Body Shop: Give blisters the rub - Military Health, military health and wellness, military physical fitness - Military Times

Body Shop: Give blisters the rub

No doubt about it, blisters suck. And with rucking, training and ramped-up physical fitness requirements, they can be all too common.

Repeated rubbing from new shoes, longer-than-normal activity or bunched socks causes layers of skin to separate, and the accompanying fluid accumulation (plasma or blood) forms the actual blister.

Air Force Capt. (Dr.) Sean Martin, sports medicine fellow at the Uniformed Services University of the Health Sciences, says studies show a 48 percent to 77 percent incidence of blisters in studies of troops during long road marches (and one ROTC summer camp), compared with 39 percent in the general population of runners. Avoidance is the best course of action, but when you have to keep moving, effective treatment can keep you pushing toward your goal.

Causes and prevention

When you run, ruck or hike, your feet get hot and sweaty. Even if you’re used to long miles in your shoes, a few grains of sand or running on an incline or decline can lead to hot spots.

Martin stresses the importance of well-fitted shoes — too loose or too tight can cause blisters. Test shoes before you buy, and make sure seams and liners are smooth and comfortable. Increase mileage gradually, check for hot spots after every wear, and let your feet build up protective calluses.

Army 2nd Lt. Andy Oh, a third-year medical student, used his Army infantry experience to keep himself and his rucking partners virtually blister-free during the 2010 Marine Corps Marathon’s Wounded Warrior Project ruck.

“We gradually progressed in our training to toughen our feet for the long ruck on concrete,” says Oh, whose crew covered the 26.2 miles in boots while carrying packs weighing 25 to 45 pounds.

Wet feet blister faster, and drying powders can help control moisture. Talc or cornstarch powder works until it gets damp, and rubbing antiperspirant on the bottom of feet can minimize sweating. Spreading on a layer of petroleum jelly or other anti-chafing agent may help reduce friction. For known blister-prone areas, consider a second-skin product, moleskin or zinc-oxide tape.

Wick-ed gear

Socks — not cotton — are critical to blister prevention. Padded polyester, synthetic, acrylic and wool are the best for wicking, performance and durability. Change into dry socks as needed.

“The newer-style combination socks designed to wick moisture and keep the boot cool are superior to traditional boot socks,” Martin says. “Combos that feature wool, polypropylene and polyester are preferred.”

For Oh’s Marine Corps Marathon crew, those prone to between-the-toe blisters wore toe socks with good results.

While popular, layering two pairs of traditional boot socks probably isn’t the best approach.

“The two-layer sock system is pretty standard, but many troops do not like layering because the inner layer can wrinkle, and it can make boots fit too tight,” Martin says. And studies back up troops’ findings. “A 2009 report in Military Medical ... found that a two-layer system did not prevent blisters as well as a single, padded polyester sock.”

First aid

For small blisters, it’s best to leave them alone and let them drain and heal on their own.

But for larger, more painful blisters, you may have to pop them or else they’ll pop on their own and you’ll risk damaging the skin that forms the roof of the blister.

“Rule No. 1: Do NOT remove the roof of the blister!” Martin warns. Removing the roof exposes raw skin, making treatment more painful and difficult.

To safely drain a blister, puncture the roof with a sterile needle to drain the fluid. Clean the wound, and cover it with a protective and flexible dressing — a nonstick pad is a good idea.

If you can’t rest and let the blister heal, Martin suggests injecting a 50-50 mixture of zinc oxide and bacitracin antibiotic ointment under the roof of the blister, mitigating pain and protecting layers of skin. For proper healing, keep the area clean and covered.

Allison Pattillo is a Military Times fitness writer.