Blister prevention and field treatment

The following information comes courtesy of one of our coaches with over 10 years of SOF active duty and a lot of rucking miles on his feet.

Arrrg! FOOT BLISTERS. They are brutal, and there is no way to ignore them. Blisters do not care how fit you are. Nothing will shut you down faster and more definitively than bad blisters.  Not only your job but your safety depends on being able to move long distances quickly on your feet.

Taking care of your feet to prevent blisters requires forethought and planning. You would not expect to perform well in a 12-mile timed ruck if you had not spent time training.  Similarly, you can’t expect your feet to hold up to the rigors of rucking without preparing them.  That’s what the first part of the article focuses on.  If your approach is to ignore your feet, take them for granted, and just hope for the best, you will want to pay close attention to the second part of this article that addresses the proper field care for blisters.

An Ounce of Prevention is Worth a Pound of Cure

Avoiding blisters in the first place will save you a lot of trouble when you are reliant on your feet.  So, let’s start there with some preventative measures that have stood the test of time.

Break in your boots and your feet during shorter outings. Do not head out for a long difficult ruck in new boots. Don’t show up at selection with new boots.  Find boots that fit you well that you can rely on.  Different brands fit differently. Try them on. Test them and be prepared to move to another brand if they don’t work for you.

Do this every day for two weeks before starting to do a lot of rucking or long runs. After you start rucking, do this immediately after each long ruck or run. And do it one other time per week.

• Epsom salt baths
  • Dissolve 2 cups (.5L) of Epsom Salts in 3 gallons (11L) of VERY hot water.
  • The temp should barely be tolerable and require slow immersion of your feet
  • Soak till the water is cool
  • Let feet air-dry
• Use a pumice stone on foot callouses when you shower, and callouses are soft.

 Following this protocol will help minimize the chance of getting blisters in the first place.

Socks

A simple and very cheap sock layering method to prevent blisters is to wear women’s knee-high nylon stockings (the kind your grandma may wear) as your first layer next to your skin.  This allows the slipping and rubbing that causes blisters in the first place to occur between the nylon stocking and the sock rather than between your skin and the sock. While the nylons are a bit fragile, they are cheap, super light, and highly compressible.  So, carrying a couple of extra pairs for multiday excursions is not an issue.

The Ellsworth Tactical boot sock is an innovative sock that will keep your feet drier and makes a great layer over knee-high nylon stockings. They are long enough that they can be folded down over the tops of your boots to keep them from sliding down. https://ellsworthsocks.com/product/boot/

Another sock product that has been used with good results is the https://www.injinji.com/boot-original-weight-otc.html

Skin Treatment

Hike Goo. Good for prevention of blisters on feet, chafing on thighs and crotch, and preventing chafing and skin being rubbed raw from the rucksack waist pad and strap.  https://www.amazon.com/dp/B008RCIPH8?starsLeft=1&ref_=cm_sw_r_cso_cp_apin_dp_9MZNXVFFHCYM2EN87GFY_1

Leukotape. Good for treating hotspots to prevent blisters. Use only if a blister has not formed. Cut a piece 1/4-1/2 inch larger on each side than the size of the hot spot and place it directly on the hot spot. Also great for placing where the rucksack waist pad and strap rub to prevent chafing and skin from being rubbed raw: https://www.amazon.com/dp/B000FMMTKM?starsLeft=1&ref_=cm_sw_r_cso_cp_apin_dp_GEB30VTW1TMZFS407QHM_1

Tuff foot. Good for maintenance when you’re not rucking. https://tuffoot.com/about/tuf-foot-for-humans

Treating Hot Spots

 By far, the single biggest cause of blister formation is the failure by the owner of these soon-to-be bloody messes to stop and deal with them while they are still hot spots and BEFORE they become blisters.  This usually happens in an effort to avoid stopping the forward progress of yourself or a group.  “That hot spot will go away” is the usual thought process……NOT!  That rarely happens, and when the blister forms, you will lose much more time dealing with it than if you treat the hot spot.

 Hot spots respond well to being covered, and there are myriad products for this. The Leukotape mentioned above works great and should be in your kit.  Dr. Scholl’s Moleskin works well also, but it does not stretch, so it can be hard to fit into the rounded parts of a foot. Cotton athletic tape also works, but you need enough to wrap the whole foot so it can adhere to itself. Otherwise, it will roll and cause more problems later.  Band-Aids do not work and are a waste of time.

Treating Blisters

To speed healing, you must preserve the skin that blisters. Blisters form between the outermost layer, the epidermis, and the underlayer, the dermis.  If you let the rubbing get to the stage where the blistered skin tears away, exposing raw dermis, you’re looking a lot more pain and longer healing.

Treating the blister before the epidermis is damaged prevents a lot of pain and speeds up the healing process.   So, stop and treat your blisters before they become a torn, bloody mess.

Do this by using a sewing needle to puncture the blister at its base near the undamaged skin and drain the fluid.  Do not use a knife blade because the hole must be very small, so the blister skin is less likely to tear.

Next, using that needle and cotton thread, push the threaded needle through the blister so it comes out on the other side of the blister, also near the base of a blister, close to healthy skin.  Do this in the same direction of travel (lengthwise on your foot).  Pull the thread through the blister so there is just a single thread running through the blister. Cut the thread so that 1/8-14” of thread remains outside the blister.

Do not apply any sort of tape over the drained blister, or you will tear the blister off when you remove the tape.  Instead, cover it with one of the sock combos mentioned above.  The cotton thread will wick any new fluid out of the blister.  When the blistered epidermis becomes tough and calloused the skin under it will have healed and you can pull the thread out.

Caring for your feet before and during your training and selection will allow you to keep your energy and attention focused on the task at hand rather than being distracted by the pain in your feet.