Blisters the Size of Texas--Prevention

The 6th Law of Running Injuries:
Treat the cause not the effect: Because each running injury has a cause, it follows that the injury can never be cured until the causative factors are eliminated.--Tim Noakes, MD, The Lore of Running

The above quote was taken from my new summer reading book Fixing Your Feet by John Vonhof. You might be wondering why I would decide to tackle such a stimulating topic such as feet, and I only have one answer for you--BLISTERS THE SIZE OF TEXAS! I can't take credit for this hyperbole, but I can tell you that I can take credit for feeling this way about my feet during my Nanny Goat 24-hour race. Blisters have now become my obsession.

Let me take you back a bit to even before the Nanny Goat event. I trained for many factors I would encounter during this race: hydration, nutrition, endurance, chaffing, dressing for the weather, finding ways to distract myself (music and Audible books), training for early and late hours, training for heat and cold, but I never once thought about blisters. In my seven years of running, I had encountered one "almost" blister, but having never actually experienced a full on blister, I wasn't worried. My friend Stephanie made me buy blister pads, but they were thrown in at the last minute and only because Stephanie wouldn't stop bothering me about them. Famous last words, "Why would I need to buy those Stephanie...I NEVER get blisters!" She was right as usual!

I now know that blisters are almost inevitable in long-mile races, especially if you don't have a plan for preventing them in the first place.  So here I sit relaxing by the pool reading my foot book and making sure that I have a blister prevention plan and a blister treatment plan--just in case.

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First, just what is a blister anyway?  A blister is a collection of fluid just under the top layer of skin. Running blisters are usually caused by moisture, heat, and friction between the foot and your sock or shoe.  Our best defense is to stop the blisters from popping up at all.  I am hoping that these suggestions will help me and anyone else who reads this blog to avoid the kind of pain I felt during the race and for weeks after:

1. Shoes: Make sure that you purchase shoes that fit your feet properly.  I buy my running shoes one size larger than my everyday shoes because with the miles I put in, my feet swell.  Also, wear them in a bit before racing or doing long miles in them.
   
2. Socks: Cotton is Rotten is one of the first phrases I learned in running--look for breathable and sweat-wicking fabrics. I love my Balega socks and I just found a pair that they advertise as blister resistant. They have two layers and are made of mohair.  They feel great--I will update in a future blog how they actually work to prevent the blisters. People also swear by Wright socks (double layer) and Injini toe socks.  Try several kinds and see what works for you. Also, I suggest that you bring several pairs of socks to the race because when socks get too sweaty, they can become an environment for blisters to begin to pop up.
3. Lubricants: This was my big mistake at Nanny Goat.  I had good socks and shoes but did not put anything extra on my feet to prevent the friction from happening. People use products such as Glide and TriSlide (my favorite to prevent chaffing), but I learned from various runners that Desitin and A&D ointment work just as well and cost much less.  I have found that A&D works for me and does not leave the white residue that Desitin does. So far no blisters, even on my longer runs--keeping my fingers crossed that it continues to be effective. If lubricants don't work, you can also try powders.
4. Hydration: This is one factor that had not occurred to me until Coach Ed mentioned it to me.  This article explains the reasoning behind hydration's effect on your feet better than I could, so here it is: How to Avoid Blisters on a Run
5. Taping: Some people swear by taping for blister prevention. This keeps your skin itself from actually rubbing against your socks and shoes. I noticed a lot of runners using duct tape at Nanny Goat, but I would suggest you try these things before a big race so you can see how they affect you personally.
6. Gaiters: Before Nanny Goat I had no idea what gaiters were.  When I saw them on the list I skipped right over them because I figured they must not be important because no one had ever mentioned them to me.  The second I stepped onto Nanny Goats dusty course, I knew right away that I had made a huge mistake.  For those of you that like me have no clue what these are, I must share that they are basically covers you wear over your ankles to cover the opening at the tops of your shoes to prevent debris from getting into your shoes and causing problems like blisters.  Not only did I not lubricate my feet, but all the dust and sand that accumulated in my shoes during that race made blisters almost inevitable.  So if you are doing a race where you will be on a trail, gaiters are a must!

A quick summary of what John Vonhof shares as the first and second lines of defense against blisters (taken from Fixing Your Feet):

• First line of defense: socks, lubricants, and powders
• Second line of defense--including a few additional suggestions: Frequent sock and shoe changes, nutrition and hydration, gaiters, taping, skin tougheners and adherents, foot antiperspirants, orthotics, and lacing (link to Vonhof's shoe lacing tips).

The unfortunate thing is that no matter how much you plan to prevent the blisters, if you put large numbers of miles on your feet those blisters may still rear up on you. And what works for one person might not work for another, so experimenting before a big event is crucial to protecting your feet.  In a future blog I will share what I have learned about how to treat your feet once those pesky blisters appear.  Below find some additional resources on blister prevention:
The Runner's Guide to Treat and Prevent Blisters
Three Simple Steps to Blister Prevention for Runners

"When you don't take care of your feet during a long run or race, each step becomes a reminder of your ignorance."  
                                             Dave Scott