Backpacker Magazine – April 2001

Blister Prevention: Hiker, Heel Thyself

Think blisters are a sure thing when you hike? Think again: Here's your ticket to preventing and treating the dreaded sores.

by: BACKPACKER Editors

Tags:
• Hiking boots
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• Health & first aid
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• Skills
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• Technique
|

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Consider your average ripe peach. Press your thumb against the juicy fruit and gently move it back and forth. What happens? The skin moves under your thumb. Now press harder and rub. The skin rips and wrinkles, and peach juice dribbles down your hand.

The same pressure-and-friction principle comes into play when you hike. The outer layers of your foot's skin can move more than the sensitive inner layers can. Boots and socks apply pressure and friction as you walk, causing these skin layers to separate and fluid to fill the voida blister.

Now, let's get back to that peach. Say you dunk it in hot water. When you rub it, it peels more easily, right? Again, it's the same with your feet: Warm, moist skin blisters quicker than cool, dry skin.

The obvious lesson here is to keep your peaches out of hot water. You might also want to keep your feet dry, cool, and friction-free so you avoid blisters. To that end, we consulted a slew of foot and boot experts and tested a host of blister preventives and remedies. The results follow.

-The Editors

Preventing Ball Blisters

1. Place a long, wide strip of tape on the floor, adhesive side up, and set the ball of your foot directly atop it.
2. Press down to make your foot as wide as possible. Pull the ends of the tape up around the sides of your foot to meet on the top of your foot.
3. Trim the tape to conform to the shape of your foot so the tape doesn't contact your toes.

Recommended by John Vonhof, fastpacker, ultrarunner, and author of Fixing Your Feet: Prevention and Treatments for Athletes (Footwork Publications, 877-421-7323; www.footworkpub.com; $15.95)

SCOREBOARD: BLISTER BEATERS

Who better to test blister products than tenderfoots who develop hot spots just pulling on their hiking boots? For 3 months, five brave testers put their feet at the mercy of blister products we found at drugstores, supermarkets, and medical supply stores. Products are listed in order of overall performance.

Product	Price	Effectiveness	Durability	Final Grade
Band-Aid Blister Block	$4.49 for four 21/8 x 11/4-inch sterile cushions	4.5	4	4.5
"Like instantly having new skin on my foot.
Generic athletic tape	about $2 per 360-inch roll	3	3	3.5
"If you tape it right-covering 1/4 to 1/2 inch beyond the blistered area-it stays put.
Dr. Scholl's Cushlin Blister Treatment (gel-filled dressing)	$4.75 for six 2 x 13/4-inch (size large)sterile cushions	3.5	2.5	3.5
"It worked great, but didn't stay put as well as some other products.
*Body Guard Skin Protection Sheets (flannel-like tape)	$3.50 for two 41/2 x 41/2-inch sheets	3.5	3	3.5
"Because it's stretchy, it's ideal for odd spots-around toes, on arches.
Dr. Scholl's Moleskin Plus (flannel-like tape)	$3.29 for two 41/2 x 3-inch sheets	3.5	3.5	3
"Great for toe blisters because the soft surface doesn't chafe neighboring toes.
Dr. Scholl's Molefoam (padded tape)	$3.29 for two 41/2 x 3-inch pads that are 3/8 inch thick	3	3	3
"A doughnut of Molefoam creates the deepest pocket for a tricky-to-protect spot.
Silver duct tape	$1 to $5 per roll	2.5	3	2.5
"It's better than nothing, but there are more effective remedies out there.
Spenco 2nd Skin Blister Pads	$6.99 for five moist, nonsterile pads; one large and six small sheets of flannel-like tape; and 11 pressure pads	3	2.5	2.5
"It's a challenge to apply all the different parts.
Effectiveness:Did it prevent a hot spot from turning into a blister? If a blister did form, did this material keep it under control? Did it ease the pain? Durability: How often did you need to replace it? Did it hurt when you removed it? Final grade: Would you buy and use this product? Note: This rating is not an average of other scores, but a gut-level reaction to overall performance. * Body Guard has only recently reached grocery and drugstores and may be hard to find. Contact Body Guard at (800) 887-3370; www.cm-tech.com.			Rating Scale 5=Excellent, superior gear 4=Very good, beats most 3=Good, decent gear 2=Fair, okay, but... 1=Poor, miserable

Should You Pop?
To pop or not to pop is the big and hotly debated question. Even the experts disagree about when to drain a blister. Buck Tilton, Backpacker contributing editor and director of the Wilderness Medicine Institute (WMI) of the National Outdoor Leadership School, has treated hundreds of backpackers' backwoods blisters, so we consulted him for the final word.

"At WMI, we open and drain almost all blisters (the exceptions are those caused by burns), including the controversial ones: blisters filled with hazy, cloudy fluid and even blood blisters on the heel or ball of the foot. Our philosophy is that a blister in a high-stress area is going to pop if you keep walking on it. We'd rather drain it in a controlled setting than have it burst inside a sweaty, dirty boot and sock."

To properly drain a blister:

1. Clean the area with soap and water, alcohol, or an antiseptic towelette. Dry thoroughly.
2. Sterilize a needle or sharp blade, either by holding it over a flame until it's red-hot or submerging it in boiling water for 2 minutes.
3. Puncture the bottom end of the blister so gravity can help drain it. The opening should be no bigger than is necessary to get the fluid out. Starting at the top of the blister, massage the fluid toward the opening.
4. Apply antibiotic ointment to prevent infection, then wrap with the dressing or blister product of your choice.

-Kristin Hostetter

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