Blisters and other foot problems are like mosquitoes: some people seem to get them almost every time they hit the trail, while others can march in ill-fitting boots full of pond water for days and be just fine. Unlike mosquitoes however, which are usually just an annoyance, a blister or boot bang early on a trip can ruin the whole outing. The risk of infection from blisters on a longer trip is also a serious problem.

The bad news is that if you are susceptible to this sort of trouble you may have to watch out for it your whole life. The good news is that every foot I've ever encountered (including my own - I'm one of the susceptible ones) can be protected by preventive measures and the miracle of modern pharmaceutical products.

You will need to get to know your own feet, and their unique tendencies and abilities to torture you, and then arm yourself against their particular cussedness. Unfortunately this will mean learning by experience, in this case painful experience. However, you can minimize the suffering of this process by knowing some generalizations about foot problems and by carrying a really good "foot kit" (see suggested kit below)

My feet seem to have just about every problem ever documented, so I can offer my comments based on years of bitter personal experience.

Let's start with some keys to preventing blisters.

Fit :

Blisters are almost certain if you wear ill-fitting boots and shoes. Everyone knows this - the number one most effective prevention is to make sure your footwear fits you well. That's easier said than done however, when you have hard-to-fit feet.

In my case, a very bad bunion on the knuckle bone of one big toe, and smaller bunions on the knuckles of both little toes, make boot fitting a real challenge, and virtually guarantee that all my boots will rub and pinch in these places. Very large, wide, small or narrow feet can be a challenge. Flat arches (which by the way are the cause of these bunions in my case) need attention, and very high arches are an even greater challenge. Try on different boots every chance you get, and be picky about fit.

The single most useful strategy for fitting problems caused by bunions is this: get a technician to "punch out" the area over the bunion. A good ski shop can do this, or possibly a good cobbler. You will need to put the boots on your feet and tap around the bunion with the blunt end of a pen to pinpoint, and then mark the spot to be punched. This can be done very effectively on plastic boots, while leather boots can only be improved somewhat.

Don't forget to break in your boots. This seems so obvious, but it's not that easy. It sometimes takes quite a bit of wearing to get boots to feel really broken in. In my case, stiff leather mountaineering boots sometimes hurt me to some extent until they're almost too worn out to keep!

Taping :

Once you know that you are prone to blistering in a certain area, tape it well before you start your day's walk. You should try to cover the problem area, at least an inch around on all sides (the larger the area you tape, the better the chances it will stay put. I often cover several inches around the problem spot). The best way to do this will take some experimentation on your part, but lay on as many strips as it takes to cover the area, then "anchor" those strips down with one more at each end, at 90 degrees to the covering strips. Use care to stretch or extend your joints while taping so that the tape won't bind or pull away in use, and don't accept wrinkles. Neatness counts! Also use care in putting on socks, so that the tape job doesn't just roll up and bunch inside the sock.

Use athletic tape, one and a half inches wide - the kind rock climbers and gymnasts use. The thicker, usually narrower first aid tape you find in most drug stores doesn't stay on very well. The most common spots that need taping are: heels, arches (for the flat footed), and bunions, sometimes the tops of some toes. When taping rounded areas such as bunions or heels, use two strips (or more) to "articulate" around the curve, to prevent wrinkles. You can cut the tape into narrower strips if necessary.

If you do a good job with taping, you can often get the tape to stay on and be effective for more than one day. In fact, the compression inside the boots sometimes makes the tape stay on better and better over time. It takes a bit of time in the morning to do all this taping, and really bad feet use up a lot of tape, so keeping it on for multiple days is desirable, unless an open cut or blister makes it necessary to clean, disinfect and air out occasionally. Some people report using duct tape to good effect, since it is more slippery it generates less friction and heat than athletic tape. Personally I've never had much success getting it to stay on and fit well to my knobby gnarls, but it's worth considering.

Attention :

Be on the lookout for problems, and respond immediately to rubbing and hot spots before they actually become blisters. Do not let social or other pressures prevent you from taking the time you need to do this! A stitch in time saves 99, in this case.

It's surprisingly easy to ignore hot spots while you're walking. For some reason which I've never fully understood, problem spots and even full blown blisters tend to begin hurting less after a few minutes of walking. The discomfort is always worst when just starting out after a break. This is the moment when you should feel for potential problems and be prepared to take action.

Unfortunately, it's also the moment when everyone is most motivated to get on their way. Your friends have had their break, they've put all their kit away and hefted their often heavy packs, maybe a chill wind has come up and the sweat on their backs is making them feel cold and eager to get moving, and the last thing they want to do is take it all off again to sit down and wait for you to fix your feet. Tough patooties, as they say.

You can make this awkwardness a little easier by planning ahead for it. It helps to talk together about the importance of preventing blisters, and realize that everyone will have to wait much more and maybe even abort or alter their trip if someone gets bad blisters. That way everyone is invested in helping take care of each other, and it puts these little preventive delays in perspective. For your own part, you should anticipate the likelihood of this happening, and have your foot fixing materials somewhere very easy to get to as you hoist your pack for the next stint. You should also try hard to be ready before everyone else, and take a few steps while they are still packing up. You will probably be able to do your taping before everyone else is waiting for you anyway.

Experimentation :

Try different strategies. I'm not quite sure what to advise on socks, at this point. I have heard some people swear that a light inner sock protects against blisters in the same way as the inner boot on plastics: by reducing friction against the skin and transferring that friction to the next layer of socks. That seems logical, but I've also seen lots of blisters on people wearing high quality inner socks, and have even heard some people insist that inner socks make blisters more likely! Myself, I wear medium bulky socks - one layer - and am convinced I can't do any better in terms of blister prevention. Try various strategies, and decide for yourself. Be sure whatever you wear to keep your feet dry, and carry spare, dry socks in case they get wet.

OK, so despite all this good advice, you now have a problem area or a blister, what should you do about it?

Know Your Enemy :

Rubbing between toes, under the balls of your feet, or sometimes on the outside of your feet along the edge, is often the result of loose shoes and too much slopping around inside. You should get snugger shoes, or wear thicker socks, or wear a more supportive insole. Lamb's wool, (available in foot departments at drugstores) between the toes prevents and/or soothes blisters there. Taping is harder under the sole of your foot because it bears weight, so wear an insole or get a better fit, and/or tape before you start.

If you have no blister, but an ache in the knuckle of your big toe, especially when you take your boots off, it's probably because you're being squeezed there. Get the boot punched out, and also get a more supportive insole. Custom molded insoles, personally fitted for you in a good boot shop, are a major investment but worth every penny. Support of flat arches will prevent foot problems from getting worse, or at least slow down the process. Whenever you get a hot spot or a blister, assume it will happen again in the same place next time, and tape preventively for future trips.

Use Spenco Second Skin :

This product has revolutionized the problem of blisters, in my opinion. It is a sort of gooey mucilaginous gunk (like synthetic snot) with just enough structure to hold together in a sheet. You cut out a piece to cover the blister, and tape carefully over it. It feels cold and clammy going on, and is incredibly soothing and lubricating once you get walking again. It literally makes the booboo go away, and feels like the blister never happened! I would sooner leave home without my pocket knife, lighter, or all the ten so-called essentials than go on a major hike without plenty of Second Skin in my foot care kit. God help me if I ever get a major blister and run out of this stuff. Another product, Compeed, is similar, thicker and drier, easier to use and stays on better than Second Skin. However in my opinion it's not as soothing on an already formed blister. Just as pricey.

The problems with Second Skin are: cost (this stuff is NOT CHEAP!) and some difficulty in putting it on and getting it to stay on. Here are some tips. Use scissors or a very sharp knife blade. Cut out a piece big enough to overlap the painful area by 1/2 inch all around (follow instructions for use). Tape generously, overlapping the Second Skin by at least another inch. Use anchoring strips to hold your tape covering down well. Be careful putting it back in its plastic pouch. Fold the opening edge over at least twice and seal with a strip of athletic tape that wraps around the whole edge. It's important to keep this goo clean and moist for next time. Second Skin, well taped on, will stay on for several days unless it migrates around under the tape. This is most likely if there is a big area involved, or if for some reason the tape isn't very well adhered. Check it daily, and redo as necessary.

Pad It :

Personally I have had limited success with this technique, and find that for the same time, care and effort I get better and longer-holding results with the Second Skin. I include it here because I know that many people swear by it, and because Mole Foam is probably easier to find than is Second Skin. I'm not convinced it's any cheaper in the long run, as you'll probably go through more Mole Foam than Second Skin in a given period of time.

Mole Foam is about a quarter inch thick foam material with a sticky backing, not to be confused with the thinner, more slippery Moleskin. To make a donut around a blister or painful area, cut a round or rounded-edged piece of the Mole Foam big enough to overlap the area by at least a half inch all around. Cut a hole in this piece, big enough to accommodate the ow-ie with about an eight of an inch to spare. If the area is big, extremely sensitive or sticks up, make another donut just slightly smaller than the first, and stack it on top of the first. Tape carefully over the whole area. If you are covering an open sore or blister, first put on some antibacterial such as Neosporin, and cover with clean cotton gauze before taping over that as well as the donut. This construction is bulky and therefore very liable to move around as you walk, so check it often and reposition or rebuild as necessary.

It's not always blisters that cause foot problems. A good case of boot bang can make you truly miserable, too.

Boot bang is bruising on the bony front of your shin, usually due to wearing your boots too tightly laced, or to the boot tongue getting out of position. It can be excrutiatingly painful, and once it happens it takes several days of not wearing your boots before it will go away. If your pain is due to bruising rather than blisters, padding around it will help but it's hard to really get the pressure off the area entirely - the slightest pressure can hurt a lot - and the padding can make the pain and bruising worse instead of better if you don't get it right. Here are some tips:

Pad It 2 :

You will probably need more bulk and padding than Mole Foam provides. I usually carry some pieces of a foam sleeping pad, cut into strips about 3 inches wide by 6 or 7 inches long, to be cut down to size as needed. Extra socks can be used in a pinch, but they generally shift around too much. Identify the sensitive area's full extent, and determine how high you have to build your padding to keep the boot from touching it AT ALL! Any touch is going to hurt. Your goal is zero pressure on that spot. You will probably have to wear the boot much wider or looser than normal to accommodate the bulk of the padding.

Tape It :

Use tons of tape to keep the padding in place, and tape a very large area. The bulkier it is, the more it will want to move. The larger an area you tape, the more you spread out the push and pull on the tape, and the more comfortable and secure the whole structure will be. I once made the mistake of taping too small an area to keep the padding in place, and although the bruise was protected and relieved, the pull on the tape caused further injury by irritating, blistering and eventually breaking the skin there.

Be Creative :

I once cut out an oval piece of the curved "shoulder" area of a plastic mineral water bottle to make a protective bubble over a boot bang bruise on the front of a partner's shin. I padded carefully around the edge of the plastic so it wouldn't cut in to her skin, and then taped over the whole thing, and it very effectively kept her boot from touching the sensitive spot, with much less bulk than the foam approach. She was able to complete the climb, which she was sure she wouldn't have been able to do otherwise because of the pain.

OK, so what does the well-thought-out foot repair kit contain? Here's what I carry on every blessed trip.

• At least one roll, maybe two, of athletic tape
• one and a half inch wide Spenco Second Skin and/or Compeed Cotton gauze squares or roll
• Neosporin or other antibiotic ointment
• Lamb's Wool
• 2 to 4 three inch by seven inch pieces of sleeping pad foam
• An oval piece of curved plastic, cut out of a pop bottle! About 2 inches diameter is a good size, for padding bruises.
• Optional additions include Spenco Mole Foam and Moleskin.

Don't let the possibility or even history of blisters deter you from going out there to play. A little planning, and you can deal with anything.

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