advice on what to do about a blister that's complicating marathon training

Aug 19, 17 21:24

Post #1 of 24 (2366 views)

I could use advice. I'm trying to figure out what to do about a blister that may complicate my training for a marathon in seven weeks. I think I need to explain the specifics to get feedback, so either bear with me or scroll on to more interesting/less unappealing social media content elsewhere.

I very rarely get blisters, and this one is in an odd location, on the inside front of my big toe ahead of the index toe (a location where, oddly, nothing--not a sock, not the shoe, and not the index toe--rubs on the big toe). It didn't hurt at first, so I'm not even sure when I got it, either during last weekend's 18-mile run or Tuesday's hill sprints. Running irritates it just by the action of the bottom of the big toe compressing, so it gets worse each time I run (Thursday's tempo run and today's 15-mile run so far), and bandages/padding don't seem to help, given the location. I figure my options are:

1) Stop running to let it heal, adding in more biking to try to maintain fitness. I'm guessing it would take a solid week to heal (possibly more?), and then I could bandage or lubricate the site to try to prevent a re-occurrence.

2) Stop running but also drain the (now fairly impressively sized) blister with a sterile needle to expedite healing (I'm uncertain about whether this would actually expedite healing, and it obviously entails at least some modest risk of infection).

3) Keep running but find some innovative way of padding the blister (given the location, I'm skeptical such an option exists).

4) Keep running as long as the blister doesn't get intensely painful/infected. Although it wasn't painful at first, it does hurt a bit now. I suspect after another run or two I'd have a fairly epic blister.

A week off running certainly isn't ideal, especially in light of the compressed training schedule I planned, but it seems like it may be the least bad of the options. For what it's worth, my planned weekend long runs were 18 next weekend, then 20, then 15, then 20, then 15, then 10, and the following weekend is the marathon.

Re: advice on what to do about a blister that's complicating marathon training [niccolo] [ In reply to ]

Aug 19, 17 21:35

Post #2 of 24 (2360 views)

For 11 bucks this book will answer your question from a true professional, John Vonhof.

https://www.amazon.com/...-ebook/dp/B004K6MDZU

If it was me I would go with #2.

FWIW... Good Luck

Re: advice on what to do about a blister that's complicating marathon training [niccolo] [ In reply to ]

Aug 19, 17 22:09

Post #3 of 24 (2344 views)

I have had similar blisters before. I would drain it, if it is bad it may have to be drained a few times. I would make sure it is cleaned and apply leukotape or something similar and continue running. I would also probably try different socks.

Re: advice on what to do about a blister that's complicating marathon training [dirtbag] [ In reply to ]

Aug 19, 17 22:32

Post #4 of 24 (2334 views)

Is there any reason to think draining will accelerate healing?

I've drained it, bandaged, and run a few times now. Each time it gets bigger.

Re: advice on what to do about a blister that's complicating marathon training [niccolo] [ In reply to ]

Aug 19, 17 22:40

Post #5 of 24 (2325 views)

I'm a surgeon, specializing in wound care.

Drain the blister and pad it with silipos silicon sleeve. That's what I do myself.

Re: advice on what to do about a blister that's complicating marathon training [Shiv88] [ In reply to ]

Aug 19, 17 23:00

Post #6 of 24 (2318 views)

Shiv88 wrote:

I'm a surgeon, specializing in wound care.

Drain the blister and pad it with silipos silicon sleeve. That's what I do myself.

I've drained it several times with alcohol prep, sterile needle, and antibiotic ointment after, and then padded it before runs, and after each run it's full of liquid again but bigger each time and hurts a little more. That's what's giving me pause. I should have been clearer in my initial note.

Re: advice on what to do about a blister that's complicating marathon training [niccolo] [ In reply to ]

Aug 20, 17 6:26

Post #7 of 24 (2244 views)

I you do not think it is the shoes?

Re: advice on what to do about a blister that's complicating marathon training [niccolo] [ In reply to ]

Aug 20, 17 6:54

Post #8 of 24 (2232 views)

niccolo wrote:

Is there any reason to think draining will accelerate healing?

I've drained it, bandaged, and run a few times now. Each time it gets bigger.

In the spot it is in I have found that if it does not get drained it will spread and get bigger.

Re: advice on what to do about a blister that's complicating marathon training [niccolo] [ In reply to ]

Aug 20, 17 13:12

Post #9 of 24 (2189 views)

niccolo wrote:

Shiv88 wrote:

I'm a surgeon, specializing in wound care.

Drain the blister and pad it with silipos silicon sleeve. That's what I do myself.

I've drained it several times with alcohol prep, sterile needle, and antibiotic ointment after, and then padded it before runs, and after each run it's full of liquid again but bigger each time and hurts a little more. That's what's giving me pause. I should have been clearer in my initial note.

When my Marines would get a blister I would, drain the blister then inject tincture of benzoin. Place a 2 x 2 gauze pad. Get some moleskin, but a whole slightly lager than the blister, leave the adhesive strip on the moleskin, use athletic tape to secure the bandage.

All I Wanted Was A Pepsi, Just One Pepsi

Team Zoot, Team Zoot Mid-Atlantic

Re: advice on what to do about a blister that's complicating marathon training [niccolo] [ In reply to ]

Aug 20, 17 17:06

Post #10 of 24 (2149 views)

didn't read the whole thread. if it pops, get Duoderm. You'll have to order it online. Expensive but worth it.

maybe she's born with it, maybe it's chlorine
If you're injured and need some sympathy, PM me and I'm very happy to write back.
disclaimer: PhD not MD

Re: advice on what to do about a blister that's complicating marathon training [niccolo] [ In reply to ]

Aug 20, 17 18:26

Post #11 of 24 (2124 views)

niccolo wrote:

Is there any reason to think draining will accelerate healing?

I've drained it, bandaged, and run a few times now. Each time it gets bigger.

Normally after I drain a blister I'll leave it exposed overnight (no socks etc) to dry the covering skin out. I'll only stick a bandage on if it's going to be rubbed throughout the day, but as soon as possible I'll get the bandage off again.

Re: advice on what to do about a blister that's complicating marathon training [TravelingTri] [ In reply to ]

Aug 20, 17 20:26

Post #12 of 24 (2101 views)

Drain it, put one of those blister protectors on. Keep it clean with warm salty water rather than antiseptic cream (as that can delay healing).
I got a major blister 6 weeks out from an IM a few years ago. I was able to keep run training by wearing two pairs of thin socks, and taping over the blister patch with duct tape. If it felt sore on a run I'd stop and walk home. Also, I used to go to beach and do some barefoot running when the blister was too sore for shoes.
Good luck

Re: advice on what to do about a blister that's complicating marathon training [niccolo] [ In reply to ]

Aug 21, 17 6:44

Post #13 of 24 (2049 views)

Try Injinji socks. I was getting a blister in the exact same spot at the start of this season. Switched to these socks and I have been fine ever since. I am in prep/build for the Chicago Marathon.

Charity is injurious unless it helps the recipient to become independent of it. John D. Rockefeller Sr.

Re: advice on what to do about a blister that's complicating marathon training [niccolo] [ In reply to ]

Aug 21, 17 7:10

Post #14 of 24 (2035 views)

Shoe questions and some thoughts.

1. How old are the shoes you are running in?
2. Do you have multiple pairs or just one pair?
3. Is this your first marathon?
4. Did you recently change shoes? If so from what to what?
5. Did you recently change the size of your shoe?

It's quite common during a run that you won't feel something. As an example when my legs pull through while running each foot catches the opposite calf. It's been that way since I started running. I never feel it but at the end of every run my ther is a dirt pattern on each calf.

1. Worn out shoes could easily be the cause. If you have one pair of shoes you run in and are training for a marathon you will have to replace your shoes during a typical build up.
2. Marathon and shoe size - With longer running, your feet swell. If you fit your shoes close their's a good chance at 18 miles the toes will be jamming the front. Again by 18 miles you wouldn't feel it.
3. A change of shoes - If you changed from a shoe with a flexible forefoot to a shoe with a stiff forefoot or rocker you are changing the action in the forefoot. Same if you went from stiff to flexible too.
4. Socks - Injini is the right thing I think.

Fixing the blister is priority but everything you said tells me it's probably in the shoes somewhere.

Dave Jewell
Free Run Speed

Re: advice on what to do about a blister that's complicating marathon training [SDJ] [ In reply to ]

Aug 21, 17 7:59

Post #15 of 24 (2017 views)

I switched from Mizuno Wave Riders to Hoka Clifton 2's in June, and it's really helped with some minor knee tendinitis. I'm between sizes, but in the larger of the two options. No issues till this recent blister. And it's an odd blister, apparently not caused by any direct rubbing, but by compression of the toe which indirectly affects the area where the blister is forming. Longest runs ever, this will be my first marathon.

Re: advice on what to do about a blister that's complicating marathon training [niccolo] [ In reply to ]

Aug 21, 17 8:27

Post #16 of 24 (2006 views)

The best solution I have found is duct tape. The key is eliminating the friction/rubbing on the skin. The duct tape adheres to the skin, does not move relative to the skin, and the sock, other toe, or whatever, slides over the duct tape. This allowed me to run 3 days after an IM in which I developed huge blisters on the ball of my right foot that spread in between my big toe and index toe, all during the race..it was so painful I could barely walk the next day. With the duct tape I was able to do a 12 mi run 3 days after the race (tired, but the feet were bearable). I keep some in my pack when trail running...when I feel a blister coming on, I slap on some duct tape and all is better.

As for the source, I have had similar blisters in the past...I attributed them to a looser toe box that allows my toes to move relatively freely and rub one another, even though they are not rubbing the sock or the shoe.

Re: advice on what to do about a blister that's complicating marathon training [niccolo] [ In reply to ]

Aug 21, 17 8:33

Post #17 of 24 (2005 views)

There it is.

You switched from a tradional designed running shoe with a flexible forefoot to a shoe with wrapped side walls and a rocker forefoot.

Running in the Mizuno as you go to toe off, your foot flexes because the shoe is built with flexibility.

Now in the Clifton your foot rolls over the midsole (rocker) to toe off. There is no flexibility happening. The sidewalls simply help your foot track to that same toe off every time.

Your forefoot is now adjusting to the new forefoot action. That's where your blister is coming from. Because the shoes cleared up other issues your best avenue is through socks. The Injini are probably the best Option.

With care for the current issue (socks included) and more time in the Clifton you should be able to overcome the blister.

Dave Jewell
Free Run Speed

Re: advice on what to do about a blister that's complicating marathon training [niccolo] [ In reply to ]

Aug 21, 17 9:23

Post #18 of 24 (1994 views)

I agree with Dave. I've been a Clifton runner for a few years, and I got some weird blisters in the 2's. The toebox seemed narrower than in the 1's (which Hoka never should have messed with, but I digress) or 3's. Try different shoes. Weird story, but I got lucky when a dog ran off with one of my Clifton 2's (yes took off with one shoe, and I never found it!). That was the end of trying to suffer through blisters - I was able to run a bit more in some older Clifton 1's until the 3's came out.

Blog: http://262toboylstonstreet.blogspot.com/
https://twitter.com/NateThomasTri
Coaching: https://bybtricoaching.com/ - accepting athletes for 2023

Re: advice on what to do about a blister that's complicating marathon training [natethomas] [ In reply to ]

Aug 21, 17 9:46

Post #19 of 24 (1987 views)

Drain it without teariing the top layer off. Just prick it with a needle. Put a pad over it, gel foam duct tape, whatever. Run through it. I played 4 years of soccer for a very strict british coach who made us play through our blisters and it was no big deal, 2 days of discomfort and it will heal.

Re: advice on what to do about a blister that's complicating marathon training [niccolo] [ In reply to ]

Aug 21, 17 10:58

Post #20 of 24 (1973 views)

Adding to what everyone is saying about lancing it - prick it with a sterile needle and then soak it in epsom salt. I have terrible recurrent blister problems, and I have found that soaking it in epsom salt immediately after draining helps really clear everything out, plus it dries the skin out faster.

Re: advice on what to do about a blister that's complicating marathon training [niccolo] [ In reply to ]

Aug 21, 17 16:06

Post #21 of 24 (1920 views)

This product for burns is great for any skin wound/blisters. It takes friction down to zero. I would wear it 100% of the time until the skin is healed. Do whatever else you want to do keep it clean, etc.

It is like a thin firm jello and always got me through.

Spenco 2nd Skin Moist Burn Pads, Medium (2 x 3 Inches), 4-Count
Spenco
4.7 out of 5 stars [/url] 195 customer reviews

| 12 answered questions

Re: advice on what to do about a blister that's complicating marathon training [niccolo] [ In reply to ]

Aug 21, 17 18:57

Post #22 of 24 (1893 views)

FWIW, I started nailing marathon PRs after switching the majority of my training to the bike due to an inflamed Achilles tendon. After that (resulting in my first sub 3:00) I just kept doing lots of cycling and bricks. Nearly all my "long" days turned into long rides and runs of 50-90 minutes. That got me to 2:38 and also led me into triathlon (because I was a swimmer first). Assuming you've got adequate miles in your legs to be marathon ready, you can log more hours biking than you could running without fear of injury and thus enhance aerobic capacity. Hit some 4-5 hour weekend rides where you breathe exclusively through your nose, which will keep you at or below max aerobic function, which builds endurance capacity better than tempo or speed work. With your marathon so close, you'll also have fresher legs from not running so much. Try to get in a lot of time at your anticipated marathon heart rate.

Cousin Elwood - Team Over-the-hill Racing
Brought to you by the good folks at Metamucil and Geritol...

Re: advice on what to do about a blister that's complicating marathon training [niccolo] [ In reply to ]

Aug 21, 17 19:21

Post #23 of 24 (1888 views)

Lots of great feedback here, appreciated.

I take away from it that draining large blisters is likely helpful, repeatedly if necessary, especially if it enables continued running but perhaps also because it speeds healing (though not sure about the latter).

I'm a bit skeptical about Epsom salt soaks with a drained blister, seems like it risks infection. Injecting tincture of benzoin sounds pretty intense, and like it might possibly create counterproductive reactions in the injured tissue, but I don't have any expertise to evaluate that.

I'm going to play with a few options--e.g. gel toe cap, other forms of padding, toe socks--to see if they let me run without making the (drained) blister worse. This particular blister is weird, because it doesn't seem to be caused, or at least exacerbated, by direct rubbing, but rather by the toe tissue being squished upwards as it compresses. So that makes padding hard or impossible, but I'll keep experimenting.

I'm also going to see if different shoes help--specifically getting back into my Mizunos for hill sprints and shorter runs where I don't need the Hoka cushioning and am less likely to injure myself (e.g. knee tendinitis that led me to switch from Mizunos to Hokas in the first place).

Will also dial up the bike cross-training a bit.

Last edited by: niccolo: Aug 21, 17 19:26

Re: advice on what to do about a blister that's complicating marathon training [niccolo] [ In reply to ]

Aug 21, 17 22:35

Post #24 of 24 (1875 views)

I can't inspect you via internet, so I will speak in general terms.

Blister is caused by thermal energy (let's say, spilled coffee) and/or repeated shearing forces, which leads to skin heating up and breaking down. For diabetic patients, we have a good medical evidence that skin temp indeed increases prior to forming a skin ulceration.

Maybe you need new socks, or double layer socks. Maybe different shoes (I like hokas). I use silipos silicon pads, purchased from amazon, for my toe blister prevention. Some people use Vaseline and lubes, I don't personally, but it may work for you. I had a running friend with chronic 5th toe blisters from hammer toe, so I did a flexor tenotomy to fix the toe deformity. It's a radical approach, but if you have a bad bunion or curled hammer toe, it may need to be fixed.

I wrote a "road rash" article for slow twitch and for LA times. Search and Read it. In general, we do lance the blisters and apply appropriate wound dressings with mild compression to let them heal. Perhaps you may need to let your skin heal and you need to cross train with bike, as others have suggested. I've got a suspicion that you may be digging your hole deeper (no pun intended) by running on your injured feet.

That's all I can come up for now. Good luck.

Our Partners

transition-DOT-area-AT-slowtwitch-DOT-com

Advertise with us

©1999-2024 Slowtwitch, Inc., and Slowtwitch.com
Reproduction of material from any Slowtwitch.com page
without written permission is strictly prohibited.