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Foot care on hiking and backpacking trips

Posted: Tuesday, February 5, 2013

My first long backpacking trip was 40 years ago in the Sawtooth Mountains of Idaho. The first week my companion had constant trouble with blisters, trying a variety of treatments that were marginally successful. In all honesty, I was not completely sympathetic - I was sure there was something she was doing wrong or she wasn't tough or she had brought the wrong boots. The second week her feet were fine and mine went all to hell. I learned two things from that: 1) blister prevention is way more effective than treatment; and 2) never be smug. Since then I've learned alot about how to keep my own and others feet happy and healthy - and really, your feet are key to a good trip. You can be in the most beautiful place imaginable but if all you can think about is how soon you can get your boots off, you aren't going to enjoy it.

Before the trip starts

1. Buy boots that fit well. If your feet are hard to fit, buy them from a store with trained salespeople who can help. Women often have low volume feet and wearing beefier insoles, such as Superfeet, can help keep your foot from sliding around in the boot. You can read more suggestions here. If you arrive at the start of a hike with boots that don't fit, there isn't much you can do after that.

2. Break your boots in before the trip. Boots that are all leather take longer to break in than leather and synthetic mixtures so make sure you start in plenty of time. And insoles have a break in time too so put them in as soon as you get them.

3. Consider liner socks. Some people always need them, some never need them, and some need them sometimes. You can read a longer post here.

4. Trim your toenails. They should be shorter than your toes or they can get jammed into your boot and cause severe bruising of the nail bed.

Prevention on the trip

1. Keep your feet and your socks as clean and dry as possible. Wash your feet every evening and don't wear your socks for more than one or two days before washing them. If your socks become stiff they have a greater tendency to chafe the skin.  Clean socks also help prevent other foot ailments such as bacteria growth. Dry socks inside wet boots are better than wet socks.  If your feet are wet during the day it is important to dry them at night and either air them out with no socks while you sleep or use clean dry socks. Foot powder can be a boon to people with sweaty feet. I always carry at least 2 pairs, wearing one and drying out the other. In a very wet environment, I take 3 pairs.

2. Say hello to your feet every morning and evening. Sit down and really look at them.  Know what your feet look like when they are healthy. Are there red places or sore spots? If there are, of if there are spots you know you are prone to developing blisters, put duct tape over that spot.

3. Socks should fit well.  Avoid having wrinkles or lumps inside your boot, and if you feel wrinkles, stop and smooth your socks out.

3. Soak your feet in cold water. If you're walking by a stream, take the time to pull your boots off. Not only will it feel delightful, it actually helps to prevent blisters by reducing swelling. Putting your feet up when you take a break does the same thing.

4. If you feel a hotspot, stop and treat it immediately.  A hotspot is a place where the skin is being chafed and can quickly develop into a blister if not cared for. A simple piece of duct tape is often all you need. If the area is quite sore or red, a piece of moleskin with a hole cut out of the middle is more effective. The hole should be placed over the hotspot - this decreases the friction over that area.

5. Change what you're wearing on your feet. If you wear liner socks and you're getting lots of hotspots, take them off. If you're not wearing liners and you're getting lots of hotspots, try wearing some.

Blister treatment

Sometimes no matter what you do, you get blisters. This is not a moral failing. However, they should be treated immediately.

1. Decide if the blister needs to be popped.  It is less likely to develop infection if it is left intact. However, if it more than 3/4 inch in diameter, if it is likely to pop anyway because of it's location (which it usually is), or if the fluid is hazy, it is better to pop it in a controlled fashion that leaves a covering of skin. Typically I don't cover or pop blisters in the evening - I wait to see what they look like the next morning.

2. If you don't need to pop the blister:  Cover the blister with a piece of mole skin cut to a size larger than the blister itself. It should have rounded edges to avoid being lifted when it is back inside you boot.  Then cut a hole slightly larger than the blister itself and place it over the blister.  If the blister is particularly tall, another piece of mole skin with a hole in it may be placed over the first. Cover the blister and mole skin with a dressing and an adhesive bandage.

3. If you do need to pop the blister:

  • With flame-sterilized nail clippers or small scissors make a small “V” cut in the side of the blister. Make the cut at the edges of the blister where ongoing foot pressure will push out additional fluid. This allows better drainage than needle holes. Push all the fluid out with your fingers.
  • Apply a small dab of antibiotic ointment or zinc oxide to the top of the blister.
  • Directly over the blister, apply a blister patch like Spenco’s Sports Blister Pads, or a large duct tape patch with a piece of toilet paper in the middle to keep the tape from sticking to the roof of the blister.
  • After applying a patch, roll socks on and off to avoid disturbing the patch, and use a shoe horn to ease the heel into the shoe.

Like many things, over time you will learn what works best for you!

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