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The Low Down on Blisters -- Prevention and Treatment

Discussion in 'Medical Problems' started by HuskyNerd, Jun 28, 2011.

  1. HuskyNerd

    HuskyNerd Super Moderator

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    Few topics have more interest for pilgrims than blisters. And few topics have more strong opinions or more remedies. I thought it'd be great to have a discussion about blisters and I'll get the ball rolling by sharing these ideas for prevention and treatment that come from my three caminos.

    Prevention
    The best way to deal with blisters is to prevent them, and here are some strategies:
    • Make certain your boots fit your feet properly. Your boots should fit your feet snugly with little movement front/back or left/right. Test them in advance of your pilgrimage by walking long distances, if possible with a loaded pack on uneven terrain. If you get blisters in your test walks, consider a different boot for your camino or reconsider how you're tying your boot strings. You may need to go tighter than normal to reduce slippage. Most boots allow separate tightening between the upper and lower boots. You'll want to play with this until you get the right balance of comfort and snugness.
    • Socks are important! Tight fitting wool socks or other wicking material help. Consider sock liners or nylons (or 1000 Mile Socks which have liners inside already) which reduce friction between your sock and foot.
    • Many people use Vaseline or deer fat on their feet each morning to reduce friction, particularly between toes.
    • Consider taping your feet. Some people use duct tape or adhesive/sport tape on blister-prone areas to reduce the possibility of blisters. My little toe seems to curl under my 4th toe a bit, leading to ongoing friction. I now tape my little toe each morning to keep it under control, then put Vaseline between each of my toes to keep them happy and safe.
    • Keep your feet dry -- moisture in the boot leads to blisters. Your socks should wick moisture from your feet and your boots should allow moisture out but not in. When you stop to rest, take off your boots and air out your socks to help this process. For this reason some people swear by hiking sandals since the feet stay much dryer and it's unnecessary to air out socks.

    Treatment
    There are many schools of thought. Here are a few:
    • Compeed -- this is declining in popularity, it seems, since its heyday a few years ago. Essentially you pop the blister (most people say), disinfect it, then apply a patch of Compeed that you keep on until it falls off of its own volition. It seems that most people now feel Compeed's moisture-proof nature actually makes the blister last longer. My personal preference is to keep a few Compeed patches handy to protect hot spots that could develop into blisters, but not to use Compeed for blister treatment.
    • Needle and thread -- the strategy here is to pop the blister, disinfect it, and then with a sterilized needle (good luck with this) put a thread between the old and new layers of skin (where the water is). The thread wicks water from under the old skin to hasten the healing/drying process. After threading the blister it is left without a bandage to cover it when not walking. When walking the blister is covered with a bandage to keep it from getting irritated.
    • Open and dry -- Camino doctors and blister specialists all seem to follow the same strategy lately, which is to open the blister, disinfect it thoroughly, then bandage it with adhesive tape and gauze to keep it clean. Tape and gauze are for the first day and when wearing boots, but otherwise the blister should be exposed to air to let it dry and heal more quickly

    I'm sure I've skipped some important steps or missed some popular strategies. What are your thoughts?
     
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  2. Lipka149

    Lipka149 Active Member

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    Couldn't agree more with everything you say here, Sandy.

    To add my 2 cents worth:

    1) Dr. Scholls Corn Cushions http://www.drscholls.com/drscholls/productSearch.do?method=doProductDetailsLookup&searchArg=17 are great for protecting hot spots. They are about 1/8" thick and have a hole in the middle like a doughnut. They come in various sizes and worked extremely well to protect the bony protrusions on my feet from rubbing against the inside of my boot. The larger ones were great for the ball of my foot. The trick is to apply them before the blister forms, but can be used over a small blister quite effectively.

    2) Being aware of what is happening to your feet while you are walking is essential to prevention. Pain is a signal that something is wrong ! Take the time to stop, look at your feet, apply a remedy, and see if the pain goes away. If it doesn't, stop again and repeat the process. Those corn cushions were INVALUABLE to me in this regard ! That and dry socks ... :D

    3) Blisters, and other friction problems, can take place wherever movement is taking place. Consider underwear that does not chafe. A delicate subject, to be sure, but one that deserves some attention. http://www.ideal-hiking-equipment.com/sports-underwear.html
     
  3. promqueen

    promqueen New Member

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    They're a big pain! But I always try to prevent it by putting band aids on the usual spot where it usually grows. Then I put a lotion at night.
     
  4. highlander

    highlander Donating Member Donating Member

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    This is much better advice on blister treatment by Sandy....when I did my last training course which talked about blisters when leading groups (Compeed) was then see in a new light for those doing more than a days walk, as Sandy says not to treat a blister to prevent hot spots. overall lots of you are going to follow the pack and do what they do......prevention
     
  5. A.C.

    A.C. New Member

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    My thought on blisters - I walked with pilgrims carrying very heavy packs and they all had massive trouble with blisters. I have the baby toe issue of it curling under the forth toe. I used a toe sock , it helped. Changing footwear at half day also helped. (From boots to walking sandals ) A tiny little blister can be a big pain....
     
  6. EhorShk Canada

    EhorShk Canada New Member

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    Re: Blister treatment - On the Camino in the spring of 2014, I was plagued by blisters for several days under the joint of my big toe last spring. Every evening I lanced blisters, old and new. In the morning I applied Compeed bandages (after squeezing any blisters, which reappeared during the night). But they came back each day and seemed to be spreading.

    Then I met my Angel in the form of a hospitalera at a municipal albergue somewhere before Leon. The first thing she did was scold me for using Compeed as she gently pulled them off . She told me to never use them. She then lanced the blisters with a needle, which she took from a sealed package. It appeared she lanced each blister twice, on opposite sides, and drained them. She used no thread. She applied iodine, then a gauze pad from a sealed package, using surgical tape to hold it in place. Several peregrinos followed me to have their blisters looked after by the 'Angel' and, like me, were most grateful.

    Surgical tape is a very thin, stretchy and breathable fabric tape. The tape went between my toes but I felt no discomfort from it. She said to leave it on for 24 hours, which I did (and missed one shower), and the blisters and pain were gone - what a relief!

    When I returned home, I assembled my own blister kit:

    Roll of soft cloth surgical tape, brand: 3M Medipore H (made in Germany);
    Small bottle of iodine;
    several packages of Johnson & Johnson triple layer non-stick pads (individually sealed);
    needles (which I can sterilize with the iodine); and
    moleskin (for prevention - to stick on 'hot spots' that appear when I'm walking).

    /Ehor.
     
  7. EhorShk Canada

    EhorShk Canada New Member

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    On the Camino Oct 11, 2015. I met the angel I referred to above a few days ago when I stopped in the Mansilla municipal allergue (a day's walk before Leon). The hospitalera, Laura, is the one who has been carefully treating the blisters of pilgrims for years.

    Stop by to see her if you are plagued by blisters and you will call her an angel, too!
    /Ehor.
     
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  8. Orava

    Orava Active Member

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    Laura also took care of some if my buddies' feet back in May time and saved their caminos. She is a vet by trade and is highly entertaining to boot. Look her up at Mansillas de las mulas just before Leon.
     
  9. EhorShk Canada

    EhorShk Canada New Member

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    You'r right about Laura being highly entertaining. Last year in the spring after she treated my blisters, an Asian gal was coaxed by friends to have her blisters treated.

    Hers were in bad shape and covered in Compeed bandages. It was clear she was in pain and kept reaching for her feet as Laura removed the Compeed. Laura reached into her bag and pulled out a saw! Everyone burst out laughing. Even the gal being treated broke into a smile after an initial surprised expression.

    I had no blisters in this year's trip, which I just completed in Leon, but it was a joy to see her still helping pilgrims with their blisters. I made a point of telling her how much her work is appreciated and gave her a donation to help cover the medical supplies she buys. All of these volunteer assisted albergues are tight on funds.

    There's another Camino story.
    /Ehor.
     
  10. RJS

    RJS Well-Known Member

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    Just a few more thoughts on prevention of blisters, mind you I if anyone had a Sure way of stopping blisters then they would make a fortune selling their secret ;-)

    Anyway -

    1) Wear Well fitted and broken in footwear

    2) Take a good sock combination, Inners and then heavier cushioned outer socks, then keep them clean and fresh as possible.

    3) Travel as light as possible, The more weight you have on your back, the more weight is transmitted to your feet !!

    4) Consider using trekking pole(s) or a stick, these can help, especially on downhill sections when your toes can rub against the front of your boots, thus creating blisters

    5) Pamper your feet and the end of the day, give them a good wash, dry them properly and rub in a good foot-balm. Dress any small blisters and cuts before they get infected and become Big blisters and cuts

    Good Luck and Buen Camino
    Rob
     
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  11. Leslie

    Leslie Administrator

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    In a recent email someone suggested that using a needle to suck out the fluid, using iodine, and then tapping worked for them.

    So far in life I have never had to use a needle on myself and I am sure that I want to.

    Anyone seen this?
     
  12. Orava

    Orava Active Member

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    After having had time to reflect on my ( blister free) SJPdP to Finisterre Camino last May, I have these observations: I trained 300 km using my camino pack weight in the 10 weeks before departure to find out what my feet liked. My feet were therefore quite hardened beforehand. I realised anything over the 25 to 30 km distance always have me the hot aching dogs feeling. I tried using inners but that did not work for me so went with just midweight merino socks ( changed every 2 hours). On the Camino my socks always dried off on the back of my pack in a short time. I took 3 pairs. I used greenfeet generic insoles. I used glide stick between my toes and on the ball of the heels. I wrapped my little toe in micropore tape every morning ( as they were always a bit tender). I didn't moisturise my feet except once ( and that was nearly a disaster as the next day my baby soft moisterised feet felt very tender indeed and I walked my shortest day on them!) I also recommend not to cut off any callused skin during the camino ( I did that after getting back from the Camino and voila! I got a blister the first time I went for a hike back home. Listen to your feet and stop when they tell you to...
     
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  13. Dylan Price

    Dylan Price Member

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    My wife suffered terrible blisters on the base of her feet thanks to her having to buy a new pair of boots half way through the Camino. Totally agree about the compeds - they seem to be great for very small blisters but anything big they can (and do) make the blister even worse.

    I got to be very good at using gauze pads, sticking plasters and paper tape to protect my wife's feet and they worked better than anything. That and letting them air out well at the end of each day saw her feet toughen up well - by the end we were easily doing 20-25km a day.

    I was very blessed in I had one very small blister on day three and nothing else.
     
  14. akshay ortho

    akshay ortho New Member

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    On the one hand, Orthofeet is foot problems footwear and on other end the most comfortable orthotic-friendly sandals, I have ever owned. The orthotics slip inside a compartment underneath a removable inner sole, leaving your toes free to breathe. The thick soles add bounce and comfort to your step. They are a dream for the feet!
     
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