Blister Busting

MORE ON BLISTER PREVENTION AND TREATMENT
An article from Competitor.com by Allison Patillo, “8 Blister-Busting Items For Happy Feet”, is something I ran across several weeks ago in early April just before starting to investigate ruck walking. Searching to find it again, I also quickly checked the medical literature and found a newly published article “Paper Tape Prevents Foot Blisters: A Randomized Prevention Trial Assessing Paper Tape In Endurance Distances (Pre-Taped II)" by Grant S. Lipman M.D. from Stanford University,and colleagues.

Their study examined the blister-preventing effects of foot pre-taping on 128 ultra-distance runners competing in the 6-stage, 250K (155 mile), 2014 RacingThePlanet event. Foot races in this ultra-marathon took them through the Gobi Desert in China (35 runners), Atacama Desert of Chile (53 runners), and the Jordan (19) and Madagascar (21) Deserts. In this event there were 25 mile races on each of 4 consecutive days, a 50 mile race (combined on the 5th and 6th days), and a finishing 5-6 mile race on the last day. The mean age was 39.3 years and body mass index was 24.2, with 31 (22.5%) females. Participants carried their own equipment for the race duration, which included a minimum of 2000 calories/day, and every 6-7 miles, an offered 1.5 liters of water (mean pack weight was listed as "10.3"; not given as kg or lb. Would this be like light rucking?).
 
“The objective of this study was to examine whether paper tape could prevent hot spots and
blisters on specific blister-prone areas”.  A coin toss determined which ONE of the runner’s two feet was studied (the “intervention” foot; the opposite foot was not studied). On the evening before the first day of racing, medical staff trained in application procedures plus an on-site researcher dried and brushed clean the intervention foot, then covered blister prone areas (directed by each individual runner according to his/her experience) with 2.5-cm (1-inch) 3M Micropore™ paper tape. In roughly 3/4's of runners the blisters occurred at uncovered areas rather than underneath the paper tape; “paper tape had an absolute reduction of blister incidence of 40%”, according to the authors reported results.
 
Most of the study participants had 1 blister (78%), with the toes (50%) being the most common location, followed by the heel (23%). The greatest incidence of blister formation occurred early in the race (80% by stage 2) and those participants running in the wettest locations (Gobi and Madagascar). Blisters under the tape occurred early on (proof of the area being blister-prone) and those not under the tape developed towards the end of the event. There was no correlation with blisters and Injinji brand™ socks (sock fabric separates the toes). The researchers thought this was likely because runners who wore them were not prone to getting blisters between the toes, so they did not direct the tape application to the toes. Forty-five percent of the compliant runners in the study wore Injinji socks; they “are popular among ultra-endurance runners”. The authors commented that “it seems reasonable to avoid the use of paper tape on the toes with Injinji™ socks.”
 
Why worry so much about blisters, other than they’re obviously painful and the pain may cause you not to complete a race?  The authors indicate that a more subtle effect of running with blister pain may be that it leads to changes in gait, “which can exacerbate underlying injuries.” Although runners claiming that sprains and other muscle injuries were the reason for withdrawing from a race, they “may in fact have blisters that are worsening these injuries. Military trainees with blisters were found to have a higher incidence of overuse injuries, particularly to their knees and ankles, and those with blisters were 50% more likely to experience additional injuries”.
 
BOTTOM LINE: it’s worth the time and effort to try various preventative measures to avoid developing blisters, ESPECIALLY if they are a problem for you or tend to form under certain conditions (longer or wetter runs, or those in which you carry a pack) .  You may want to investigate the 8 items listed in the “blister-busting” piece from Competitor.com AS WELL AS plain paper tape, which may be an inexpensive and readily available solution!

 RUN, WALK, and RUCK HAPPY!
 
http://running.competitor.com/2016/04/photos/8-blister-busting-items-for-happy-feet_147819

http://graphics8.nytimes.com/packages/pdf/health/blisters.pdf