Ski Review 03-04 The Fall Line Blisters 100 ... - Off-Piste Magazine

Blisters Revisited
A Closer Look at Prevention and Treatment
Blisters are equal
opportunists. It does
not matter what activity you
pursue, if you are active in
the outdoors, chances are
you have, at some point,
suffered the bane of
blisters.
You know the routine, an initial
“hot spot” warns of their onset
and far too often we simply
ignore it. Eventually, there is the
subsequent burning pain as
fluid seeps between the skin
layers and, finally, although
often too late to stop it, the
actual blister demands our
attention.
Some people seem prone to
blisters and others immune.
Most blisters occur on the feet
and significant blisters can
derail a trip. Day two on a hut
trip that you have been
planning for a full year is no
by Paul Nicolazzo
time to be derailed by an open
oozing blister.
Myths and methods abound for
prevention and treatment alike.
In order to separate myth from
truth, we must first understand
the forces that create blisters.
MECHANISM OF INJURY
Shear Forces
Shear forces are exerted on our
skin, socks, and footwear as we
walk, run, ski, etc. When the
force is strong enough to
breakdown the surface
resistance between two layers,
movement results. With
movement, comes friction and
with friction comes heat (hence
the term “hot spots”).
Movement on the surface of the
skin or between the skin’s
layers is responsible for blister
formation hence the importance
of sock choice and footwear fit.
Movement between multiple
pair of socks or between the
outer sock and the footwear
rarely causes blisters.
PREVENTION
Conceptually, prevention is
three-fold: 1) reduce general
movement between layers in
the footwear system,
especially in or on the skin; 2)
reduce friction and heat in, on,
or near the skin; and, 3)
deliberately create a “weak”
shear layer as far from the skin
as possible.
Reduce general movement:
• Choose well fitted footwear.
Remember to size your boots
with the socks you will be
wearing
• Choose good quality socks
appropriate to the activity.
• Make sure leather boots are
well broken in.
• Custom footbeds or liners in
both ski and climbing boots go
a long way in achieving a
perfect fit.
Reduce friction:
• Keep your feet, socks, and
boots clean; wash them on a
regular basis.
• Wear gaiters to help eliminate
dirt, gravel, and snow from
contaminating your system.
• Keep your feet dry. Wet skin
increases the surface
adhesion while reducing the
shear forces between the skin
layers. Plastic shells and vapor
barrier socks often exacerbate
blister issues by trapping
moisture next to the skin. Use
synthetic socks next to your
skin to wick excess moisture
away from the surface and, if
possible, air and dry your feet
on a regular basis. If you have
consistently moist skin (and
blisters), you need to change
your socks more frequently, air
your feet out so that they
remain dryer, or use less
insulated footwear/socks.
Deliberately create a
weak shear layer
• Wear a pair of liner socks and
a pair of shock-absorbing
socks.
• Paint the affected areas with
tincture of Benzoin and cover
with cloth tape. Duct or pipe
tape is okay if it the adhesive
doesn’t irritate your skin. You
will only know after you try it. I
prefer cloth tape. CAUTION:
Benzoin may cause skin
irritation.
• Use ShearBan on socks or
footwear where there is a
history of blister formation (it is
not designed for direct skin
application). ShearBan is a
Teflon coated material originally
designed for the prosthetics
industry that reduces the shear
forces between the socks or
between the socks and
footwear. I’ve field tested it for
the past two years and found it
to be amazing. Find out more
about ShearBan at
www.wildmedcenter.com
TROUBLE SHOOTING
• Are you giving your skin
enough time to toughen under
a new activity before pushing
hard? If not, take it easier or
add skin protection.
• Is there a pattern to where the
blisters appear (back of heals,
instep, etc.)? If so, this is a
potentially weak area and
needs more time to toughen. Or
you can try adding skin
protection such as ShearBan.
• Are the blisters related to a
specific activity? If so, your
boot/sock combination may not
be as good as it could be.
PREVENTION SUMMARY
• Wear well-fitted and appropriate
socks/footwear.
• Keep feet/socks clean, cool,
& dry.
• Use a blister (liner) sock & a
continued on page 22
Issue Issue XVIII XVIII XVIII Off-Piste 15