If foot blisters are the most common injury in sport why don’t you have many patients come to you and ask for help? If they did ask, what kind of preventive help would you be able to provide? Here are the clues to look and listen out for that indicate current and imminent foot blisters.
The Frustrating Reality
Our patients have a frighteningly low expectation of our ability to help them with this foot problem. They rarely blame us for not proactively warning them about blister issues. And when our recommendations and treatments fall short of effective prevention or pain-relief, they just think it’s something they have to put up with, and so they don’t ask again.
The result is a catch-22: no demand, and the illusion of no problem to fix. People stop asking for our help, or don’t ask in the first place because they don’t think there’s anything we can do, other than what they can already do themselves.
And it’s true, the way things are now, too many of us can’t/don’t help them like we should help them. And so the problem is perpetuated.
Are Blisters That Big A Problem?
I can tell you, they are. Even though as a podiatrist, you might not be seeing may patients asking you directly for blister advice, they are searching for it. A lot of people are doing a lot of searching online for blister fixes.
If you truly believe blisters aren’t that big a problem, how do you reconcile the fact they are the most common injury in running and walking activities?
Spotting The Opportunity To Help
There are clues to be on the lookout for that indicate current or imminent blister issues.
Current Blister Issues
These are easy to pick up. However, your patient will often try and minimise the issue by blaming it on their shoes, their activity, their feet, the weather… It’s likely you’re also in the habit of minimising the issue too, leaving them to simply use bandaids to “stop the rubbing”.
Here are some scenarios:
- People who actually ask for your help with blisters
- Visible intact, torn or defoofed blisters, or remnants of healing skin
- People with bandaids or tape on their toes/heels/anywhere
- Or open sores or scabs they haven’t bothered to cover because they’re so accustomed to the damage
- Anything your patient puts down to “rubbing”
Imminent Blister Issues – Upcoming Increased or unaccustomed activity
You need to be listening out for hints of upcoming unaccustomed activity or that an increase in activity level is imminent. This increased time on their feet is the initiating factor for blisters that your patient has no idea about, but you do. Not making the connection known to them is doing them a disservice, as their podiatrist. By not alerting them to this, is one of the factors contributing to the current state of affairs where people think blisters are completely unpredictable – and why they don’t blame you for the blisters they get – even though they came to see you about preparing them for their participating in Oxfam Trailwalker or training for their marathon or funrun or in preparation for hiking Kokoda or Cradle Mountain or the Camino or the PCT.
Let’s go through some common scenarios where your ears should prick up and you should immediately start thinking about blisters.
- It’s anyone on a fitness kick. They might be starting to walk more or getting into running for their fitness.
- It’s anyone training for running events like funruns, half-marathons, marathons, ultramarathons.
- It’s anyone who has signed up for charity walking events like Oxfam Trailwalker. There are millions of them.
- It’s anyone heading off on long weekend trips to go skiing or hiking with friends.
- It’s anyone of your patients, young or old, who proudly tell you they have weight-loss goals they’re working towards and walking more.
- It’s anyone who plays blister-heavy sports like netball, football, hockey and tennis, especially at the start of the season
- It’s anyone planning holidays where they’ll be walking much more than usual.
That’s a lot of people that you see on a daily basis, isn’t it?
What Happens If You Don’t?
Blisters might not be the most debilitating foot injury there is. But they’re not insignificant. Imagine:
- A netball player afraid to reach that little bit further to receive a pass because of the blister under the ball of their foot? How happy do you think their teammates are, and their coach?
- Someone on holiday with their friends or family, cringing as they pull their shoe on over their blistered little toes before setting off for the day? They don’t want to sit in their hotel for the next 3 or 4 days to let their blisters heal a bit while everyone else is out having fun.
- Or a hiker cringing as they pull their boots on over their blistered toes and heels each morning only to have to keep up to get to the next camp. It’s not even an option to stay behind and wait for their blisters to heal.
- A runner reaching the last 10 days of their training plan only to suffer a painful blister, unsure whether to put a halt to their training, or continue regardless and risk the blister getting worse and being a bigger problem on race day?
- Your over-weight or diabetic patient is who is desperate to hit their weight-loss goals or keep their blood sugar levels down, only to be foiled by a blister in the early stages of their effort, let alone a blister that recurs. Momentum is difficult to maintain for some people.
By advising on blisters, you’ll be removing the most likely block to their momentum – and maintaining momentum is so important when you’re starting a fitness regime or training for an athletic event or trying to improve your systemic health.
I’ve consulted with patients, both in-clinic and remotely, in all of these scenarios. They’re desperately serious about finding a solution. The frustrating thing is, most of these blisters were predictable. And very preventable.
Blister Advice Is Our Job As Podiatrists
As a podiatrist, you take pride in your ability to keep people on their feet, keep them active and help them live their best lives. I just want you to see that proactive blister education must be part of this.
Get The Blister Conversation Started
Look and listen for the clues of blister issues, current or imminent. And start the blister conversation.
It couldn’t be easier. Just ask where they’ve had blisters before. These are the blister locations they can expect to get again, and exactly where they should take proactive preventive action, now!
A huge fan & advocate for Engo patches. Have used them in my hiking boots & sandshoes for ages. Bought large rectangles for husband, but they came off after his first hike as it was through several creek crossings, so not good if conditions very wet.
I think, in most cases of blisters, athletes don’t go to their doctor. They just wait for it to heal on its own. Too often, podiatrists, even sports podiatrists, don’t update their knowledge and skills about best practices in blister formation and care.
Agreed, John. I’m hoping to change that 🙂