Blisters & Foot Care

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Experience From - Jeff Wold, Geraldine "Lady G" Wales, Jay Hodde, Jay Hodde#2, Charles Steele, Dave Emmons, Richard Pon, George Beinhorn, Suzi Cope#1, Nick Williams, Martha Eisentraut , Dave Littlehales , George Beinhorn , Matt Mahoney#1 , Diane Barker , Jim Stephenson , Nikki Robinson#1 , Dan Barnett , Nick Williams , Chip Marz , Nikki Robinson#2 , Suzi Cope #2 , Suzi Cope #3 , Jay Hodde , Dan Baglione , Melanie Jonker, Payton Robinson, Will Brown, Marv Skagerberg#1, Marv Skagerberg#2, John Vonhof , Damon Lease, Kevin O'Neal, Rob Grant, John Vonhof#1 , Rich Schick , Chisholm Deupree , Al Zeller , Tom Andrews , Karl King , John Vonhof#2 , Bill Ramsey , Matt Mahoney#2 , Kevin Sayers


Jeff Wold

Regarding my foot care question (what to do about the mostly cured blisters when I have a 50 miler to do?) of a week or so ago...

Based on collective wisdom, I'll be using Tincture of Benzoin to bond Compeed patches to the balls of my feet where I had blistering problems during FANS.

I had a tough time finding Benzoin, but I finally pestered a pharmacist at Walgreens to look it up. Turns out he had an opened bottle on his shelf but couldn't give me any without a prescription. But I could order a whole bottle myself -- .5 OZ for $6.09 or 2 OZ for $7.69.


Geraldine "Lady G" Wales

First some Vaseline wouldn't hurt and then ankle lengths are fine, then socks and then shoes wouldn't hurt I suppose. This really does work; I swear by it. It helps prevent blisters, hot spots, and one person even said it helped a heel injury he was having. I did a whole 48 hour run and had no hot spots or blisters.


Jay Hodde #1

On the foot problem thread, I guess I'm still quite amazed at what everyone else tries in order to prevent blisters, etc during ultras. I guess I'm one of the lucky ones, as the blisters I've had are due to one of two things:

  1. A fold in the heel counter material of the shoe (which caused me to run 92 miles at AC100 with a blister).

  2. Downhill pounding -- the blister forms on the bottom, not the back, of the heel. There ain't no duct tape or Vaseline available that can help that! I just "will the pain away".

My prevention strategy? Shoes that fit a little bit big, a double-layer sock, and **proper hydration**.

Staying well hydrated is a key to preventing blister formation (though I admit it won't matter at all if you have a rock in your shoe).


Jay Hodde #2

I initially wrote:

"My prevention strategy? Shoes that fit a little bit big, a double-layer sock, and "proper hydration"... Staying well hydrated is a key to preventing blister formation"
And Damon replied:
"I was definitely well-hydrated - so hydrated that I made at least 20 "stops" along the trail."
I wanted to reiterate a point that Karl King made: that adequate sodium intake is important in preventing blister formation (see his post for the full details).

When I wrote the above, I mentioned "proper hydration" and then followed with the term "well hydrated". They shouldn't be used interchangeably. Being "well hydrated" with fluids says nothing about the sodium content of the fluid; both are important. As Karl mentioned, low levels of sodium intake during an ultra can result in swelling in the hands and feet. That extra fluid, coupled with the rubbing/pounding will result in blister formation. So, "proper hydration" is important! Likewise, being "well hydrated" is important. If you are fluid-deficient, skin turger is lost. When you lose the normal levels of water in the skin, the skin can more easily rub and/or fold over itself -- this will also lead to blisters.

At AC100, I was fortunate to be able to try Karl's sodium replacement concoction (for lack of a better description). I got only the blister on the bottom of my heel (but it wasn't painful) and the small spot from the defective shoe (which I was forced to wear for 53 miles) never got larger. Amazingly, the nausea that I experienced at times during the run went away within 10 minutes of taking a "salt tablet". I'm sold on the idea that food and Gatorbarf (and other drinks) don't provide enough sodium replacement during the long events; as such, supplementation of sodium appears to help with fluid balance and really helps the stomach feel "nicer"!


Charles Steele

... Regarding blisters, I taped my feet substantially for arch support; this had the fortunate side effect of reducing blistering. I don't usually have bad problems with blisters, but had fewer than usual, which surprised me given my low mileage training this year. I taped as follows: applied tincture of benzoin to all places where tape would go, then applied strips of cheap athletic tape running laterally, starting back at the heel, with each successive strip closer to the front of the foot, and each strip slightly overlapping. The tape was applied tightly with the foot in a relaxed position, being *VERY CAREFUL* to avoid wrinkles in the tape, which will create blisters very quickly. The only blister I earned this time was on top (!) of my left foot, in a spot where the tape rubbed a tendon. I didn't notice this blister until it popped at mile 49.


Dave Emmons

At the recent AC 100 I had a rather large blister on the bottom of my foot. The blister had ruptured during the race at about 62 miles. I did my usual Spenco second skin and Adhesive Knit repair on trail and it served well until the end of the race. After the race my wife found a product called Spyroflex. Spyroflex , as the manufacturer claims, is a passive rubber membrane with intelligent adhesive. The idea behind this thing is that you apply the bandage directly on the injured area. The adhesive sticks to only the healthy skin and allows the damaged area to weep the exudate right through the bandage. The manufacturer claims you can wear the bandage up to 7 days without removal even while bathing or swimming! I have been favorably impressed with the product. It does everything the manufacturer claims. I even wore the bandage while in the Jacuzzi without it falling off. The blister I had, which was very inflamed and sore completely healed in one week. The package I got had five 2" X 2" square bandages and sold for $ 5.00 at the local Sav-On drug store. I did only limited running when I was wearing the bandage so I don't know how they would hold up during a trail race. The most running I did was 6 miles on pavement and had no problem with the bandage coming off. The only down side is the bandages are extremely thin. I would guess only 2 to 3 mils thick so therefore they do not provide any cushioning effect like the Spenco Second Skin.


Richard Pon

Dave wrote:

"I did only limited running when I was wearing the bandage so I don't know how they would hold up during a trail race. The most running I did was 6 miles on pavement and had no problem with the bandage coming off. The only down side is the bandages are extremely thin. I would guess only 2 to 3 mils thick so therefore they do not provide any cushioning effect like the Spenco Second Skin. If any of you have had experience with this bandage I would like to hear any comments."
Spyroflex looks like it would work well on existing blisters, and for "normal" use. For long runs I would prefer using another product.

I bought a box of Spyroflex at the San Francisco Marathon Expo in July. For me, the pads tend to move around and come off after 20 miles on pavement and just 15 miles on trails. I have been keeping the pads in place by wrapping athletic tape around my feet. This seems to work ok (at least up to 50 miles), but it doesn't seem to have the cushioning effect or be able to stay in place like Compeed. When I'm done with this box of Spyroflex, I switching back to Compeed. These products are expensive and I generally use them only on runs of 50k or more.


George Beinhorn

Gloria Deem wrote:

"There have been a lot of talk lately regarding the use of "duct tape" and wrapping the feet. Could anyone expound on this procedure? What kind of tape is duct tape? How does the tape go on the feet, from heel to toes or from one side of the foot to the other? How far up the foot do you tape? What keeps the tape from coming off or getting wrinkled? How do you know if the tape is too tight?"
You should hope Suzi T responds. She's the duct tape expert. However...

Okay, duct tape was created to wrap ducts. (Surprise.) I.e., heating ducts, etc. like under the ceiling in your basement. Great thing about it is, if you get the real kind, not the wimpy household kind, it really sticks and it doesn't fray. Go to the lumber yard or hardware store and get some heavy duty duct tape.

Personal experience: wrapping my feet, I often have to pull off what I've done and start over. Too many wrinkles, too tight, too loose, etc. I generally start in the forefoot and work backwards. The important thing is to get the tape smooth, no wrinkles, and not too tight. Feet swell during an ultra, and you don't want to cut off the circulation.

If I had run ultras and never had blister problems, or if I fully trusted my Trail Gators, I'd probably skip the duct tape. But it's kind of a cool ultrarunner kind of thing to do. I enjoy the ritual, and I never inhale.


Suzi Cope

Evelyn Rodriguez wrote:

"I went hiking on Thanksgiving and wore some old hiking boots with socks that were obviously too thick. On the uphill, I think the shoe/sock just rubbed too hard on the back of my foot (just above the heel) to wipe off the first layer of flesh in an area the "size of a sand dollar. I am doing a 67K ultra next weekend in NZ and was wondering if anyone had any suggestions just in case this does not heal adequately in the next week. I don't think Compeed would work in this case. It works great for blisters, but I'd rather not place sticky tape on this raw skin (will have to strip it off eventually...ouch!). Has anyone tried the stray-on Second Skin Bandage? Also, how about any ideas on what can help the healing process (this may be similar tactics as with blisters)."
With a similar injury I would clean the area well and then apply Second Skin (not the spray) in a large enough piece to cover the entire raw spot. Second skin is used in burn wound care, because it acts as a moist bandage. Cover the second skin with either the tape provided in the "all- inclusive" pack, or use my favorite, Johnson and Johnsons Elastocon. You need a tape that is both MAJOR adhesive, porous, and flexible. Be certain all the edges of the second skin are covered so that dirt cannot get into the wounded area.

I find that even if the wound is on the bottom of my feet, the second skin provides pain relief, cushion, cleanliness, and a healthy healing environment.


Nick Williams

Suzi's advice is really great. I have another thing you can try if you can't find Second Skin. Take Duct Tape and cut a square of it bigger than the blister and put it on another piece of Duct Tape stick side to sticky side and then place it over the blister. That way the silver back that is over the blister will slide over the blister and not cause problems. I carry about a foot of Duct Tape with me on really long runs so if there is a problem I can sit down and tape a blister up and not have to get to an aide station to treat it.


Martha Eisentraut

Every time my blisters heal the top skin dries up, peels off and leaves me with tender new baby skin underneath. I tend to get blisters in the same place repeatedly. I've tried taping my feet with Duct Tape which works for a few hours. I used Compeed during the JFK50 but blisters rose up under the Compeed and then popped. I'm willing to try new ideas, so maybe I'll start with running without socks and see how it goes from there.


Dave Littlehales

Martha Eisentraut wrote:

"I thought I heard somewhere about a product you paint on your feet that toughens them up. Does anyone know about that?"
Sorry, Martha, I don't, but please don't make the mistake that I did 1 week before the Cool Canyon Crawl 50K. Thinking that I would be kind to myself, I had a pedicure. I was reading a magazine, and before I knew it the pedicurist had "scrapped" (not sure of the technical term) my callouses off the bottom of my right foot. Predictably, I had HELL to pay @ Cool Canyon with major blisters. So Matt Mahoney is right, don't taper with those callouses-- they develop for a reason...


Matt Mahoney #1

George Beinhorn writes:

"Maybe some people don't know this yet, but wrapping your feet with duct tape (carefully and not too tightly) before an ultra works great. Also, wearing Trail Gators."
I have not yet tried such advanced techniques, though I have seen some fairly elaborate schemes, sometimes requiring hours of work the night before an ultra. I've heard of one story in which a runner at Western States peeled off the tape covering the bottom of his foot -- and all the skin with it.

I have also discovered the miracle of Vaseline. I used it for the first time at Barkley, just a couple of small dabs on some hot spots. Even though my feet were wet the entire 24 hours and looked like white prunes on the bottoms, I had no blisters. Don't overdo the Vaseline, since you don't want your feet to slide around inside your shoes.

Now that the temperatures here in Florida are in the 90's every day, with bright sunshine and high humidity, I have taken to walking barefoot on hot pavement to toughen my feet for the upcoming summer ultras (such as the Wickham Park marathon and 50 mile fun run in 3 weeks).


Diane Barker

In reply to Martha Eeisentraut's query about a product to put on the feet to toughen them up, there is also some stuff called *New Skin* liquid bandage, which I have used on occasion. It contains: Alcohol 6.7%, Pyoxlyn solution, Oil of Cloves, and 8-Hydroxyquinoline, according to the label.

It smells a lot like turpentine, so I'd have an open window when putting it on :-) , but it seemed to do the job for me. I don't know how it would hold up in a 50- or 100-miler, however. Perhaps someone could try it and report back later....


Jim Stephenson

I stole a concoction from one of George Sheehan's books - tincture benzoin, alum, tannic acid, and petroleum jelly. I replaced the petrolatum with skin lube (which just has some stearic acid added to raise the melting point), and I took out virtually all of the tannic acid, as it has too many side effects. In theory it should help. (I believe Dr. Sheehan just soaked his feet in brine, and only offered this goop as an option.)

My resulting cost was about $2.50 an ounce, making it from scratch. Considering all the leftovers I have, probably more like $40 an ounce. I think it is better to run in socks and/or shoes, or to learn how to run without touching the ground, than to fool around with such things.


Nikki Robinson #1

Diane Barker wrote regarding a product called New Skin:

"It smells a lot like turpentine, so I'd have an open window when putting it on :-) , but it seemed to do the job for me. I don't know how it would hold up in a 50- or 100-miler, however. Perhaps someone could try it and report back later...."
I tried this stuff during the Mardi Gras Ultradistance Classic 125 miler in March. I put it on *after* I developed bad blisters (after lancing the blisters, draining them, and packing them with antibiotic cream). I sprayed it on, let it dry, and put on clean socks. It seemed to work reasonably well, but I think once you get the blisters, you are in trouble. And nothing will help much.

I may try from the get-go in a run. Actually, I'll give it a go a Ice Age this weekend. I got fairly bad blisters there last year. I assumed the blisters, in that instance, were due to all the squish, squish, mud & water we had.

I'll report on the success (or lack thereof) after the event.

from succeeding post...

As I promised Diane I tested New Skin liquid bandage this weekend at the Ice Age 50. I sprayed it on all over my toes and the balls of my feet in the hotel room and let it dry before putting on socks and shoes. Result: it worked reasonably well -- I got fewer blisters than I had gotten previously. I would use it again with some confidence. I still need to try duct tape sometime though. The tape would be cheaper.


Dan Barnett

When I played high school sports (many moons ago) our trainers had a product called Tuffskin or Toughskin, or something like that. Anyway, It was made by Cramer, who also made Cramer-gesic, a foul-smelling Ben-Gay sort of goop with which we perpetrated unspeakable horrors on freshmen. This Tuffskin stuff I think would be good for preventing blisters: it made a sort of fake callous on your feet. I'm not certain if it is available to the general public, though: You might have to be a certified athletic trainer or something to get it. I know there are times that I wish I had some...


Nick Williams

I have used duct tape for several years and it works really well even if you have blisters and then apply it.

The way to do it is to either put a piece of paper or another piece of duct tape the size of the blister or just a little larger on the inside of the duct tape on the sticky part. If you put duct tape to duct tape, put the sticky parts together. What happens is the slick part against your skin slides over the blistered area and will not cause friction on the blister so it won't get worse.

Paper or tissue (I have used both) will disappear over time or it will roll up. Sticky part to sticky part will not. I do my big toes and my small toes. I don't have trouble with the other ones. I tape across the balls of my feet from up on the side of the feet. I overlap the tape about 1/2 inch or so and I usually do two pieces of tape. If the course is side hill I will also do my heels, but I usually don't have to do that.

There can be a problem with the toes if you do not tape all of them but that is usually not a problem. If there is I carry Vaseline and I will put it on the side of the tape so the tape slides and not sticks. If that is a problem I will remove the tape from my toes.


Chip Marz

Nikki mentioned that she wanted to try duct tape on her feet as a blister preventative. One caution...be REAL careful taking it off. On more than one occasion I pulled toenails off with the tape. I used to tend to blister under the toenails, and eventually they would die and fall off. That, however, usually took several weeks. Pulling them off with the duct tape BEFORE THEY WERE READY to come off was quite painful.


Nikki Robinson #2

Thanks for the great advice about how to apply duct tape. One of the reasons that I had not tried it was that I could not quite see how one would avoid pulling skin off with the sticky side if one put it on already-formed blisters. (Which Chip Marz also warns me of, regarding toe-nails, in another post.) You suggest cutting out a smaller piece of tape, applying sticky side to sticky side, then the slick side facing the blistered skin can slide and protect all at once.

I have one point regarding your advice that I am not quite clear on. Do you suggest doing the "sticky side to sticky side" taping even if you do *not* have blisters. That is, before the run, if I wanted to protect the balls of my feet, would I apply a strip of tape, sticky side down, directly to the skin? Or would you cut out a long strip smaller than a bigger strip, put them sticky side to sticky side, then tape across the ball?


Suzi Cope #2

Runners using Duct Tape, or my favorite, "Elasticon" may be pleased to have a suggestion on the painless removal of foot tape. I tried everything from finger nail polish remover, soap and water, paint thinner, and just plan pain tolerance. No method seemed to help, especially with tender tired post 100 feet. Adding to the condition of course is a runners tendency to cramp any where while attending to these SIMPLE post ultra functions. Finally I stumbled upon the solution that is the solution. BABY OIL! Gentle message, lots of oil make the feet feel sooo good, just rolls the tape and excess adhesive off gently. Only thing better would be getting some other person to do this for you!


Suzi Cope #3

Will Brown wrote:

"Following a blister extravaganza at Umstead, I'm back at square one trying to break the code on prevention. The terrain was probably a factor - hard dirt bridle trail strewn with small rocks, but I think the bigger problem was moisture control. I rubbed Runner's Lube into my feet well, followed by nylons and the thin version of Wigwam's Ultimax sock. That had worked well in 50 milers. I changed nylons and socks at 50 miles and noticed that my feet were pretty slick with Runner's Lube and sweat.

My theory is that it was mostly moisture that caused the blistering in the second 50. I think the nylons may have prevented moisture from wisking out well through the Ultimax sock. My feet swelled up in the second 50, which caused big toe problems, but I don't think that contributed to the blistering. If anything, that would have reduced friction in my shoes. Any thoughts?

I think I'll drop the Runner's Lube and nylons and concentrate on moisture control with more frequent sock changes, and maybe a different sock. I saw a Merino Wool and Nylon sock reviewed in Runner's World recently (I buy it for the pictures, mostly). What caught my eye was that Martha Swath won last year's Leadville in them. The name of the company is Smart Wool. Has anyone tried these?

I've been using the Wigwam Ultimax "outdoor trainer" for over a year now and find it very good for the tough courses. The blend is 40% Olefin (polypropylen) 30% nylon, 20% Acrylic, 5% spandex and 5% wool. They seem to wick very well. Even better, they have both cushion and very conforming fit. The only drawback has been the dye in the upper sock area leaves my skin greenish when they are new. I'll take the green over the blisters any day. I can say honestly that I have been using preventative taping less since discovering these socks.


Jay Hodde

Will says:

My theory is that it was mostly moisture that caused the blistering in the second 50. I think the nylons may have prevented moisture from wisking out well through the Ultimax sock. My feet swelled up in the second 50, which caused big toe problems, but I don't think that contributed to the blistering. If anything, that would have reduced friction in my shoes.

I disagree. The foot swelling contributes to the formation of blisters for the following reason: Fluid is being shunted from the bloodstream into the extracellular space. This extra fluid decreases adhesion between adjacent layers of skin, causing them to rub against one another. The rubbing leads to blister formation.

Dehydration leads to blister formation, too, but for a different reason. In dehydration, the skin loses its turgor and begins to fold on itself. The folding enhances blister formation.

Adequate and proper hydration is necessary for blister prevention.

Will says the "unwickability" of his nylons/socks increased the amount of moisture that stayed around the sock, leading to blisters. My personal experience (which is different from other's, I acknowledge) is that moisture has very little effect on blister formation. I can run with wet feet all day without a problem.

So what was it at Umstead that could have led to problems? The dust. Sand particles end up getting trapped between the skin and the socks, which leads to friction, which leads to blisters. The swelling that Will mentions reduced the amount of room in his shoes to such a degree that the friction was enhanced.


Dan Baglione

I wear single layer socks over double layer socks. I don't change socks, I walk through major streams, I don't get blisters.


Melanie Jonker

In Gary Yanker's book "Walking Medicine", he recommends covering your feet with cornstarch before running. Simply place some cornstarch in a plastic bag and place your foot in the bag, holding the opening around your ankle to prevent spillage. Shake your foot and try to get it completely covered. He finds this keeps his feet dry during a run. If you want more of a description, let me know and I'll bring the book in and try to describe it a bit better.


Peyton Robinson

Duct tape clean feet, if not prior to running, then *try* to tape them before blisters actually appear. Though even over blisters or holes in the skin, duct tape still works to prevent further damage to the area.

Put the tape cross-ways on the sole of your feet, at a hot spot. Do not wrap tape around the foot, nor even close to being a wrap -- the foot needs room to swell. At least, my feet seem to need some room. Strips about 6 inches long work for me. Even in wrapping toes, I try not to go completely around, but it doesn't seem to be as critical to allow for toe swelling.

There's not really much too it, though I've seen people with lots more tape on them, completely wrapped around feet and ankles. Others may not have the swelling that I do.

I got a quick lesson in taping during an ultra, and with a little home practice, got it down to what works pretty quickly.


Will Brown

Thanks to all who offered advice, both on-list and off. I thought I'd summarize the off-list responses for all. I know blisters have been discussed at length before, but it seems to be a wide enough problem to rehash it periodically.

The MINIMALISTS suggested single layer, tight fitting socks that can't bunch up. Coolmax socks and the Wigwam Ultimax Triathlon sock were preferred brands. This group did not feel that lubricants helped, and may in fact worsen the situation. Many in this group did not believe in changing socks or shoes in a 100 miler, preferring not to mess with their feet unless they hurt very badly. The role of hydration and sodium in preventing swelling and blisters was part of this group's strategy. In summary, this group felt that LESS is MORE, when it comes to blister prevention.

The MAXIMALISTS tended toward more complex solutions. The lubricant, nylons and wisking socks combination worked for some, but not for others. The Smart Wool socks got a good review, as did Cramer Skin-Lube for 100's. This group tended towards frequent foot maintenance and repair in a 100, including sock and shoe changes. Foot powder was preferred by some over lubricants. One person noted the role of the insole in moisture control, preferring Spenco over others. The diversity of solutions in this group suggests that what worked in one race may not work in another, and that what worked early in a race may not work later on.

Thanks to the lists, I've got a new game plan. I'm going to drop the lubricant and nylons and stay with a thin sock like the Ultimax Triathlon. I will have a pair of larger shoes in a drop bag at 60 miles, in case swelling occurs. I will increase my sodium dosage - it might have been a little low to prevent swelling. Finally, I'll use physical protection on the balls of my feet, which I now know are prone to blistering beyond 50 miles when swelling occurs.


Marv Skagerberg #1

One more thing to add to the summary. interesting that any hint of this thread leads always to a heavy response -- probably an indication that blisters are the number one universal problem at least a lot of the time.

my thought in summary is that HEAT is the culprit. old ultrarunners used to pour water into their shoes for cooling. and dehydration lurks where you find heat also.

I think any combination of fairly frequently applied lubrication/sock changing causes frequent cleaning AND cooling of the feet in the process. Of course, these processes also slow you down. When you really go for it, you generally end up with blisters anyway that you just pound into the ground. they're not bad really if you don't stop.


Marv Skagerberg #2

In Gary Yanker's book "Walking Medicine", he recommends covering your feet with cornstarch before running. Simply place some cornstarch in a plastic bag and place your foot in the bag, holding the opening around your ankle to prevent spillage. Shake your foot and try to get it completely covered. He finds this keeps his feet dry during a run. If you want more of a description, let me know and I'll bring the book in and try to describe it a bit better.

Interesting. I've never seen corn starch used on feet. But, corn starch has long been used by multi-day runners as the anti-chafing solution of last resort. After all else has failed, you just pour the stuff down your shorts or wherever, and the relief is immediate and good for a few hours, then you do it again. However, it's very messy and coats your legs or whatever with a layer of white crap, to top off the lotions, unguents, sun block, hot stuff, Ben Gay, mud, dirt, cinders, airborne pollens, bits of nuclear radiation, low flying bird feathers, envirolube, etc. previously applied.

I have a particular memory of Gary Cantrell at Pennsauken in one of his few pitiful (his words) attempt at a multi-day -- feet ENTIRELY wrapped in duct tape, toes taped separately underneath, & corn starch all over his lower body with muttered references to where it was doing the most good - somewhere the sun was shining or not.


John Vonhof

In a recent email, Chip Marz wrote....

Based on the variety of responses, we at least have diversity in our blister prevention techniques if nothing else. Also seems like any one of those methods may or may not work at any given time. Maybe a change of feet will do the trick.

The eye-openers as I researched and wrote my book on foot care was the following five findings:
  1. the extent of the problem so many athletes have with their feet;
  2. that so many of these same athletes naturally expect to have problems, because;
  3. what has worked for them in the past no longer works;
  4. what they see other athletes do with their feet does not work for them,
  5. they do not know what options they have to fix their feet.
Hence, frustration. Chip is right. Each athlete, whether a runner, adventure racer, or long distance hiker, needs to find what works for them by exploring the foot care options available to them. Some will be proactive, dealing with blister prevention, while others will be reactive, dealing with their blisters after they form. This is all based on what experience they have, what they read on the subject, and/or what friends have told them. Some works and some doesn't. But you have to explore the options.

Author of: FIXING YOUR FEET: Preventive Maintenance and Treatments for Foot Problems of Runners, Hikers, and Adventure Racers.


Damon Lease

I got lots of e-mail on this subject last week. I even compiled a summary of all the answers if anyone wants to see it. The overwhelming favorite choice seemed to be to try duct tape again, with lots of Vaseline on the outside of the tape.

So, I covered my toes with tincture of benzoine, carefully wrapped them in duct tape, put lots of Vaseline around them, and headed out for a 30 miler on Saturday. The little toes were sore already before I started, but I barely noticed. I got through the run with no blisters at all, and I was thrilled. This was the most pain-free long run I've done in months, at least from a blister perspective.


Kevin O'Neal

Subject: Compeed

Mark A Kunkel wrote:

"Caroline, the recent finisher of the Bartram Bash 35-miler (notice new name), long-time training partner, and ongoing blister sufferer, has asked me to post to the list on her behalf and see if anyone has leads on sources for Compeed. I seem to remember getting a sample at one of my recent outings (Mountain Mist? Mississippi Trail?), but can't for the life of me remember what I did with it. Put it on a toe, I guess. Any suggestions for Caroline?"

I get the local pharmacist to order it for me. He's willing as long as I buy a case. I think it's around $25. Make sure to order the large size. They also come in odd shapes. I got stuck with a case of Compeed strips that are about 1/2 inch by 3 inches.

You can stick it on a blister and keep running. I know where I tend to blister so I put one over the spot before a race. At a hot, sweaty marathon last year, I got through it pain-free. When I pulled off the Compeed I found a blood-filled blister more than an inch in diameter. I put another patch over it and left it there for 2 weeks--that's how long they can last, even with daily showers.


Rob Grant

I was serious about sanding the calluses off the feet to prevent blisters with 60 grit sandpaper. I really believe if callus builds up too much it changes the foot's position ever so slightly so parts of the foot are rubbing where they shouldn't in the shoe. Anyway we all know what it's like to get a blister under a callus, so if there"s no callus and a blister does develop, it heals a lot faster. Have to be careful on the sanding, it's a delicate balance to not remove too much. Foot Sculpturing! there's a whole new field for someone.


John Vonhof

Bill asks,

"Has anyone heard of using Tincture Benzoin Compound to prevent blisters? A local pharmacist told me that rodeo bull riders use Tincture Benzoin Compound on their hands to prevent blisters. Apparently the compound tightens and toughens the skin."
Tincture of benzoin can be used several ways.

  1. It can be used as a coating for the feet, toughening the skin. This is then usually followed by a lubricant such as AVON's Silicone Glove (a cream). Tincture by itself is sticky and must be allowed to dry before applying any other substance to the skin. Instead of a lubricant, one can use a good powder on the skin. Be sure the toes do not stick together!
  2. Tincture can be used as a taping base. Apply it to the area where you want to tape or apply a blister patch, and let it dry. Then apply the tape. It is routinely used in hospitals to help bandages and steri-strips adhere to the skin.
  3. Tincture can be injected via a needleless syringe, into a drained blister. Immediately press the blister's roof down and it will adhere to the blister's base skin. This seals the blister. Be forewarned that this is rated as a "very painful" yet it is short lasting pain. It will produce a severe burning sensation. With the blister sealed, apply tincture to the skin around the blister, and then apply a tape patch over the top. This extreme method of blister repair is suited for sports where the participant must continue in the event, not at the finish line of an event.


Rich Schick

The practice of injecting Benzoin into blisters was a common practice in the Army for some years. It resulted most times in some relief after the initial pain subsided but in some cases it resulted in severe inflammation and prolonged disability. The practice was banned under threat of legal action for anyone caught practicing it.

My own favorite technique is to snip a small hole in the blister with a pair of scissors. This creates a fish mouth shaped opening that does not seal shut as easily. Another very effective treatment if you have access to suture supplies (easily obtained through veternary supply catalogs and stores) is to pass a single strand of suture through the blister, tie a knot on both ends to keep it from pulling out, and snip off the excess. This technique has the advantages of being relatively sterile and not allowing air to get to the interior of the blister which makes it less painful. The suture acts as a wick. It will sometimes quit draining in which case you pull it back and forth from knot to knot a couple time and it will work properly again. The suture is removed in a couple days when the soreness subsides.

For duct tape afficiendos another good technique is to drain the blister with scissors as above if it hasn't popped on its own, clean it up good, then apply a steroid cream, hydrocortisone or something more potent if you can get it, then apply the duct tape over the top. Be sure to stretch out the skin to its fullest when appling the tape or it will pull when running. I know someone out there will point out that using a steroid under an occlusive dressing and over an open wound will lead to systemic absorption of the steroid, and this is true, but the risks are minimal if not done on a habitual basis. They are considerably less than such common practices as taking Motrin, Aspirin and other anti-inflammatories during ultras.

Of course as always these are not medical recommendations, just things I've heard work and except for the benzoin bit, have and will continue to do myself.


Chisholm Deupree

Tincture of Benzoine has many uses for the treatment and prevention of blisters but my experience with it is that the stuff is messy and painful . After the blister has formed a runner may puncture the pillow and fill the void with the tarish substance.(use a hypodermic) Once it dries the void hardens and the friction of skin seems absent.But the burning sensation on open skin is intense. Others may use it to replace stickum spray to keep tape from peeling but the mess is best as a last resort. Anyway that's how I see it.


Al Zeller

Drix wrote:

"I am not so sure this is the truth. Everytime my feet got wet, I also had blisters. The water tend to soften and soak the skin on the sole of the foot, and then it blisters."
I tend to agree with Karl that wet feet do not a blister make. Mohican 100: cool, rain, rain and many stream crossings - feet stayed wet whole 24 hrs - not one blister. Arkansas 100: dry, cool, same shoes, same sox, same time - blisters galore.


Tom Andrews

I have run trail ultras and track runs for years and found something that works well for me if my feet will be getting wet. I coat my feet with a light coating of Vaseline; just enough to make my feet waterproof so they won't wrinkle all up.


Karl King

The primary causes of blisters in ultra runners are two:

  1. poor mechanical fit of shoes and socks, and/or

  2. insufficient sodium in the body due to losses while sweating.

What happens in the latter condition is that as a runner sweats in hot conditions or very dry conditions, sodium is lost thorugh the sweat glands, and is deposited on the skin (white side burns, crusty clothes). If additional electrolytes are not ingested to replace the losses, the sodium concentration of the blood plasma begins to decrease. The body will adjust kidney function, and plasma concentrtion of the hormone aldosterone to help maintain sodium concentration. If, however, not enough electrolytes are taken in, the sodium level of the blood will fall to seriously low levels. At that point, water from the blood plasma will be transferred into tissues external to the circulatory system, causing hands and FEET to swell. Those swollen tissues are less able to support the mechanical abuse of running on them. Friction spots in the shoes become the site of blister formation.

Thus, Marv Skagerburg's comment that heat, not water causes blisters. It is the heat that drives the sweat rate up, the sodium levels down, and ultimately leads to blister formation. Wetting the feet, the head, the shirt or whatever helps cool the body and reduce the sweat rate.

Before I worked on my electrolyte formulation, I had the black toenails like many ultra runners ( 6 at one time ). Since using the electrolytes on my hot runs, all toenails got a rest from the damage and have grown back. Now there are 10 pink ones down there. I changed nothing else of significance in my training and racing.

Stay cool, replace your lost electrolytes, and blisters and black toenails will be greatly reduced or eliminated.

Refer to Sodium Dehydration Article for additional information.


John Vonhof #2

Karl King wrote:

"The primary causes of blisters in ultra runners are two: poor mechanical fit of shoes and socks, and/or insufficient sodium in the body due to losses while sweating."

Then after an explanation on the relation of insufficient sodium and blisters forming wrote the following

"Stay cool, replace your lost electrolytes, and blisters and black toenails will be greatly reduced or eliminated."
Remember to deal with the "poor mechanical fit of shoes and socks" as well as related factors which cause blisters:

The bottom line is to educate yourself and learn what works for you. There are as many different suggestions as there are runners. If there was one "sure-fire" method of preventing blisters that worked for everybody, there would be no market for my book and we would all run with healthy feet. Until the perfect shoe, the prefect sock, and the perfect foot is made, learn for yourself and heed the advice of those more experienced than you. Karl make sense.


Bill Ramsey

From my own experience, Karl is right-on with respect to electrolytes. Until I succeeded in consuming adequate salt in the course of 100 miles, I had terrible blisters including several layers of skin separating from the bottom of my feet. I've found that the combination of thin Coolmax (or comparable) socks, sock changes and re-lubricating (Bag Balm) every 25 miles, and continuous fluid and salt intake will effectively stave off blisters. Last year, I ran two hundreds resulting in a hot spot or two but NO blisters. To be successful at 100 miles, you have to take care of your feet!


Matt Mahoney #2

Blistering is an adaptive response to friction. You will notice that after a blister heals and the outer skin peels off (assuming you didn't pop it), the skin underneith is tougher and more resistant to blistering in the future.

You can therefore TRAIN to avoid blisters. The idea is to exaggerate the wear on your feet, training to the point of causing blisters, then let them heal. Do not pop them. It takes 2 days for the fluid to drain naturally, after which you can run on them normally. The outer layer of skin protects the blister while the new layer is still growing, which takes a week or two depending on your age.

A good way to toughen your feet is to run without socks in a variety of shoes, and to walk and run barefoot over progressively rougher surfaces and longer distances. Going barefoot toughens the bottoms of the feet, the most important area you should train.

The first time I ran without socks, several years ago, my shoes were bloody after 3 miles. Last Sept. I ran the Superior Trail 100 without socks and without blisters. This year I plan to run Barkley, Western States and Hardrock without socks. Running without socks has many advantages: your feet are lighter (especially when wet), they dry quicker, and you get a better grip on the soles so your feet don't slide around in your shoes when running downhill.


Kevin Sayers

Matt wrote:

"You can therefore TRAIN to avoid blisters. The idea is to exaggerate the wear on your feet, training to the point of causing blisters, then let them heal. Do not pop them. It takes 2 days for the fluid to drain naturally, after which you can run on them normally. The outer layer of skin protects the blister while the new layer is still growing, which takes a week or two depending on your age."
Toughening of the feet does NOT guarantee blister free running. In fact this approach can cause damage that takes longer to heal. At one time I could challenge anyone to a ...whose feet are tougher game. My feet were a bushmen/firewalker's dream. Impervious to almost all minor punctures and discomfort. Since ultra running I now get blisters underneath my calluses on the balls of my feet. In fact the only places that I get blisters are underneath calluses.

I'd much rather tape a blister that I can see and deal with it rather than one that's beneath the skin. Past history has shown me that a blister usually heals in less than two weeks. If I get a blister underneath a callus it takes 4-6 weeks for the skin to peal off and another 4-5 weeks to replace it with decent skin.

Another problem with calluses is that as they toughen up they also grow. That growth can/will interfere with the fit of the shoes which in turn will cause a blister one way or another.

I now use a callus file, making sure that no callus is too big and that the skin remains reasonably soft.

"A good way to toughen your feet is to run without socks in a variety of shoes, and to walk and run barefoot over progressively rougher surfaces and longer distances. Going barefoot toughens the bottoms of the feet, the most important area you should train."

I agree with this. But don't make it too easy on yourself. I found that walking on hot asphalt sprinkled with glass in the summer also has advantages, not to mention heat acclimation benefits. In addition, running in a variety of shoes like... wingtips... is a fashion statement that will gain the admiration and praise of all types of runners. :-)

"The first time I ran without socks, several years ago, my shoes were bloody after 3 miles..."

...Yea, I was trying to train myself from having headaches by beating my head against a brick wall. After the first few bloody encounters it got better... :-)

Why someone would want to put themselves through this kind of training is beyond me. Why not run smart and at the first sign of potential problem take care of it.

"Running without socks has many advantages: your feet are lighter (especially when wet)"

Do not know about anyone else but I've never had socks that by taking them off made any weight difference. My logic tells me shoe weight would be more critical if your into that kind of thing. But then again the first step in mud, water or slime would negate any weight advantages anyway.

"they dry quicker, and you get a better grip on the soles so your feet don't slide around in your shoes when running downhill."

Maybe I'm unique but my feet sweat and when they sweat they dampen socks and shoes. Without changing my socks, my shoes would have a permanent sweat slick on the bottom. (I base this scientific finding on a lifetime of wearing loafers w/no socks.). My feet slip all over the place when this happens. If my shoes are dry my feet do not slip. If a stream crossing or rain is in the picture my shoes expand slightly and unless I change into heavier socks they will slip. So I figure what's the point.

For some runners sockless feet or even bare feet will work to their advantage. Judging from the runners that I've seen crossing the finish line those wearing socks appear to be in the majority.

A little prevention with tape, Vaseline, jells, socks, nylons etc. and common sense during an event makes more sense,to this runner, than counting on a questionable tuff feet routine that my or may not work and in my case it has not worked.