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5 Ways To Prevent A Blister On Bottom Of Foot

5 Ways To Prevent A Blister On Bottom Of Foot

It’s difficult to walk with a blister on the bottom of your foot, particularly under the ball of your foot. This is a major weightbearing area of your foot, after all. In this article you’ll learn about the anatomy and biomechanics of the ball of your foot, why it’s susceptible to blisters and the best ways to prevent them

Different locations of blisters under the ball of your foot

Deroofed blisters on balls of feet (image credit)

The location is important. It gives clues as to the cause and how to fix them. You can get them:

  • Under the big toe knuckle (above)
  • Under the little toe knuckle
  • Right in the middle of the forefoot
  • Less commonly across the WHOLE ball of the foot!

Why we get blisters on bottom of feet

Firstly, ball of foot blisters are just like any other blister; they’re caused by shear distortions in the skin. You can think of shear as stretching – the skin stretches back and forth with every step. These are the factors that go into creating blister-causing shear distortions:

  • Pressure: This is a weightbearing area of your foot, more so that most other parts of the foot. 
  • Moving bones: You may not be aware, but foot bones move around quite a lot under the skin, especially the bones in this part of the foot.
  • Type of skin: The skin on the sole of the foot is thicker and less mobile than other parts of the foot and this is suited to blister formation. Also, there are more sweat glands on the sole of the foot compared to other areas and this contributes to high friction levels.
  • High friction levels: It’s warm and humid in your shoe. That means high friction levels – as in things are clammy and sticky. What’s more, the fabric of your sock and shoe lining are made from relatively high friction materials. This is intentional and quite appropriate as it helps keep your foot stable in your shoe. It’s only a problem if we’re getting blisters. Thankfully, there is an easy way around this which I’ll explain with a video shortly.
  • Repetition: The more time the skin stretches back and forth, the more likely it is to fatigue. When the connections between skin cells fatigue, a tear occurs under the skin surface. Within two hours, that injured area fills with fluid and makes the skin surface bubble up to look and feel like what we know as a blister.

Let’s talk a little more about anatomy and biomechanics

Ball of foot anatomy

Anatomically, this is where the metatarsal heads are. These are weightbearing bones so the skin is subjected to really high pressures. And as part of normal healthy foot function, the metatarsal heads move back and forth under the skin.

Ball of foot biomechanics & blisters under feet

Metatarsal heads move back and forth with every step we take:

  • During propulsion (push-off)
  • When changing direction
  • Going uphill and downhill 
  • Whether walking or running

Picture this. When the foot plants, the metatarsal heads skid forward over the skin, and then backwards during propulsion. Moving bones above, high friction levels below and weightbearing pressure compressing everything together, this creates a lot of skin shear (the cause of blisters). This is completely normal and usually below our blister-causing threshold – but not always. Watch this video to see how moving bones cause blisters.

Video: How moving bones, high friction levels and weightbearing pressure causes blisters under foot

You can imagine that as your activity increases in intensity and/or duration, shear may reach a point where it becomes excessive … more than the skin can handle. At this point, skin damage occurs. And it occurs under the surface of the skin, a few layers deep. Blister medical researcher Stanley Comaish described this skin damage as epidermal fatigue because the connections that bind these skin layers tear under the excessive and repetitive shear load. This type of injury is not as deep as the blood vessels, so bleeding does not ordinarily occur.

The 5 best strategies for a blister on ball of foot

1. Taping techniques

Preventive taping is a good place to start. Pre-taping won’t always work – be sure to read this article to understand why. But it’s a good starting point if you haven’t tried anything. In the following video, I’ll show you how. The tape I use is Fixomull Stretch but you can use another tape if you prefer.

2. Cushioned insoles

Cushioning has a double blister prevention effect. Firstly, it reduces peak pressure a little and therefore reduces skin shear. And secondly, cushioning materials absorb shear via their shear modulus. That is, shear goes on within the material so less of it occurs within the skin. Research has shown some cushioning does this better than others, for example, peer-reviewed research shows that Spenco works a little better than Poron. It’s important to know that blisters can still form in spite of cushioning. But if you need just a little bit of blister prevention oomph, and your current insoles are old, worn or compressed, a new pair could make all the difference. Interestingly, the top surface of cushioning materials typically exhibit a high friction level! So if you’re still getting blisters in spite of cushioned insoles, add the next strategy.

3. Engo blister patches

This is the best way to keep friction levels low under the ball of the foot – better and longer-lasting than lubricants and powders. These patches stick onto the insole of your shoe (or orthotic) and they just stay there until they wear through about 500kms later. They make the friction side of blister prevention easy to take care of. Pictured are the large ovals. If you need broader protection, you can use the larger rectangle patches (see below).

Treat a blister under foot with ENGO Blister Prevention patches
ENGO Blister Prevention Patches under the ball of the foot reduce friction levels.

4. Biomechanical improvements

Blisters under the ball of the foot are often associated with structural and biomechanical issues. There is a lot that a podiatrist or sports medicine professional can do to alter your biomechanics to reduce the incidence of blisters under the metatarsal heads. This could involve paddings, insoles, orthotics, stretches (especially calf stretches), joint mobilisations and modifications in your gait or running style. Seriously consider seeing a podiatrist if you have ongoing blister issues here in spite of using the above three strategies!

5. Donut pads

Donut pads can be a bit bulky and cumbersome when used as a prevention. They come into their own as a ball of foot treatment though. If you have a blister, you’ll need to take the pressure off it. The best policy is the thicker the material (I use 5mm or 7mm orthopedic felt) the better the pressure relief – but the more room they take up in your shoe. If you get prevention right, you won’t need these.

blisters on bottom of feet treated with donut pads
Donut pad to reduce pressure from a central blister on ball of foot

Take home messages

  • The ball of the foot is inherently susceptible to blister development due to its skin properties, bone structure and important biomechanical functions.
  • Taping, cushioned insoles and an ENGO blister patch must be tried. At a guess, this will prevent 95% of ball of foot blisters.
  • Consult a podiatrist if you continue to get blisters in this area so they can assess your foot structure and function and find the root cause of your sore balls of feet. With your consent, they will implement the best possible blister care and prevention for your feet.
Rebecca Rushton

Podiatrist, blister prone ex-hockey player, foot blister thought-leader, author and educator. Can’t cook. Loves test cricket.

No Comments
  • Belinda McNab
    21 October 2014 at 2:49 am

    Thank you for this article Rebecca. It is very informative as I thought I was the only one who got blisters on the balls of their feet. Now that I actually have blisters, and am waiting on my Engo patches to arrive, what do you suggest is the best course of action to help my feet feel better and heal without re-blistering the new skin where the old blister top has lifted? I play netball about 3-4 times a week, and unfortunately nothing I am doing is helping to stop them from hurting or re-blistering/lifting the new skin off. Is it just a matter of resting them until they heal, or some topical treatment I should apply? Any suggestions would be welcome. Thanks for this website, it is a fantastic resource!!

  • Rebecca Rushton
    22 October 2014 at 1:14 am

    Cheers Belinda. The ENGO Patches are going to help like nothing else can. Until then, assuming you don’t have the option of a week without netball, I would apply a dressing or tape (Compeed might be a good choice – you can leave it on for several days). Make sure your insoles are nice and cushioning. And if you can see your podiatrist, they’ll have a material they can use to take pressure off the area. I hope this helps!

  • Cindy from va
    13 May 2015 at 5:46 am

    I have been looking up stuff for a few days when I came across your article. I have started back walking about 3 weeks ago. Last week I walked 4 miles one morning. I now have a blister on the ball. The top pulled off last night and now I have two raw spots. i am going on a beachfront vacation Saturday. I am resting it and putting neosporine on it and when I have to go out placing gauze and elastic tape on it. It is painful since I can’t put my weight directly on it. Any suggestions

  • Rebecca Rushton
    13 May 2015 at 7:52 am

    Yes Cindy.

    The dressing you need for a deroofed blister is called a hydrocolloid – read this https://blisterprevention.com.au/blister-blog/foot-blister-treatment

    And the blue patches I spoke about in the article you just read – read this https://blisterprevention.com.au/fast-blister-healing/

  • Paula
    11 September 2015 at 7:05 am

    Hi I love walking for fitness but whatever footwear – boots or trainers – I wear I always end up with blisters on the balls of my feet and in between my big toe and the next one. Any advise please?

  • Rebecca Rushton
    12 September 2015 at 10:46 am

    Well yes Paula. I have four options for you, as you’ve read in this article. Is none of this helpful?

    You can also read about how to treat a blister here: https://blisterprevention.com.au/blister-blog/foot-blister-treatment

  • Kristel M
    24 September 2015 at 4:08 am

    Hi Rebecca,Great article! I have a large blister on the pad of my foot under the big toe. It was so painful that I cut it open to drain it. It went a lot deeper than expected and in order to help keep it dry I cut away a chunk of the dead skin. I put a compeed patch on it to help keep it clean, but it keeps swelling under the patch and remains painful. Any suggestions?

  • Rebecca Rushton
    24 September 2015 at 6:37 am

    From the sound of it Kristel, you haven’t done anything about pressure or friction levels yet. It’s no wonder it’s still sore and weeping. The article tells you how to address both. And have a read of this article for more info: https://blisterprevention.com.au/blister-blog/foot-blister-treatment. Of course, if you’re still unsure what to do and how to do it, see a podiatrist.

  • Claire Kluever
    22 October 2015 at 3:04 am

    Thank you for the information about Engo patches! Having recently developed a large and painful blister on the ball of my foot due to 5-6 mile walks daily, I needed help on treating and preventing this from happening again. Thanks to your advice, I have now ordered all of the Engo patches that I will need to treat and prevent this painful occurance from hindering my workouts. Much appreciated, Claire Kluever

  • Rebecca Rushton
    22 October 2015 at 11:36 am

    It’s a pleasure Claire. All the best!

  • Dave
    7 December 2015 at 2:25 am

    Hi Rebecca,I have a walking routine that l have followed for the past year and have been walking 6 miles a day 3 days a week. Because of a possible stress fracture on the top of my left foot my doctor advised me to rest the foot and stop the walking for a month. A few weeks after stopping all the accumulated foot callus had peeled off the bottoms of my feet and now having resumed my walking have developed a blister under the ball of my right foot.I wear Saucony Triumph ISO and belaga Hidden comfort socks and with this combo have never before had blisters. Should l continue my routine or wait for the blister to dry up?Many thanks and happy l found your site.Dave

  • Rebecca Rushton
    8 December 2015 at 3:41 am

    If it was me Dave, I’d put an ENGO Patch on the insole of my shoe where the blister was. That would give me the best chance of continuing to walk without recurring damage to the resolving blister. In the absence of an ENGO Patch, I’d wait for the blisters to resolve and then build up gradually to your usual 6 miles. This will give your skin the time it needs to adapt to the shear stresses that you were previously used to, but that are now causing a blister. Have a quick read of this: https://blisterprevention.com.au/blister-blog/breaking-in-your-shoes Does that help Dave?

  • Matthew
    7 January 2016 at 7:49 am

    Hi Rebecca, I developed a blister this past weekend after a long day of basketball in poor shoe choice. The blister is on the ball of my foot, its not painful but can noticeably feel that its there. Its a darker color and still seems to have a liquid feel to it, is there any cause for concern if its not causing me any pain? Thanks

  • Rebecca Rushton
    8 January 2016 at 12:22 pm

    You should always be cautious about a blister, particularly a blood blister, because the last thing you want is for it to get infected. You should be doubly cautious if you have sensory neuropathy for any reason eg: diabetic neuropathy. If you need advice on treating it Matthew, read the articles tagged "blister treatment". If in doubt, get it checked by your podiatrist or medical practitioner.

  • lbill
    29 March 2016 at 2:41 am

    Wish I would have read this before I went to Disneyworld!

  • Caitlin
    26 April 2016 at 2:45 am

    I just got a blood blister on the ball of my foot the size of a silver dollar. I am running a half marathon this weekend and can’t really walk on it right. Would getting it drained in order to run my half marathon, then letting it heal later be a good idea? I am going to take off until then, but I am on campus all day walking around.I just want to be able to run my race!

  • Rebecca Rushton
    26 April 2016 at 4:04 am

    You’d do best by seeing a professional about your blister Caitlin. Your podiatrist or doctor will be able to treat it and give the best advice based on what they see in front of them to get you in the best shape for your half marathon.

  • Leeta
    20 May 2016 at 2:36 am

    My 10 year old daughter developed a blister across her entire left ball and bottom of toes. But it’s only the one foot! She had complained a little and then it just took over. We’re going to try the moisture wick socks and pads. Any ideas why it would be one foot?

  • cindy
    19 June 2016 at 9:45 am

    Rebecca, I ave a quick question and unfortunately need a quick response. I play tennis and have had several crucial matches that have been played on hard courts that are extremly hot. The lateral movements and conditions have caused me to develop a large deep blister on the ball of both feet, about an inch wide. Of course, I know rest would be best but I have State matches this weekend in which I may have to play four matches in two days. Can I heal these quicker by draining them even though these are deep. I can order the prevention patches but they will not arrive in time I fear. Any info on participating in these matches safely!! Thank you. Cindy

  • Rebecca Rushton
    19 June 2016 at 10:17 am

    Contact me here Cindy and I’ll be in touch later today: https://blisterprevention.com.au/contact-us

  • Jack
    21 July 2016 at 9:18 am

    I get these pretty commonly from skateboarding. Not fun because my leg is sore along with the blister.

  • Jaymi Devans
    4 September 2016 at 3:11 am

    Rebecca, thank you for your article. My blister is deep to the foot pad on the ball of my foot. My skin surface is fine. It feels like my foot pad is shearing from the underlying tissue. Walking barefoot on tile is the worst. Walking barefoot on carpet is the easiest. Do you have any suggestions for me? Thank you!

  • Jodie
    9 September 2016 at 12:27 pm

    Hi, my son has started a new job and in aquatics teaching and under his big toes he developed a big blister under each foot. They have burst and bled. What is the best treatment and prevention in future for him while teaching. He is very flat footed so no doubt that’s why it has happened? Is thefe a waterproof dressing he can put on to help treat/prevent more and also on ball of feet?

  • John Henry
    28 September 2016 at 3:28 am

    you never mentioned the ways to treat and heal a blister already there, and that was what I was trying to find out.On the ball or on the sides …that is one thing…but in the middle, and it can take a month to heal on its own! after all you have to continue to walk every day!

  • Tammy
    6 October 2016 at 1:11 am

    What do you think of using duct tape for the ball of foot and heels?Too slippery or stiff?
    Isn’t the overlapping seam in your technique for taping the ball of the foot going to cause a Ridge and therefore a blister?

  • Rebecca Rushton
    6 October 2016 at 1:54 am

    THE GOODDefinitely stiff Tammy, so a shear load spreader.Definitely low friction (good if used in a targeted way).
    THE BADThe adhesive isn’t medical grade and so you shouldn’t have it on your skin.If used over too big an area, the low friction property will be bad, for the reasons outlined in the article.

  • Karen
    14 December 2016 at 8:04 am

    Great article Rebecca! I started to use the treadmill for it is too cold to walk outside now, and started to get a blister between my big toe and the ball of my foot. Tried different shoes. Took 5 days off treadmill to rest foot. Today after being on treadmill for 2 days, now have blood blisters forming in same place!

  • Christina
    23 March 2017 at 12:16 pm

    Are the engo pads you suggested reusable or one time use only?

  • Rebecca Rushton
    23 March 2017 at 12:28 pm

    Hi Christina. The Engo patches are applied one time only but last about 300 miles. Please note, you apply them to your shoe or insole, not your foot. More info here: https://blisterprevention.com.au/engo-blister-prevention-patches/

  • Julie Page
    27 May 2018 at 8:08 am

    Hi, so glad I found this. I’ve been getting blisters nearly every time I walk. Could you tell me what type of tape you use please? I’m in the uk. Thanks Julie

  • Rebecca Rushton
    27 May 2018 at 8:21 am

    I’ve used Fixomull Stretch 5cm here Julie. Truth be told, I’m not the biggest fan of taping. It might help, so definitely try it. But don’t be too surprised if it doesn’t work. Take a look at this article (esp the first video from 14mins): https://blisterprevention.com.au/blister-blog/taping-for-blister-prevention

  • Nick
    1 June 2018 at 7:14 am

    Thank you for taking the time to post this. Great information.

  • Luke K
    3 February 2019 at 11:42 am

    I’m experiencing blisters under the balls of my feet while running workouts or races on 200m indoor tracks. Hot spots develop and flare into blisters sometimes in as little as 800m into a race. The tight turns seem to be a major problem for my feet. I am a forefoot striker, and I have tried multiple types of footwear (from cushioned trainers to road racing flats to several types of racing spikes) along with multiple types of socks and placements of ENGO patches. Do you have any recommended treatments, or does this sound like cause to make an appointment with a podiatrist?

  • Rebecca Rushton BSc(Pod)
    4 February 2019 at 12:28 pm

    Hi Luke. Sorry to hear your blisters are proving to be so stubborn. The ENGO patches would have taken friction levels out of the equation, so this sounds like a pressure issue (related to your foot structure and/or function). I think a visit to the podiatrist is warranted. If that proves unsuccessful, join me here and we’ll chat more: https://courses.blisterprevention.com.au/courses/fix-my-foot-blisters-fast

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