How To Choose a Blister Prevention Strategy - that works! Find out how to choose a blister prevention strategy that will work for you, your sport, your level of activity, your climate and your feet. The reference for this presentation is The Advanced Guide To Blister Prevention - for athletes and sports medicine professionals. WHY? “... many myths continue to be propagated regarding the prevention and treatment of friction blisters. Physicians, coaches and athletic trainers continue to advocate the use of petrolatum jelly and skin powders to prevent blisters while the scientific literature suggests these measures may actually increase the chance of blistering on the feet.” (Douglas Richie DPM, 2010) Q: WHAT CAUSES BLISTERS? A: Rubbing under the skin (not rubbing on the skin). High friction level at skin surface + moving bone = everything in between stretches “SHEAR” Q: WHAT CAUSES BLISTERS? A: Rubbing under the skin (not rubbing on the skin). Shear is the sliding of tissue layers (including skin layers) across one another. These layers have fine strong connections. These connections will break when shear is excessive and repetitive. This is the initial blister injury. Then fluid fills the area to form a blister. BLISTER PREVENTION STRATEGIES: Let’s look at the pros & cons of each strategy - based on the following criteria: effectiveness and ease of use maintenance of normal function research evidence a lack of harmful effects.

1. How To
Choose a
Blister
Prevention
Strategy
that works!

2. “... many myths continue to be propagated
regarding the prevention and treatment of
friction blisters. Physicians, coaches and
athletic trainers continue to advocate the
use of petrolatum jelly and skin powders to
prevent blisters while the scientific
literature suggests these measures may
actually increase the chance of blistering
on the feet.”
(Douglas Richie DPM, 2010)
WHY?

3. High friction level at skin surface
+
moving bone
=
everything in between stretches
“SHEAR”
Q: WHAT CAUSES BLISTERS?
A: Rubbing under the skin (not rubbing on the skin)

4. Shear is the sliding of tissue
layers (including skin layers)
across one another. These layers
have fine strong connections.
These connections will break
when shear is excessive and
repetitive. This is the initial blister
injury. Then fluid fills the area to
form a blister.
Q: WHAT CAUSES BLISTERS?
A: Rubbing under the skin (not rubbing on the skin)

5. Based on the following criteria:
effectiveness and ease of use
maintenance of normal function
research evidence
a lack of harmful effects
BLISTER PREVENTION STRATEGIES
Let’s look at the pros & cons
of each strategy

6. FOOTWEAR

7. SHOE-FIT & LACING
Your first and foremost
blister prevention strategy.
May not ensure full
blister protection but
must not be ignored.
PROs
CONs
MOISTURE-WICKING SOCKS
You need socks anyway so
why not choose socks with
advanced moisture
management properties!
Absorptive capacity of sock can
be exceeded and long-term
effect relies on evaporation
through the shoe upper.
PROs
CON
s
CONs

8. DOUBLE-SOCKS
Provides an additional interface.
Thin inner sock will not
adversely affect shoe fit.
Absorptive capacity of socks
can be exceeded.
Optimal combination will take
trial and error.
PROs
CON
s
CUSHIONING & INSOLES
Proprietary insoles can
easily be replaced.
Cushioning devices for toes
are readily available.
More cushioning is not always
better for functional efficiency.
Keeping toe cushioning in
place can be tricky.
PROs
CON
s
CONs CONs

9. ORTHOTICS
Can be relevant to some
blister locations.
Often neglected but offers
large preventive potential.
Not relevant to all blisters.
Requires professional
assistance.
PROs
CON
s
ENGO PATCHES
Extremely low friction.
Long-lasting (500kms).
Unaffected by moisture.
Targeted friction management.
Patch adhesion compromised
with water-logging.
Can’t be used for blisters
between toes.
PROs
CON
s
CONs CONs

10. SKIN

11. ADAPTION
A basic blister prevention
requirement.
Requires preparation –
training in gear and on
terrain before event.
PROs
CON
s
ANTI-PERSPIRANTS
Easy to apply.
Usually ineffective or only
short term effect.
Stronger preparations can
cause skin irritation.
PROs
CON
s
CONs CONs

12. POWDERS
Readily available.
Short term effect.
Delayed increase in friction.
Messy.
PROs
CON
s
ASTRINGENTS
Popular.
No research exists.
Theoretically only has a
short term drying effect.
PROs
CON
s
CONs CONs

13. LUBRICANTS
Very popular.
Large initial friction reduction.
Initial lack of traction.
Later increase in friction.
Weakens the skin.
Messy.
PROs
CON
s
TAPING & DRESSINGS
Very popular.
Good abrasion prevention
strategy.
Sweat is a constant threat to
adhesion.
Difficult to perfect technique.
Time consuming.
PROs
CON
s
CONs CONs

14. ACTIVITY

15. TECHNIQUE
Can help if running form or
biomechanical function is at
fault.
Changing technique may have
adverse effect elsewhere.
PROs
CON
s
TRAINING REGIME
Theoretically easy to institute.
Rarely practical or
acceptable.
PROs
CON
s
CONs CONs

16. www.blisterprevention.com.au
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THE ADVANCED GUIDE TO
BLISTER PREVENTION