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Health & Exercise Forum

Steamtown Marathon: Blister Management and Prevention

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Oct 4, 2010

Dr. Mackarey's Health & Exercise ForumKudos to the hard working organizers of the Steamtown Marathon! The race has been filled to maximum capacity for months. With the growing popularity of the Steamtown Marathon more and more local runners are running greater distances to train for the October event. As a result, more and more runners are asking me about blister prevention. Nothing can ruin a great run like a nagging painful blister. As you attempt to “run through” the pain, you compensate your gait in such a way that you irritate something else, such as your knee, hip or lower back. With this in mind, as many local runners prepare for this year’s marathon, I thought information on blister prevention would be of great value.

Blisters are not unusual for anyone who participates in sports that require repetition over a long period of time. Blisters occur when the skin rubs against an object causing friction to build up over time. A tear is created in the upper layers of the skin to form a space. Fluid seeps into the space. The soles of the feet and palms of the hand are the areas most vulnerable to blisters for many reasons. Hiking shoes, running sneakers, tennis rackets and golf clubs repeatedly rub the skin and form blisters.

Three things you want to do if you get a blister are: relieve pain, keep the blister from enlarging and avoid infection. Pain is relieved by, limiting the size of the blister and eliminating the source of friction. The best protection from infection is a blister’s own skin. Allow the skin to stay intact, use ice to control the fluid accumulation and eliminate further trauma to the skin. This is very effective in small blisters with minimal fluid. However, larger blisters filled with fluid may require drainage without skin removal. For blisters that require drainage, consult your podiatrist or family physician, especially if you have other health issues, such as diabetes

Blister Prevention for Steamtown Marathon Runners

(This advice is also applicable to hikers and distance walkers)

  • Minimize Friction, Minimize Friction, Minimize Friction
  • Proper Shoes: Size – too big allows too much movement (friction) and too small allows too much compression (friction)
  • Proper Shoe Shape – not too wide, not too narrow for same reasons as above
  • Proper Socks – not too thick, not too thick
    • use synthetic materials that are light weight and stay dry – avoid cotton or wool (DryTec Material)
  • Break In – Never Ever Run in shoes or socks that have not been properly broken in! Walk in them or take short 2-3 mile runs several times before using them for a long run or race.
  • Keep Dry – don’t get shoes/socks wet.
  • Lubricate – use thin layer of petroleum jelly your skin before getting dressed on training runs and race days
    • new lubricating products (ie body glide stick)
    • cover all potential problem body parts (ie toes, feet, under arms, nipples, groin)
    • Body Map – make a mental note of red or “hot spots” on that appear on your body after a long training run (especially feet and toes), and use extra lubricant or Moleskin to prevent further friction before a blister develops.
  • Prepare a Pack – have someone bring a blister kit to the race and arrange for them to meet you at certain locations along the course in case you need something.
    • KIT:
      • Change of shoes and socks – broken in
      • Change of shirt/pants/undergarment
      • Lubricant
      • Moleskin or Second Skin products
      • Ibuprofen
      • Antibiotic ointment
      • Chemical ice pack
      • Band aide, gauze
      • Straight Pin and matches:
        • to drain a large blister -sterilize pin and poke a small hole in the skin. Place pressure on the blister and milk the fluid out without tearing the skin. Dress the area with antibiotic ointment and a small bandage.


This article is not intended as a substitute for medical treatment. If you have questions related to your medical condition, please contact your family physician. For further inquires related to this topic email:

Paul J. Mackarey PT, DHSc, OCS is a Doctor in Health Sciences specializing in orthopaedic and sports physical therapy. Dr. Mackarey is in private practice and is an affiliated faculty member at the University of  Scranton, PT Dept.