The Low Down on Blisters -- Prevention and Treatment

[HuskyNerd]

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?

[Lipka149]

The best way to deal with blisters is to prevent them, and here are some strategies:

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&sea rchArg=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 ...

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