Article written by Rebecca Rushton - podiatrist

Every bushwalker knows the threat of foot blisters. We’ve all had one. And we’ve all got our own methods of preventing them - with varying levels of success.

I know a thing or two about blisters – it only takes a 15 minute wander in the rocky coastal scrub around my place for me to get a blister on the back of my heels. It doesn’t matter what boots or shoes or how challenging the terrain.
Being a podiatrist (and a blister-prone one at that) I’ve researched this topic inside out. So if you’re not quite on top of blisters yourself, read on. Here’s a quick overview of your blister prevention options.

• Definite – Before you head out

  
  1. Footwear fit and lacing
  Make sure your footwear fits properly in length and width. If you get this wrong, you really are making it hard for yourself! For length, use the rule of thumb – perfect fit is where you have the width of your thumb between the end of your longest toe and the end of the upper. For width, you need a snug fit, but not to the point where the sides of your foot overhang the sole of the shoe. And use your laces! They allow you to maintain perfect fit while your feet change during a hike.
  2. Cushioning
  Cushioning has a double blister prevention effect: reducing pressure and the cushioning material absorbs shear so your skin doesn’t have to. Some cushioning material does this better than others. So if cushioning innersoles that came with your bushwalking footwear are too thin or flimsy, replace them with better ones. While this won’t guarantee blister prevention, and you can’t just keep adding more and more cushioning, it’s an easy step to take to help minimise the chance of blisters under your feet.
  3. Moisture-wicking socks
  The micro-climate in your shoes is moist at the best of times. And we know that moist skin has a high friction level and predisposes to blisters. So considering you’ll be wearing socks anyway, it makes sense to get some that have advanced moisture management properties: moisture-wicking socks. Cotton is anti-moisture-wicking – don’t use cotton. Merino wool and certain synthetics are better options. You may have heard of CoolMax, a popular brand. It’s important to know that moisture-wicking socks can only do so much. They rely on moisture evaporating through the upper of the shoe to work to their best. But as you know, most bushwalking footwear isn’t particularly “breathable”.
  4. Skin adaption
  Research has shown that you can toughen your skin to the rigours of your activity - the terrain, your footwear, the weight you carry etc. The more your skin is subjected to these forces, the more it can adapt to these forces, and the more resistant you’ll be to blisters. However, there is only so far your skin can adapt. But think of it from the opposite end of the spectrum - if you’re new to bushwalking or you haven’t been out since last season, or you’re on a more challenging terrain with a heavier pack and a new pair of boots etc, you’re at more risk of developing blisters. Makes sense, right? I suspect most bushwalkers already know this!

• Definite – Have in your blister kit

  1. Silicone gel toe sleeves
  Some of the most painful blisters are toe blisters – on top, underneath, on the tips or in between. When it comes to toe blisters,
  I would not leave home without silicone gel toe sleeves, obtainable from most pharmacies and podiatrists. Silicone gel toe sleeves cushion the whole toe. And there is no other material that absorbs shear like silicone gel does – it’s perfect for toes. On the down side though, some people find that after a while, their skin gets too macerated (soggy) with these.
  2. ENGO Blister Patches
  These are blue patches that stick to your shoe, insole or orthotic, not your skin. They are made of a really low-friction material and they last about 500 kilometres. I use these in every shoe I have to stop my blisters.
  I recommend including a few of these in your blister kit. They’re the perfect way to troubleshoot abrasive rubbing, hot spots and blisters on the go. You can’t use these for interdigital blisters, just because there’s no part of the shoe to apply them to. And while the adhesive is strong enough to hold them in place in spite of the extreme forces they encounter, water-logging can make them come unstuck.

• Maybe - Experiment with these if you need to, they might help

  Preventive blister taping - Research shows that even when feet are taped, blistering is common. Taping is better at preventing abrasions.
  Lubricants – Lubricants like Vaseline reduce friction initially. But friction levels will increase on longer walks. And they weaken the skin because they’re occlusive.
  Powders – Talcum powders have limited use for moderate to long walks. More advanced powders work more like a lubricant.
  Antiperspirants – Limited effect on moderate to long walks.
  Astringents – Some people soak their feet in solutions like salt water, Condy’s crystals, methylated spirits, cold black tea or rubbing alcohol thinking it toughens the skin somehow. Although popular, there is nothing to say if or how it works to “toughen” the skin.
  Double-socks – By allowing rubbing between sock layers, it saves the skin from shear. This can be successful for some bushwalkers.

• If you continue to get blisters

  If you keep getting blisters in spite of all this, see your podiatrist! We can look at whether it has anything to do with how your feet work. Depending on your unique circumstances, we might suggest orthotics, special cushioning and pressure relief, stretches, toe devices or any number of treatments.

• Summary

  We’re all different in our susceptibility to blisters. Some bushwalkers need do nothing more than pull their boots on and head out. Others of us have to be a lot more prepared. If you’re worried about blisters, or if what you’re doing now isn’t working, take another look at your prevention options again. Things have come a long way.
  For more information, check out the Blister Prevention website. And to investigate the research behind each strategy, take a look at The Advanced Guide to Blister Prevention.

Article was written by Rebecca Rushton, a podiatrist with 20 year’s experience. She has a special interest in blister management, is the founder of blisterprevention.com.au, and the author of The Advanced Guide to Blister Prevention and distributor of ENGO Blister Prevention Patches. She lives in Esperance WA and her favourite walk is the rocky limestone track just 200 metres from her back door.