Blisters conjure up fear, annoyance and hatred to most runners. Most people have experienced at least one blister in their running history and everyone knows that they aren’t enjoyable. They have the potential to ruin a run or even sabotage a marathon; so it’s important to know why blisters occur and also how best to deal with them. This article will deal with one of the most common blisters we see on runners in-store…the little blighter under (or just behind) the big toe.
Know thy enemy
Here is an example of exactly the blister location we are talking about. Whilst this is a pretty extreme example from an ultramarathon athlete, it’s the location that we are focused on here. Blisters just behind/around the big toe joint are one of the most common we see on our customers in-store.
How do blisters occur?
Whilst blisters can occur due to several types trauma to the skin (like burning, freezing or chemicals), the blisters that occur when you run or exercise are due to excess friction. This friction can occur if your shoes are too big, don’t fit properly or are incorrect for your biomechanics; they can also occur as a result of excess moisture weakening the protective outer layers of the skin.
Friction is inevitable when you run; however it’s excess friction in concentrated areas of the skin that creates blisters. If your shoes are ill fitting then parts of the shoe that are abrasive or subject to large amounts of movement will be contacting parts of the foot that they shouldn’t. Of course the normal friction between the shoe and foot when you run, increases with distance. So the further you run at any one time, the greater the chance of blisters.
Why on the big toe?
The hallux (big toe) joint is one of the most important joints in the foot for running. As the main pivot point of the foot the hallux joint is subject to great amounts of force when you run. The most common reason for blisters here is related to a common biomechanical dysfunction called functional hallux limitus or a similar condition known as a plantarflexed first ray. Both of these conditions result in excess loading of the hallux joint and the foot will normally try to compensate for them by rotating around the big toe joint when you run (abductory twist).
Another condition in the foot that can be a prime culprit for blisters is called a forefoot varus. This is a misalignment of the foot where the forefoot is tilted in relation to the rearfoot, this can cause a last minute increase in pronation of the forefoot after the rearfoot has already pronated, thus increasing friction.
So there are lots of biomechanical reasons for blisters on the big toe; however when you combine any of these with a poorly fitting shoe then blisters are very likely.
So what can be done to prevent blisters?
Luckily there are several steps you can take to minimise blisters; even if you are particularly sensitive to them. Here are the main action points to take if you are suffering from blisters under/or behind the big toe:
- Seek an up-to-date biomechanical assessment – Most people’s bodies change regularly, and so do their running biomechanics; hence why you should always have your feet assessed when buying new shoes. Even those of you who have been wearing the same model year after year should seek a “check-up” assessment every few years. Ask the person doing your assessment if you have any big toe issues (such as functional hallux limitus or a plantarflexed first ray). If the person doing the assessment only does a video assessment, then walk away! They won’t be able to accurately identify such issues from a video alone.
- Have your shoes checked – Not only is an assessment important, but applying the results of the assessment to making sure your shoes are correct for your biomechanics and they fit properly is essential. Most blisters occur due to poorly fitting shoes and this type of blister under the big toe most often occurs as a result of the wrong type of shoes for your biomechanics.
- Kinetic Wedges may help – A kinetic wedge is a piece of material that can be stuck to the underside of your insoles to help improve the function of your big toe. They should only be fitted by a professional as they can cause more harm than good if they are used or fitted incorrectly. We offer this fitting as a service in-store and so do most good podiatrists.
- Choose your socks carefully – Socks are an important, yet often overlooked, part of any runner’s kit. In last week’s blog we explored the reasons why proper running socks are so important. Socks can make or break it, when it comes to blisters, so speak to your local running shop for some honest advice on which socks are best; we normally recommend a good quality double layer sock for avoiding blisters.
- If all else fails, try anti-blister products – Once you have addressed the above fundamentals and you are still getting blisters, then it’s probably time to explore other options. Blister plasters can help to speed up recovery, strapping tape can be used as a preventative measure to protect the skin, you can try anti-blister patches that are stuck to a blister causing area of the shoe to reduce friction and balms/lotions such as Bodyglide can be used to give the skin a protective layer.
So whilst big toe blisters can be annoying, there is normally a logical reason for them and you shouldn’t suffer alone. Try the above tips and if you still have problems then seek the advice of a podiatrist as you may need custom orthotics.