Blister Treatment...

7:19 p.m. on April 30, 2009 (EDT)
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Blisters...the bane of exercise enthusiasts! I was asked to post my tips as I have picked up some good tricks and ideas over the years.

A very simple fix is to just cut a center hole in a band aid pad, just larger than the blister, and affix. For little blisters, that works pretty well.

I have also used the "holed" bandaid, then put a regular bandaid over the top of the "holed" one.

Mole skin can be used in a similar fashion. Lots of people make the mistake of plunking a chunk of moleskin right over an existing blister. That can often aggravate the problem, PLUS one can pull the blistered skin right off.

Also, be sure, when using moleskin on the pinky toe, to wrap the moleskin all the way around the toe so the moleskin sticks to itself. It helps the moleskin to stay put better. Little toes shuck blister treatment worse than any other body part, I think.

For large blisters, I recommend draining them, but ONLY with a good, sharp needle (not pin) [I carry one with me]. NEVER EVER puncture the blister on the top. After disinfecting the needle and skin, gently but firmly insert the needle at the corona of the blister. Push the needle in a ways to drain the blister. If it is a big one, the practitioner may need to insert in more than one or two other places.

Then use the "holed" method of blister treatment. The trick here is giving a space for the blister to go while providing protection. It acts almost like a moat. Plus, the fabric of choice raises the area around the blister, helping to change the pressure of the contact point.

Duct tape can be effectively used, especially if the area just has a hot spot. Always round the corners (bandaids, moleskin, ducttape, whatever) so no edges can catch. Make the dressing at least a third bigger than the hotspot, again to help diffuse pressure. I have used this technique on toes, balls of feet, heels, etc.

With each of these techniques, I have "polished" them with paraffin wax. Using a chunk of parafin wax works really well when rubbed over athletic tape and blister care as it helps smooth out any wrinkles, and it firms the adhesive down. It also helps the sock to rub over the treatment rather than want to stick to it.

BTW understand that if someone uses the ducttape methods, the adhesive may want to stick to the wearer's socks.

The last and most aggressive treatment is to use tegaderm. It was originally developed to treat burns. It is permable, but quite durable.

Cut the tegaderm at least a third larger than the affected area (after cleaning and disinfecting the site), and giving it plenty of room to stick down. If necessary, trim the torn flap made by the torn skin of the blister; otherwise, leave it or milk it.

Tegaderm does not always stick to feet well under socks, so I usually use moleskin in addition. If the blister is serious enough, use the holed method, or the holed layer method.

I had the most severe blister of my life in the middle of a 60 mile trip, and I had used all of my bag of tricks. My friend, who is a nurse, had some tegaderm with her. That additional layer was enough to help my skin tolerate the blister treatment, plus it aided healing. I was able to finish my hike when I was literally on the verge of calling it quits.

10:20 p.m. on April 30, 2009 (EDT)
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Thanks second gear,

I have not tried Tegaderm, I'll give it a try.

I've been using duct tape & moleskin, plus 1/8 inch closed cell foam padding for boot adjustments. I get scraps of it from flooring installations where it is used as a vapor and sound barrier.

10:50 p.m. on April 30, 2009 (EDT)
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Good timing for me. I have new hot spots on my pinky toe.

Here is a tape that holds well as an alternative to duct tape. A 3m Product called Leukotape P Sports tape.

Ryan Jordon: " There is no competition here. Anybody still using duct tape is living in the dark ages. Leukotape P is breathable, stretchy (and thus, form-fitting), and most important, resilient. I put Luekotape P on my heels and toes at the start of a 185 mile trek with a heavy pack and constant wet feet (June in the Arctic), and only after day 5 did it start to show the need to be replaced. I peeled it off and my underlying skin was not macerated (unlike with duct tape).

http://www.backpackinglight.com/cgi-bin/backpackinglight/leukotape_p.html

R

11:25 p.m. on April 30, 2009 (EDT)
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New insights are why I like these forums. I have not heard of Leukotape. I will have to look at it. Never thought of using closed foam padding.

Hmmm. Must think on these things, I will... :)

12:29 a.m. on May 1, 2009 (EDT)
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My question is this. How much blister is too much? I assume we all blister to some extent, but how do you know when you just outright have the wrong boot? I know I need proper backpacking boots cause the cheap old Nike ones I have sometimes give me blisters just short of a quarter in diameter after only around 6 miles of hiking. Does anyone know if they make 14.5 size backpacking boots? 14 is too small and 15 is too big I think which may be causing these blisters... About ready to donate these things to Goodwill as soon as i can afford a real pair.

12:59 a.m. on May 1, 2009 (EDT)
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I have leukotape... it does work better on the skin than duct tape. But it also seems to let the "sticky" wear through, and the socks invariably stick to the tape. However... I bet you could leave the tape on for a couple of days without much problem other than needing to peel off the socks each night.

1:03 a.m. on May 1, 2009 (EDT)
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My question is this. How much blister is too much? I assume we all blister to some extent, but how do you know when you just outright have the wrong boot? I know I need proper backpacking boots cause the cheap old Nike ones I have sometimes give me blisters just short of a quarter in diameter after only around 6 miles of hiking. Does anyone know if they make 14.5 size backpacking boots? 14 is too small and 15 is too big I think which may be causing these blisters... About ready to donate these things to Goodwill as soon as i can afford a real pair.

Since I got shoes and boots that work I don't blister at all. You have the wrong boot.

I feel your pain - three pairs of bad shoes later I know how to shop for my feet. I need to get a size and a half larger than I usually wear in street shoes, in a men's shoe. Women's shoes do not fit this woman's feet, and while the sizing means I am getting something technically two and a half sizes larger, it works. I don't argue with what works. Not all brands or styles work for all people. I make sure I don't get Goretex, but do get something breathable. My feet sweat in all conditions.

I also take out the stock insole and put in green Superfeet. No blisters, except for when fungus tore up the skin around my toes for a while. Prescription fungus junk helped a lot and while my skin is still softer than it was, a couple of squares of leukotape on typical friction points and I'm fine. Liner socks also help, as do Injinji socks (toe socks).

9:57 a.m. on May 1, 2009 (EDT)
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Don't overlook socks. Having the right socks can make good boots better. Once I started using merino wool socks, I quit getting blisters.

12:16 p.m. on May 1, 2009 (EDT)
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My question is this. How much blister is too much? I assume we all blister to some extent,

Any blister is too much. Any "hot spot" is too much. If you are getting hot spots, much less blisters, you have either the wrong boots (fit, size, shaping, breaking in, etc), the wrong sock combination, or both (there are some other adjustable and choice factors as well). If you let the socks get wrinkled, bunched up, or wet, this also can contribute to blisters.

As for "assume we all blister", wrong! I haven't had blisters in some 50 years of many miles of hiking, basically since I learned about proper fitting and sizing of boots, adjustment of boots, socks (material, fit, combination), and a few other things about foot care. The only foot blisters I have had in that time came from a poorly fitted pair of double-plastic ski boots on a hot (hot for backcountry skiing, that is) day that was way too long, so my socks got soaked with sweat (I got a fair amount of water when I wrung the socks out back at the trailhead).

The best book I have seen on the subject, which I have mentioned here on Trailspace numerous times is John VonHof's Fixing Your Feet. It is aimed athletes, backpackers, joggers, anyone who depends on their feet.

One thing that helps the wet foot problem for those of us who have warm feet and sweaty feet is to use a good foot powder (Zeasorb-AF) and an antiperspirant (not deodorant, an antiperspirant to stop or slow the sweating). Some people use BodyGlide to reduce the friction on their feet, especially between the toes. I find it a bit messy, though.

If you get to the point of needing to resort to 2nd Skin, moleskin, bandaids, duct tape, etc, you have gone way too far in neglecting your feet. Prevention is always the best cure. And for feet, fit is number 1, with socks right up there close behind.

3:31 p.m. on May 1, 2009 (EDT)
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That's what I figured. Good to know.

6:21 p.m. on May 1, 2009 (EDT)
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Bill sets the bar high don't he?

No blisters! Nothing wrong with that, a boot / sock setup should fit that well, and moisture management is real important too.

I use duct tape on my socks to reduce any friction that I feel before it gets out of hand. Most times it works great for me.

I still occasionaly get blisters though, most of the ones I get these days are moisture related even though I change socks at least twice a day, sometimes more.

I currently use foot powder, maybe I will give the antiperspirant a try.

6:55 p.m. on May 1, 2009 (EDT)
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Obviously, prevention of anything preventable is always the best cure. However, when lacking the vacuum of a perfect world, I am always up to learn more about (fill in the blank) when the (fill in the blank) goes wrong.

In a perfect world, our packs won't break, our tents won't leak (heck, it won't even rain!), our food won't get snitched or stolen by hungry (fill in the blank), and our (fill in the blank) won't get injured.

Also, in a hunt for really good boots, I have spent more money than I like to think about, having people who do have knowledge help me, with my wearing all sorts of varieties of combinations of socks, and with my feet issues, I still manage to have to treat something. Fortunately, I have managed to control the damages done...and not all of us can afford to or know how to maximize our efforts.

I am glad to glean all sorts of helpful tidbits in these forums. I appreciate the knowledge, expertise, and experience. It's like cramming for your favorite class.

7:56 p.m. on May 1, 2009 (EDT)
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There is one problem I had with my feet a few years back. The day after summiting Denali (and spending the night back at the 17k camp), we started heading straight down. We did pause for an hour to retrieve our cache at 14k and took a 3 or 4 hour nap at 11k, where we retrieved the cache there. The nap was accomplished by just inflating the pad and putting the sleeping bag on top, no time wasted on a tent setup. Then while it was still cold, we headed the rest of the way down to the air strip at 7200 ft. I had some slippage of my feet against the toe of the double plastic boots and ended up with the nails of both big toes black. They are still growing back, something like 7 years later. It isn't painful like blisters, just annoying.

I'm lucky that certain brands of boots pretty much fit me straight out of the box. My son has "weird feet", so has a favorite bootfitter who makes some adjustments to every pair of new boots he gets (including double plastics). He also does not get blisters once the boots are adjusted.

OTOH, I do a lot of orienteering (well, not that much during the house rebuild). It is amazing some of the things a number of the orienteers do to their feet to prepare for the runs in the woods (and amazing that some of the elite orienteers run 15 km through the woods, over downed logs, up and down steep hills, all while reading map and compass in less than an hour - that's as fast as I used to run on a prepared track!). They use all sorts of goop, taping, special ankle braces, etc. It takes longer to get their feet ready as it does to run the course (and some still get blisters).

10:31 p.m. on May 1, 2009 (EDT)
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I have had the black toenail myself a couple times. For me it is usually a problem on long, steep descents. Such as following a river gorge down off a plateau.

BTW, does everybody else use the term Gorge?

In the south it just means a steep river canyon.

12:17 p.m. on May 2, 2009 (EDT)
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Long steep descents - yup! The descent off Denali is something like 10-15 miles, 13,000 ft from the top (or 10,000 ft from the 17k camp), and done in roughly 24 hours including the 4 or 5 hour nap at the 11k camp. The descent from Kilimanjaro is similar, 14,000 ft, about 10 miles, done in about 30 hours, including the 2 hour nap at Barafu (the high camp) and 8 hour sleep at Mweka Camp. The Kili descent was more of a knee-buster than a toe-blackener, though - leather boots vs the plastics on Denali.

Gorge - that's what the backpacker does when first getting off the trail and finding the first restaurant. Oh! The gash in the ground type of gorge! One famous gorge in the Sierra is a "secret" climbing area - the Gorge of Despair. Not far from that one is the Kern River Gorge. There is also the (now infamous) Three Rivers Gorge in China, flooded by the Three Rivers Gorge Dam, and suspected of helping trigger a recent major earthquake. New River Gorge, at the northern boundary of The South, is another famous climbing area. Yeah, "gorge" is used for river canyons in other parts of the world.

9:23 p.m. on May 2, 2009 (EDT)
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Well actually you are correct, gorge is most certainly something I do after a trip. Good one!

I have found that my body performs much better with naps instead of just a resting break, even a 20 minute nap does wonders for me. Maybe some of that is a mental thing, not just physical. Most of my descents are under 5000' with very steep sections, and some not so steep sections. I'm getting better at following contours when not on a trail. I used to be bad about straight lining, like it was macho or something.

2:12 p.m. on May 3, 2009 (EDT)
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I too gorge when finding that first restraint after. Yes in my neck of the woods we use the term gorge usually a river gorge. We also have what is known as the gorge waterway. A 5.2km(3.2mile) water way that cuts the city into two parts. This gorge is an intertidal area. Meaning that it is sea water and freshwater mixed, as well as 2 tide changes a day. Because it is a tidal area there is a 2 way water fall about midway along. It makes for some very interesting boating as it can have a rating of a class 5 waterway at times.

1:30 p.m. on May 4, 2009 (EDT)
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I got blisters on both feet on the bottoms just below the base of the toes. The problem was traced to worn out super feet footbeds. Check their sides and bottoms after you have worn them awhile. They crack. Also be sure you buy them according to your arch and foot size, not shoe size. For example, my foot measures 9 1/2 . I often wear at least a 10 1/2 low cut. Shoe size would be a size "E" footbed (SuperFeet), foot size superfeet is a size "D". I use the smaller size.

Socks do contribute to hot spots and footwear can blister sometimes and not others. Wet feet contribute, too. For most it is not "if", but "when" one develops blisters.

A great cure for blistered feet is swimming pool water. The chlorine does the trick.

The public pool in Damascus, VA, along the AT, saved my sore feet!

8:26 p.m. on May 5, 2009 (EDT)
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Here is my two cents...

I hike with the same knee high black Doc Martins I have been wearing almost everyday for the last 3 years. Inside these I have two insoles- one for arch support on the bottom and one for overall cushion on top of that. But, when I hike I wear old lady knee high nylon socks under my fat hiking socks. It really keeps whatever moisture off of my skin.

I rarely get blisters, but when I do I use Moleskin. If I get one that's actually bothering me a lot I drain it and use Hypafix. Hypafix lets it breath a little and it lets the ooze drain out so it's not as itchy as Tegaderm while it's healing.

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