Preventing and Treating Blisters for Multi-Stage Races

My approach to blisters is to try to prevent them at all costs! So many people end up with blisters after their first day of a six day race, which I find unbelievable. Anyone who has put in the training miles in the kit they intend to use should have an appropriate blister prevention method. The terrain, frequently damp weather and volcanic ash do seem to conspire to create perfect blister forming conditions. That being said I managed to run the full Fire and Ice with only one significant blister and two Half Fire and Ice’s (now the Viking Ultra) with no blisters. I’ve also provided medical support for five ultramarathons which meant dealing with lots of other people’s blisters, so you might consider me something of a blister expert. In this article I’ll give you my personal blister prevention methods used during the Fire and Ice Ultra 2019 and talk a little about other methods I’ve seen used.

“The terrain, frequently damp weather and volcanic ash do seem to conspire to create perfect blister forming conditions”

Equipment

There are three key pieces of equipment to consider for blister prevention: socks, shoes and gaiters.

I like to use quite thick Bridgedale hiking socks because I feel they provide a good level of padding and are less permeable to sand than thinner socks. This is one area where I would experiment for yourselves. I’ve heard very good things about Injinji toe socks and think I may try these in my next training block. Other people swear by two pairs of thinner socks to reduce friction, but I find that one pair always slips down or bunches up. Also note that some socks seem to rub more than others when wet, and your feet will almost certainly get wet during the race, so try out any socks you intend to use in wet conditions before the race.

In terms of shoes I like Inov-8 because of their wide toe box allowing my toes room to move around a little. Shoes are a very personal thing. A lot of people say buy a shoe that is half a size up from your usual so that when your feet swell there is some extra space, I haven’t tried this. I personally start the race with the inner soles in and then remove them when my feet start to swell (usually around day three). Inov-8 shoes seem to be designed to work without insoles but check that your shoes do if you intend to try this. Whatever you do make sure you test it in training, you may find that a larger shoe size allows more movement and leads to more rubbing, or taking the inner soles out exposes a seam in the shoe which rubs your foot.

Gaiters seem to be used by about half of runners on the Fire and Ice. I use quite minimalist Inov8 ones which attach to specific points on my shoes. They keep the worst of the debris out, but do let in a small amount of the finest volcanic ash. They are not waterproof but nor would I want them to be, during the water crossings the water will get in one way or another. Some people use desert gaiters which cover the full shoe, these are usually people who have done desert races before. I’ve not used them before but they seem like a very good option to keep out as much sand as possible.

Blister kit – mine includes a few small sterile needles, these are available in bulk from medical suppliers or can often be found individually from specialist running shops. Kinesiology tape is my tape of choice because it sticks very well and conforms to the contours of a foot very well. I carry a small amount of Fleecy Web Roll to use as padding under the Kinesiology tape. Alcohol wipes round out the kit to make sure things are nice and clean so I don’t introduce infection into the blister.

Having the right equipment is essential to preventing blisters

Prevention

Keeping your feet healthy begins months before the start of the race. For me this means regularly moisturising my feet, which I achieve by applying Trail Toes before each run. You get used to the slippery feeling in no time. One of my ‘luxuries’ during a race is to bring a pot of trail toes foot lubricant to apply before each stage. I’ve tried things like Vaseline, Lanancane and Aqueous Cream before but Trail Toes seems to be the most tenacious and long lasting of all of these. It forms a slippery barrier on your foot which prevents any chafing. It can also be used in other areas where you get friction like the groin or where your backpack chafes. If you bring a few disposable medical gloves with you then you can apply the lubricant to your feet without getting your hands covered, you might get a few odd looks from your tent mates though!

Another common way of preventing blisters is taping your feet before you start running. I personally don’t use this method but I know many people who swear by it. You have to make sure the tape you choose is strong enough and sticky enough to last at least the length of the long day without needing to be replaced. Kinesiology tape tends to work very well for this as it conforms to the foot and sticks very well once applied. The problem with this method is that as the feet get sweating or wet from river crossings the tape can often peel off and bunch up under your foot causing more chafing that it relieves. If you are going to use this method make sure you have enough tape to last the whole race. Some people use both lubrication and taping at once, taping the areas that they know will rub and then lubricating the rest of their feet as a preventative measure.

Foot hygiene during a race is also paramount, after all your feet are the tools that will help you get to the finish line. I carry a small wash kit which consists of a freezer bag, some compressed towels and soap flakes. Keeping feet clean and free of dirt helps prevent blisters forming in the first place. Add a bit of water to the freezer bag (I divide my food up into a freezer bag for each day so at the end of each day I have a fresh freezer bag), drop in a couple of soap flakes and the compressed towel and you can give your feet a quick wipe down at the end of each day. I know some people may think this is a bit of a faff but apart from the long day most people have hours to kill after getting into camp each night and it feels nice to be clean.

There are a few other steps you can take in the build up to the race to maximise the condition of your feet. Getting rid of callouses before the race is a good idea and using a pumice stone or something similar will help you get nice soft feet. Callouses actually promote blisters forming rather than helping prevent them. Footwear and socks you use for work should be comfortable and breathable to help your feet recover between training runs. Keep toenails short so they don’t hit the front of your shoe. Trim your toenails a week before the race, do it too close to the race and you risk cutting your toes and having a wound on your foot which doesn’t have time to heal.

Applying trail toes before a stage in the 2019 Fire and Ice Ultra

Cure

Before I tell you how to treat a blister I have one piece of advice, NEVER USE COMPEED!!! Compeed are really useful if you have a blister and are going to be resting for the next few days and have access to clean socks and dry shoes every day. Compeed are designed to absorb the fluid from the blister, the problem is this means they also absorb the water from your socks and shoes. Add this to the stickiness of Compeed mixing with all that volcanic ash you end up with a soggy, sticky, sandpaper like mess in your shoe. When you try and peel a Compeed off it will often take the roof of the blister off and leave you with an open wound on your foot. Don’t even consider putting a Compeed in your race kit.

At the end of the day sometimes, despite your best efforts, you end up with a blister. The one blister I got during the race was on a long downhill stretch with wet socks, my toenail started rubbing and I could feel the blister developing. I decided to stop at the next checkpoint and because my blister kit was easy to find I deal with it in 5 minutes and was on my way again. I start by cleaning the blister and surrounding area, then I pop my blisters with a needle in two places (sometimes if you just pop it in one place the fluid re-accumulates), drain the fluid, put a layer of padding (Fleecy Web Roll) on and then hold it in place with some Kinesiology tape. The blister will still be painful, but hopefully it will reduce to a dull ache rather than an intense sharp pain. The Kinesiology tape will often last for multiple days and if it is still sticking well there is no need to peel it off and reapply at the end of each day, just wait for the end of the race when you can soak it off in the shower.

At the end of the day you are running 250km, some pain and discomfort is to be expected and sometimes you just have to put up with it.

I hope this helps you towards a blister free race, if you’ve got any other suggestions on how to deal with blisters then feel free to send in your suggestions.

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