A recent study published in the Journal of the American Podiatric Medical Association (JAPMA) evaluated the incidence, location, pain and risk factors of blisters occurring in people who participate in ultramarathons.1
The study authors assessed 50 ultramarathon participants during a five-day, multi-stage trail running competition. At the end of the each day, researchers obtained data on the frequency of blisters, their location, their severity and what preventative measures the ultramarathon participants used.
After four days of running, 76 percent of the runners had developed blisters on their feet. This is in comparison to 34 percent after day one, 54 percent after day two and 72 percent after day three. Sixty-five percent of the blisters formed on the toes with 16 percent under the ball of the foot, 14 percent at the heel and 5 percent on the sole.
Runners used a number of different preventative measures. Twenty of the runners did not use any additional aids except for standard running socks in their shoes. Ten of the runners used taping and the remainder used talcum powder, lubricant, antiperspirants or combination of those. It is very interesting to note that there was no statistically significant difference between the different prophylactic measures applied and the occurrence of blisters.
In addition, runners used different types of socks. Some runners wore cotton socks, synthetic socks or a combination of the two. Again, in this study, there was no indication of a statistically relevant reduction in blister incidents.
Finally, there was no significant correlation of blisters with age, height, weight, body mass index, shoe size or weekly training load.
The study demonstrates that a majority of ultrarunners will likely develop blisters when running a race of greater than one day in duration and standard prophylactic measures do not seem to be effective at preventing blisters.
Another option to prevent blisters is applying extremely low friction patches to orthotics, the shoe insole or the shoe itself.
1. Scheer BV, Reljic D, Murray A, Costa RJ. The enemy of the feet: blisters in ultraendurance runners. J Am Podiatr Med Assoc. 2014; 104(5):473-8.
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