How to treat your runners’ feet

The right running shoes, socks and feet care to run injury-free.

Foot blisters are the number one injury, more common than muscle-related injuries of the knee, back, ankle and foot.

Here’s how to prevent and treat them.

While walking or running, your feet need some space in our shoes to function optimal. But if there’s too much friction, it gives discomfort like blisters.
Especially when the temperature is high and/or when we run for a long time, our feet get hot and sweaty, which increases skin friction and makes blisters more likely to form.

Wear the right shoes
There’s a whole lot of shoes out there, from minimal to cushioning shoes.
Daniel Lieberman, Professor of Biological Sciences at Harvard University, studied 300 Kenyan runners since 1987 and discovered that because we learn to make better use of our muscles when we run barefoot, it reduces the impact on the body, and therefore it improves the running economy.
Despite the benefits of natural running, most of our bodies aren’t used to it anymore, so changing to more minimalistic running too sudden, can lead to injuries.
The last few years there seems to be a more in between approach that, although we need to use our natural strength, some proper support and protection sometimes is welcome as well.
Very light but cushioned shoes like HOKA one one are popular among runners from track to trail, because they give comfort, stability and support on any distance.

Which shoe is right for you?
There’s no one right shoe. Depending on your experience, personal preference and training goal (speed, distance, terrain, elevation, climate where you train and where you will race), you should choose what fits and feels best for you.
Breathability of the shoe is important in any case, to avoid swelling of your feet and discomfort like blisters.
The more variety you bring in your training, the more likely you'll need different kinds of shoes. And every kind of shoe and training has another impact on your muscles and bones, so variation in training and alternating shoes accordingly can help you avoid injuries.

Below are some links to articles to help you make the right choice for running shoes.

The MOST EFFECTIVE WAYS to prevent blisters and TOP TIPS to treat them safely
John Vonhof has 18 years of experience as a trail- and ultra runner. His book “Fixing your feet” is THE feet care resource for runners.
Podiatrist Rebecca Rushton knows all about blister prevention.
Here’s their advice:

Be well hydrated
Your skin will be supple and less likely to develop blisters if you’re well hydrated and replace lost electrolytes. It will reduce the risk of swelling of your feet, which helps preventing blisters and damaged toenails.

Take care of your feet
By moisturizing your feet and trimming your nails regularly (especially before a race) you can avoid rough skin and edges. A podiatrist can help to thin any thick nails.
Calluses damage deeper soft tissues and may cause blood blisters, so calluses need to be removed.
You can use an emery board or foot file. A pumice stone can be used as well but Vonhof prefers a product called SilkFeet because it leaves your skin more smooth afterwards.
A dry foot skin helps to keep the skin friction low during a run.
Keep your feet and skin between your toes dry with Compound Benzoin Tincture, alcohol, teatree oil, salt water or black tea. Put it on, leave your toes open for a few minutes so it can evaporate (it will only dry the skin when it evaporates), then put your shoes and socks on.
Neither antiperspirants nor powders have proven to be both safe and effective and there is no data on the use of astringent preparations.
Lubricants like Vaseline (petrolatum) reduce friction for a short amount of time and make your shoes messy and attract dirt and sand. For longer duration efforts, you would need to reapply the lubricant to maintain blister protection which is not ideal, especially not during a race. Moisturizers and less greasy lubricants increase friction so aren’t an option either.
Vonhof recommends SportSlick, BodyGlide, or a similar lube in stead.

Keep your feet dry with the right socks
Waterlogged and macerated skin is weak and prone to injury, so it’s key to keep your feet as dry as possible while you run.
Coolmax, Dry-fit or anything moisture-wicking socks significantly reduce the risk of blisters because they minimize friction.
100% wool may not be a good option unless it is Merino wool or with a high degree of thermal insulation, like SmartWool.
Avoid cotton as it doesn’t absorb moisture, so it increases friction and makes blisters more likely.
Cushioned and double-socks reduce friction and improve the absorptive capacity of the sock.
But more cushioning of sock (or insoles) is not always better as it can affect shoe fit and reduce functional efficiency.
If you get blisters between your toes, toe socks like Injinji are worth a try.
Consider taking several pairs of socks, depending on how sweaty your feet get, how long your run will be and the weather conditions.

Use ENGO Blister Prevention Patches
Polytetrafluoroethylene (PTFE) material like Teflon® and ENGO Blister Prevention Patches gives ultra-low friction and is unaffected by perspiration or moisture. ENGO Patches are adhesive patches that stick to your shoe or insole where high friction causes blisters.

"When you dont take care of your feet during a long run or race each step becomes a reminder of your ignorance."
Dave Scott

Taping technique as blister prevention
Pre-taping can save you lots of trouble when you go for an ultra (any distance above the marathon). After years of hitting the trails and taking care of his and other ultra runners’ feet, John Vonhof knows how to do a real good taping job that holds for days. Vonhof favors kinesiology tape called StrengthTape in wet conditions. To maximize adhesion he recommends applying Compound Benzoin Tincture to the skin before taping.
Then:” Apply tape at least one hour before use (if not the night before) which allows the tape’s adhesive time to bond with the skin.
Rub the tape for 20-30 seconds after applying it to the skin – it warms the adhesive to make it tackier.

When using kinesiology tapes, lay the tape on the skin and if you have to stretch the tape around a heel or toe, only apply a slight stretch. The more stretch you apply, the more likely the tape is to come loose, especially in wet conditions.
It takes as long as it takes – a precision tape job can take more than 30 minutes. Practice makes perfect and an adequate application technique can take time.” He recommends Kinesio, Leukotape and Hypafix tapes.
You can find more taping tips and applying techniques in the links below.

Lace up your shoes the right way
Now it’s time to get on your feet and get moving:

Play Video

Use the correct running form
A natural running form helps to run with less effort. By using your gravity and taking small steps you will lower the impact on the muscles and bones. This helps to reduce the friction in your shoe, especially while running downhill.

Of course you need to give your body some time to get used to new shoes, socks and gear, and when you make changes in your training or the terrain where you run. Blisters or other initial discomforts normally disappear after a few training sessions.

Blister treatment
Once the blister is there you’ll need to treat it immediately to prevent popping and infection.
Rebecca Rushton recommends the following:

Use absorbent Island Dressing pads to protect blisters that are still intact, and to use an adhesive like Primapore around it, so the blister roof won’t get damaged.

Then you’ll need to reduce the pressure by cushioning it (with insoles, silicone gels or adhesive felt) and reducing friction with a lubricant or Engo pads to make sure the blister won’t pop.

Once the blister roof is damaged you’ll need to disinfect the blister with an antiseptic like betadine, an absorbent Island Dressing pad and then reduce pressure and friction like mentioned before.
When the blister is deroofed you’ll need to use a hydrocolloid dressing like Compeed, then reduce pressure and friction like mentioned before.

Ask medical assistance when available, especially in case of infection.

Happy blister-free Running!

Running shoes: how to choose
Research on finding the right running shoe
Forget Barefoot; New Trendsetter in Running Shoes Is Cushioning
Study Backs Rotating Shoes to Lower Injury Risk
Shoelace techniques
Manage your electrolytes and hydration level
Blister-prevention with your running shoes and socks by Rebecca Rushton
Favorite trail running shoes and socks of ultra runners who finished Western States 100 Mile Endurance Run (USA)
Blister-prevention foot skin care tips by Rebecca Rushton
Book: “Fixing your feet” by John Vonhof
Taping for blisters – tips by John Vonhof
How to apply preventive taping with Fixomul for Oxfam Trailwalker
How to apply preventive taping with Leukoplast for Oxfam Trailwalker
How To Treat Your Foot Blister during an ultramarathon
How to pop a blister with a scalpel