There’s no way to sugarcoat it: Runners’ feet take a beating. Whether you’re logging double-digit miles for marathon training, powering through some hill sprints, or even just taking it easy on a long, slow jog (sometimes through mud, slush, and puddles on your favorite trail), your feet bear the brunt of the pounding that running requires.
So it’s no surprise that some of the most common injuries that can knock runners off their feet have to do with their, well, feet. Injuries like stress fractures, plantar fasciitis (inflammation along the heel that can lead to pain), or tendinitis can seriously hamper your running routine, and also just suck.
And here’s another one to add to the list: the blister. While its long-term implications are likely not as serious as something like a stress fracture—which can sideline you for weeks or even months—blisters on your feet can still wreak serious havoc on your running game.
“The main problem after blister formation is pain,” James Koo, D.P.T., physical therapy supervisor at NYU Langone’s Sports Performance Center, tells SELF. But in order to avoid pain from the blister, some runners may develop what he calls “compensatory movement strategies”—basically changing your gait to try to avoid aggravating the blister—which can hamper your performance and possibly even lead to overuse injuries. Yikes.
We asked nine podiatrists, sports medicine docs, exercise physiologists, and physical therapists for their best tips on how to keep your feet healthy, happy, and blister-free. Here’s what you need to know.
Why does running cause blisters, anyway?
Chances are you’ve had a blister at one point of your life—whether attributed to pounding the pavement or just walking around in too-tight dress shoes for one hour too many—but did you ever wonder what they actually are?
Put simply, “a blister is a raised area of skin filled with clear fluid,” David M. Smith, M.D., a sports medicine physician at the University of Kansas Health System, tells SELF. “They are caused by friction or pressure on the upper layer of skin sliding against a deeper area of skin.”
When you’re running, tight shoes and pressure points from bones on your feet close to the surface of your skin are typically to blame, since they cause repetitive rubbing of these layers of skin, he explains. The body’s response to this is to form a bubble of clear, watery fluid between the layers of your skin to help reduce tissue damage and promote healing.
What should you do when you get a blister?
It’s the fluid trapped within the blister exerting pressure on your skin that leads to the pain you feel, podiatrist Robert Eckles, D.P.M., M.P.H., an associate professor in the department of orthopedics at the New York College of Podiatric Medicine, tells SELF. Which then leads to one of the biggest questions with blisters: to pop or not to pop?
Unfortunately, there’s no clear-cut answer, says Dr. Eckles—there are experts on both sides of the issue. In fact, while the American Academy of Dermatology recommends against popping a blister in most cases to avoid infection, it does also recognize that if the blister is large and very painful, it may be necessary to drain it. (Caveat: If you have diabetes or poor circulation, you should always check with a doctor before self-treating any blister, as it may rapidly progress to infection and ulceration, says Dr. Eckles.)
Dr. Smith—an advocate of not popping—recommends simply applying an extra layer to protect it and prevent painful friction when you run.
“Take some thin moleskin [a padded adhesive available in any drugstore], cut a hole the size of the blister, and apply the moleskin with the blister fitting in the center of the hole,” says Dr. Smith. “This allows the friction and pressure to be transferred more to the moleskin and less to the blister, and may allow a runner to continue training.” If you don’t have moleskin at home, you can apply a light layer of lubricating jelly (like Vaseline or Aquaphor) over the blister, then cover with an adhesive bandage. Replace this frequently to wash the skin and reduce your chance of infection, he says.
If you must pop, podiatrist Christopher R. Hood Jr., D.P.M., a member of the American Podiatric Medical Association, recommends first cleaning the area with antiseptic and using a sterile instrument to drain the fluid. (Again, anyone whose immune system is compromised should skip popping on their own, and instead loop in their doc. Same if the blister looks infected.)
“One hint when deciding where to place the hole in the blister is to perform this at the ‘bottom,’ or lowest part, of the blister so that gravity will allow it to continue to drain,” says Dr. Hood. “For example, if you have a blister on the back of your heel, place the hole at the six o’clock position so that while you’re standing all day the fluid will run and exit the bottom, versus placing it at the twelve o’clock position, where it would not be able to drain and the fluid would re-collect in the bottom portion.”
Dab on a little antibiotic cream like Neosporin to avoid infection, and then cover the blister on your foot with a bandage. If you notice signs of infection, like if the area becomes red, hot, or swollen, or if you see pus, call your doctor or podiatrist, Dr. Hood says.
If all that sounds gross/like a hassle, here’s how to prevent them in the first place.
“The best way to prevent blisters is to take steps to stop any rubbing or friction from converting an area of irritation to a full-blown blister,” says Dr. Hood. These 10 tips to keep blisters at bay can get you started.
1. Stop running in cotton socks.
Cotton socks may feel soft and comfy, but they may also be the perfect breeding ground for blisters on your feet.
“One-hundred percent cotton socks are not the best, as they absorb sweat and stay moist, thus increasing swelling and friction,” says Dr. Smith. “A material that wicks sweat from the skin through the sock is best.” This includes materials or blends of materials like merino wool, polyester, nylon, spandex, and Teflon.
In fact, socks made of merino are particularly good choices for those who run in cold weather, since along with their wicking ability, they will also help keep your feet warm, says Dr. Hood.
2. Keep moisture out.
Even if you switch to moisture-wicking socks, your feet still can get too damp if you’re a heavy sweater. That moisture, of course, can lead to the friction that can trigger a blister.
One way to cut down on that is by sprinkling some powder on your feet before you put on your socks to eliminate that moisture.
“Keep skin dry by using baby powder or antifungal powder (like Zeasorb, $18, amazon.com) to decrease moisture that causes rubbing,” says Dr. Hood.
3. Make sure your shoes fit properly.
Tight shoes can increase your chances of blisters because they impart more pressure and friction on your feet. And even shoes that didn’t feel tight when you’re lacing up can start to feel snug while you’re running.
“As the mileage increases, your feet will swell during the run,” Katie Lawton, exercise physiologist in Rehabilitation and Sports Therapy at the Cleveland Clinic, tells SELF.
That’s why finding the right fit for your shoes is vital. One way to do that is to get properly fitted at your local running store, suggests Christopher Travers, an exercise physiologist in Rehabilitation and Sports Therapy at the Cleveland Clinic. The experts there will help you take into account things like how your feet swell during exercise to help you pick the best fit for you.
Generally, Dr. Hood recommends to wear a running shoe that is a half or full size bigger to allow plenty of room for swelling, especially for long distance runners.
4. Test out new shoes at home before you run.
Even if the pros helped you make a running shoe choice, you should still test it before you take it out for a long run.
“Wear the sneakers around the house with your running socks and any other items you wear for running,” says Dr. Hood. “See if under low-stress, low-pressure situations—walking around the house—there are any areas rubbing. If there are, this will be exacerbated with running.”
5. Do not—I repeat, do not—remove your calluses.
“They act as your body’s natural cushion by padding areas of high pressure that experience a lot of rubbing by toughening up your skin. So if you remove your ‘cushioned’ areas, skin will be more prone to blister formation,” says Cassandra A. Lee, M.D., sports medicine physician at University of California at Davis Health, tells SELF.
But you want to control them: If they become really big, they can “cause pressure points and increased friction in deeper layers of skin,” says Dr. Smith. So keep them pared down with a pumice stone or callus file.
If you’re into pedicures, ask your pedicurist to leave them intact. But if they do mess with them, you can play damage control.
“If your pedicurist removes your calluses, you can apply cloth tape over the areas prone to blistering before you run to reduce the friction,” Wil Colon, P.T., M.S., clinical specialist at NYU Langone’s Sports Performance Center, tells SELF. “Adding an additional layer of padding such as ring-shaped moleskin pads or a hydrocolloid bandage may be necessary to protect any sensitive areas.”
6. Lube up.
“Dry skin is almost as harmful as moist skin from sweating is, as it can crack and create more friction and pressure points and become infected,” says Dr. Smith. “Some athletes will apply ‘skin lube’ (like Vaseline or Aquaphor) to reduce friction in pressure points about the foot.”
You can add this to your nightly routine: Apply a skin-lubricating lotion, Vaseline, or Aquaphor, to your feet and then cover with a pair of socks before bed, says Dr. Smith.
7. If you use orthotics or inserts, foam or gel are best.
“If your foot feels like it is slipping around too much, consider the material of the insert or orthotic,” says Dr. Hood. With plastic inserts, your foot may slide around more, making it more likely to hit and rub against the sides or fronts of your shoes. Try foam or gel inserts instead.
8. Change your shoelace pattern.
If you have a blister on the top of your foot (or are more prone to getting them there), consider adjusting the shoelace pattern to take pressure from the laces off the area in question. This often means skipping a lace-set or two.
If you are getting a blister or rubbing in your heel, consider lacing your shoes to the very top lace (the one closest to your heel), which is often called the heel-lock lace, preventing your heel from slipping and rubbing around.
9. Wear two pairs of socks.
“One way to minimize frictional force between sock and foot is to wear two pairs of socks, which will allow for sock-to-sock friction rather than foot-to-sock,” Jonathan Ramin, M.D., a sports medicine fellow in the department of rehabilitation and human performance at the Icahn School of Medicine at Mount Sinai, tells SELF.
Still, many runners are divided on this tip: After all, wearing two pairs of socks might make your shoes too tight—something that can up your odds of a blister. So give it a try if your shoes are loose to begin with, and see if it works for you. (Feels too tight or uncomfortable? Abort mission.)
10. Bring blister prevention with you.
Being proactive in the moment—and maybe even hitting the pause button on your run—can pay off big later.
“When you feel rubbing during a run, stop and adjust wherever you’re feeling friction,” says Dr. Hood.
And play the preventive game too. If you’re running in wet conditions (like if it’s raining or you know the trail will be full of puddles from the night before), bring an extra pair of socks with you so you can change into them if your first pair gets damp, says Dr. Hood.
“If you run with a belt or pockets, carry a blister pack, which can be commercially purchased ($11, Amazon), or you can make your own with things like lubricant, powder, a bandage, moleskin, tape, alcohol or antiseptic pads, scissors to cut your tape or pads, and a waterproof bag to carry it all in.”
Can’t fit in all in your running pack? Stash it in your car if you’re running loops—you can take a quick detour to home base if you feel some foot rubbing going on.