“Ladies and gentlemen of the Expedition class of 2016, prevent blisters...”
“...If I could offer you only one tip for your future trips, prevent blisters would be it. The long term annoyance of blisters have been proved by scientists whereas the rest of my advice has no basis more reliable than my own meandering expedition, ultra-running and climbing experience. I will dispense this advice now.” Baz Luhrmann - sort of
Do not underestimate a blister.
Lets face it, blisters suck. They can be so small, but they are an annoyance that can ruin your day and if left untreated can be a cause for a medical evacuation.
Blisters are easier to prevent than cure.
Get the right footwear for the job? Test out your shoes and socks before you depart. It does not matter how many miles a sock is guaranteed to be blister free or how “Gucci” the boots look. Do not assume that if it works for others it will work for you. Test out your footwear before departure, but not to the point where it is on its last legs. Keep in mind that just because you haven’t had blisters before, you cannot have them on your next trip. It is quite common on expeditions to have someone at the start of the trek to claim that they do not get blisters, only to have the expedition leader treating their feet a few days later.
Take the time to show your feet some love.
Show your feet some love every time you stop longer than 10 minutes. Shake out any sand and debris from your boots. Dust down your feet with a foot powder. The antifungal powder works wonders especially in humid climates. Then pop on a dry pair of socks. Your feet will love you for this and often this is enough to prevent even the smallest of hot spots from developing.
Do not ignore your hot spots.
If you feel even the slightest of irritation (hot spot) in your socks then stop there and then and fix it. This irritation is not just a rutting sock or a small stone but most likely is the start of a blister. If you act
immediately then the blister will not develop. This is easier said than done. In a group situation people do not want to hold up others and show weakness. In general adults are more likely to let blisters to develop. Kids groups are much better than adult groups as they are less self-conscious and concerned about slowing down the team. No matter how far you are from the next planned stop or camp you must stop straight away and deal with any foot discomfort. You will slow the team down much more later on if you allow the blister to blossom.
So what to do if you start to get a hot spot? Take action immediately. Put some tape over the effected area before you dust your feet with a powder. I recommend the 5cm wide Leukoplast tape. Before applying the tape clean the skin and apply a pre-taping spray. This helps the tape to stay in place and also to disinfect the skin. The tape should contour with the shape of the foot or toe and there should be no creases in the tape. Dust the foot down with powder to finish off. This helps to stop the tape from sticking to your socks.
To pop or not to pop?
If you pop a blister you are creating a wound. If the wound gets infected then you are soon learning whole new levels of pain. So you only pop a blister if it looks like it will pop by itself. Therefore you are popping it in a clean and controlled way so that the wound can be kept free of infection. The other time to pop a blister is if it develops under a toenail. The nail contains the blister, causing pressure and pain to build quickly. Popping toenail blisters alleviates the pain almost immediately. The image below shows a friend of mine on the Marathon des Sables getting his blisters seen to by a doctor.
The image below here is his foot 3 days later. The infection that had developed had eaten 5mm into the sole of the foot and required him to drop out of the race, use crutches to walk, take strong painkillers, have 1 week off work and go on numerous trips to the hospital. The red angry looking V shows where the infection started and where the doctor slashed the blister to relive pain. Nice one doc, this obviously was not the way to go.
Follow the plan below if you do decide to pop your blister. FYI this will hurt, but the pain will be nothing compared to that of an infection. Before you start, make sure you have the kit needed to do this.
A blister kit is more than just a pack of Compeed.
1 roll of 5cm wide Leukoplast tape
1 roll of 2.5cm wide Leukoplast tape
1 roll of 2.5cm padded strapping tape
1 thumb scalpel (#11 blade)
1 1ml syringe.
1 spray bottle of pre-taping solution. It’s good to store this in an empty 50ml Lifesystems mosquito
repellent spray bottle or something similar.
1 small bottle of Iodine solution or Friars Balsam.
2 packs of 5cm x 5cm gauze swabs.
Antifungal foot powder. Keep all of this in a dry bag near the top of your backpack. The easier it is to get to the more likely you are to use it.
Popping that blister
Clean the foot, especially the area 5cm around the blister.
Use the thumb scalpel to make a 3mm incision in the blister.
Ensure the area of the blister stays clean and free from sand and dust blowing in the wind.
Holding some gauze push out any fluid from the blister.
Fill the 1ml syringe with iodine solution.
Gently pull the skin on the blister away from the surface of the foot. Allowing you to insert the tip of the 1ml syringe into the blister.
Press the syringe filling the blister with iodine solution. This will hurt.
Using gauze push out any excess fluid allowing the small incision to close and skin to sit flat.
Clean the area of the blister with pre-taping spray.
Allow the skin to dry, the skin will now feel sticky.
Cut a length of the 5cm wide Leukoplast tape with the scalpel. Cutting it and not ripping it keeps the ends of tape neat and less sticky. Use more tape then you think you need.
Cut a small length (shorter than the strip of Leukoplast) of padded strapping tape. Place this on the Leukoplast tape directly above the small incision.
Cut another length of 5cm wide Leukoplast tape and stick it over the first layer sandwiching the padded strapping tape between the two layers.
Ensure all the edges of the tape are stuck down.
Dust down the dressing with foot powder to help prevent the tape from sticking to socks.
Keep the tape on as long as possible. If it starts to come off then remove it and redress before the small incision becomes exposed to dirt.
Notes on taping
Do not over tighten the tape. Your feet will swell during activity causing a restriction in blood flow.
Try not to form complete rings of tape around digits, feet, ankles etc. Leukoplast does not stretch well, so it does not accommodate for swelling during activity. That being said, you will need to wrap the tape around your toes, so make sure the tape is as slack as possible to allow for swelling.
Trust me on the blisters...
My blister prevention routines were born from painful personal experience of running mile after mile on blistered feet. I hope to save you from going through anything similar and helping to make your expedition a better one. Achieving the extraordinary with happy feet* is so much more enjoyable. I guess this is the reason why I wear a slightly manic smile when I treat people’s feet. Which is probably the root to the rumors that circulate through the Secret Compass trips that I have a foot fetish.
“Maybe you believe these rumors maybe you don’t. Maybe you’ll go on another 10 expeditions, maybe you won't. Maybe you're still to travel abroad; maybe you've traveled to every country in the world. Maybe you’re about to run the length of the Andes in a chicken costume. Whatever you do, don't congratulate yourself too much or berate yourself either... But trust me on the blisters.” Baz Luhrmann - again sort of.
* Not the penguin
I work as an expedition guide, safety consultant and production manager. In short I keep people safe and happy so that they can achieve their goals. Click here to find more about me and what services I can offer.