#441 Blister causes in runners - DOC

#441 Blister causes in runners

Today on the Doc On The Run Podcast, we’re talking about the causes of blisters in runners.


Now listen, I know blisters are not really an exciting topic. You probably want to hear something that’s going to make you stronger and faster and finish your marathon better, but I can tell you one thing for sure. If you’re running a marathon and you get a blister, it is going to wreck your performance. You cannot perform at your best if you’re thinking about some little stinging aching pain that you’re getting because of a blister, and it really can make a real dent in your training too.

Obviously when you get blisters, you get blisters because of too much rubbing, too much friction, and then that usually happens when you have a lot of rubbing and friction like during your big training blocks. So you go do one of your long runs and you’re really ramping up and it causes a blister. And then you have to do something to let it heal. You either have to take time off or you have to run your long run shorter, or your fast run slower, but you have to do something. So blisters are all preventable. And that’s what this episode is about. I’m going to try to show you a couple things that might be helpful to make sure that you don’t continue to get blisters.

Now, there are really three causes of blisters and one of those is lack of protection and we’ll talk about that. Second one is too much friction and then the third one is too much moisture. These are all variables you can control.

The protection of your feet is really socks. I mean, that’s the bottom line is that when you train, the more you train, the tougher your feet will get. So after you get a blister, you will get some thicker skin in that area, but you can build up that thicker skin without getting a blister if you’re using the right kind of socks.

Now, you always want to use synthetic socks and most running socks are made of synthetic material and it all depends on your preferences. Like I get hot really easily. So I like to also run when it’s hot. I usually run in the late afternoon when it’s close to 100 degrees in the summertime. I like that, but part of that is also I did Ironman races for a long time and those runs are always in the afternoon. So I got used to training in the afternoon heat because whenever I go to an Ironman, well, you don’t really have a choice. Unless you’re really, really fast, your marathon is going to start in the afternoon when it’s hot. And that was the case for me so I got used to running in the heat.

Well, I get hot anyway. So I usually use some socks that are very, very thin and I like that, but I’m used to running in those and I’ve running them for a long time. Now, if I were starting out running or if I were really ramping up a new, really big training block, I would probably use some socks that are either a little bit thicker or that have two layers of material. And so you can get socks that are often marketed as blister prevention socks, and those socks will actually help prevent blisters because of the layers of material move past each other, instead of rubbing against your skin. That’s how they work.

So you’ve got to experiment with the socks, see what you like and see what will work for you. And then you can actually have a little bit better protection. And then as your season progresses, if you start out with thicker socks or you start out with those double layered socks, well, then you can actually back off and maybe use something that’s a little bit thinner later in the year. As you get closer and closer to your races, your feet get tougher and tougher.

But friction is really the enemy here when you have a blister and your skin gets a little more pliable, the layers actually separate a little easier. You don’t want excess moisture in your skin that can make the skin a little more fragile.

I’m a podiatrist. I run a lot and when I do races, I never ever run through those sprinklers or the sprayers or the garden hoses that actually can cool you off by getting you wet. I do not want to get my feet wet. I actually run and I either stop and take a sip or I run kind of bow legged so I don’t spill water on my feet when I’m actually doing a race because I do not want my feet to get wet. So I’m very careful about that.

If your feet happen to sweat a lot and you’re doing long runs, it may be actually really helpful to you if you do something as simple as just change your socks halfway through your long run. I mean, if you’re running 20 miles, it’s not going to kill you to stop for a couple seconds and change into a second pair of socks. Now that will immediately remove all the moisture that the socks have absorbed and give you a fresh pair to start drawing more moisture away from your feet so that they don’t turn into a situation where you got too much moisture and it leads to a blister.

The third thing is friction. Your feet are rubbing on the inside of the shoe and they’re going to develop hotspots or pressure points where the friction is at its peak. And those are the places you get blisters. Now, most of the time when I see somebody, if I haven’t even seen their feet and they haven’t told me where the blister is, I can take the insert out of their shoe and look at it and tell where they’re most likely to get blisters.

Now here’s an example. So I’ve got a shoe insert I took out of someone shoe. And if you look at it, it is pretty clear that there is a foot on this insert. It’s what makes it really easy. I don’t think you can probably see this just in this video, but one of the things is, if you look right here, it’s actually not only dark. The fabric is kind of worn away. And it turns out that when she does marathons and ultra marathons, this runner actually gets blisters right in this area under the big toe joint. So, that gives you a target for getting rid of the friction.

Now you don’t want to get rid of the friction everywhere. You just want to get friction reduced to the point that you’re not going to get a blister there. Couple ways to do that. One of them is to apply a patch to the insert that’s called a PTFE Patch. And that’s a kind of patch that actually decreases the friction on the insert. So you literally peel off the backing, you stick the oval on that spot, and that reduces the friction because it’s very slippery material.

A second way is to use skin lubricants. So if you use something like Body Glide or Squirrel Nut Butter, or one of these other skin lubricants, you just apply it to the skin right before you put on your socks, right before your long run or your race. And those things can make a huge difference. There’s a reason they’re handing out Vaseline on the course and that’s for people to put on blisters where they’re getting rubbing and they’re getting a blister. But the fact is, is once you get to that point, when you know that you have a blister, you know it hurts and you’re already limping. You really don’t want to stop at mile 16 or 17 and put Vaseline on it just to keep it from getting a whole lot worse, real fast, because it’s still going to hurt the whole rest of the race.

Remember, the name of the game here is prevention. And if you’re prone to getting blisters, it is worth looking at your insert and figuring out what can you do? And you need to experiment. So do something simple. Try a new pair of socks, try a little skin lubricant on that spot, or try PTFE Patch on the insert, but make sure you do something so that you don’t get this little problem that can really wreck your training and the quality of your race.

Go to https://www.docontherun.com/fasttrack/ and grab your seat now. I’ll see you in the training.