceptible to blisters where are you getting them? Is it always one particular spot (eg heel or where two toes rub)? If so, could it be your shoes or a biomechanical issue? It’s worth looking at the source of the problem rather than just firefighting. A podiatrist could help you get to the bottom of the issue.

Should you pop?

What if the damage is already done and you’ve already got a blister? The big question is – should you pop it? Rebecca says do not pop, particularly if you’re doing a multiday and living with questionable hygiene. The skin over the blister protects it and if you pop it, it can easily get infected. The best course of action if you have a blister after a run is to take your shoe and sock off, clean the area thoroughly and then leave it to dry out (ie wearing sandals rather than putting a sock and trainer back on). It will heal up much more quickly if you expose it to the air as much as possible. If you are doing a multiday and have to run on it again the following day then put some antiseptic cream on it and put some sort of dressing on it to cushion it (like a blister plaster or silicone or moleskin patch).

But Rebecca says the key thing is to be on the lookout for any foot problems before they occur. If you’re getting some friction in a particular area, stop and deal with it. A 2 minute stop could save you hours of pain. This is blindingly obvious stuff but we all know people who’ve endured lots of pain or even had to DNF races because they ignored a minor issue and it turned into a major one. Rebecca’s advice is not to go anywhere without a basic blister kit consisting of:  plasters, savlon and some padding (eg silicone/moleskin).

Blister damage
Inspecting the damage, post race (photo by Runphoto.co.uk)

Black toenails and other issues

So what about the dreaded black toenail? So many of us suffer from this issue and its inevitable successor – no toenail. Again, you need to take a look at the cause for this but it shouldn’t be inevitable that you suffer, there are things you can do to alleviate the problem. For instance, if the issue is that your toenails are slamming into the end of your shoes going downhill (and you’re certain you’ve got the correct sized shoes on) you could try gel toe caps to lessen the impact.

So what else can a podiatrist help you with, apart from helping you get your feet in better condition? Well actually, anything lower limb related is the podiatrist’s territory. They take a holistic approach and while you might go to them with a bunion or black toenail, they might find that it’s being caused by a biomechanical issue. They can analyse your posture, how you put pressure through the different parts of your foot when you run, and how aspects of your gait might be causing recurring injuries. As Rebecca puts it ‘the foot is the foundation of your body and you wouldn’t build a house on faulty foundations’. You might find that the podiatrist is just the person to get to the bottom of lower limb injury issues that you haven’t been able to resolve.

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