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How To Prevent Blisters Between Toes & Pinch Blisters

pinch blister pinky toe

How To Prevent Blisters Between Toes & Pinch Blisters

Blisters between toes are common to both running and walking activities. They are really difficult to get relief from, so prevention is the key! 

interdigital blisters (blisters between toes) and pinch blisters
Pinch blisters between toes (Image credit)

There are two types of blisters between toes

  • True interdigital blisters – Literally blisters between two toes. These aren’t as common as the next type.
  • Pinch blisters – Blisters towards the bottom or end of the toe, common with adductovarus (curly) toes. The underside of the toe often takes on a triangular shape. These blisters are a result of how one toe curls under the next one. The toe basically gets ‘trodden on’ with every step. A pinch blister is the result. Here’s a video of someone lancing his pinch blister (sorry if squeemish!).

Toe anatomy

Toes are bony little things. There are 3 phalanges (toe bones) in each toe (except the big toe which has 2, like your thumb). Phalanges aren’t smooth straight bones, they’re pretty lumpy. Look at the x-ray of the big toe and second toe. In this image you can see the soft tissue of each toe and even the nails if you look closely. And you can see the phalanges under the skin. Notice how they are wide at the ends and skinny in the middle.

Even at the best of times, you can see how the bony prominence of one toe can press on the bony prominence of the adjacent toe. This is even more-so when a toe is bent or curly – one gets “trodden on” and pinched. And the toes don’t necessarily remain still in the shoe as you walk and run. They move relative to one another.

Notice how the phalanges are skinny in the middle and wide at the ends.
interdigital blister between the toes of a runner
A true interdigital blister on the curly 4th toe in an athlete (image courtesy Christian Madsen)

How to stop getting interdigital blisters

1. Foam or gel wedges

Foam and gel (pictured) wedges keep the toes physically separated and cushion bony prominences. The gel material absorbs a lot (repeat, a lot) of shear via its very low shear modulus. Interdigital wedges are almost always comfortable because the material is soft. But they can dislodge and move around, because apart from the toes sitting close together, there’s nothing actually holding them in place. In-shoe conditions (sweat/grit) cause them to degrade prematurely, especially foam wedges. These products are available at pharmacies and from some podiatrists. Please note, you probably won’t be able to fit a wedge between all your toes – it will spread them too much and will feel tight in your shoe.

gel toe protectors for toe blisters, including blisters between toes
Gel toe wedges (right – yellow arrows) reduce interdigital pressure and absorb blister-causing forces

2. Gel toe protector caps & sleeves

These are like a little sock for an individual toe and come either open or closed at one end. The best ones have gel all around thereby providing 360 degree toe protection. Compared to the wedges (above), they are more likely to stay in place because they are elasticised. The gel material is the same so they still absorb a lot of blister-causing shear (in fact, gel absorbs too much shear for the main weightbearing parts of the foot, but for toes they are perfect). They encapsulate the soft tissue component of the toe so it’s not getting “trodden on” as much with each step. 

Some people find they make the skin too sweaty; and I have seen this happen (a runner whose skin became macerated after 6 hours of wear). But I have also seen an ultramarathoner wear one of these 24/7 for 6 days (6-day ultramarathon) without skin maceration. Like everything, tolerance is very individual, but I highly recommend trying them. We have the BlisterPod brand of gel toe protectors. They have a deluxe double-thick gel layer compared to all other brands and they have been designed with stubborn pinch blisters in mind. These blisters need more protection than most others. Watch the video below to see the little-known technique for ensuring they don’t bunch up between your toe, or fall off.

3. Custom wedges or toeprops (made by your podiatrist)

Otoform K is a moldable putty material that sets and holds its shape. Podiatrists use it frequently to achieve an even pressure along the entire interdigital space, in spite of even the most significant toe deformities. The aim is either to get the toe to sit straighter; or if not, at least prevent high focal pressure by moulding the material to the interdigital space. You need to be standing while the material sets – because non-weightbearing toe alignment is different to weightbearing alignment. The good thing about Otoform K is it’s long-lasting (months to years) and is easy to keep clean. However, they aren’t always tolerated because they can feel hard and foreign. The video below shows me making a prop (a bit more involved than a simple wedge) for my toes – just so you can get the idea.

4. Pre-taping

Tapes or dressings can be used to reposition a toe, to encapsulate the soft tissue of the toe or just to protect the skin from rubbing. To reposition a toe eg: a curly toe that tucks in & under the next toe, you can tape it up & out so that it sits a bit straighter. But tape stretches and/or comes loose over time so it requires reapplication each day or sometimes several times a day depending on your activity. Sweat is a constant threat to adhesion.

For toes that suffer pinch blisters, often the fleshy underside of the toe is misshapen to the point where it can be triangular! Anything that can hold this soft tissue in and less triangular, means there’s less toe that the next toe can tread on – and that means less blisters. Below is a video on my toe taping technique that I learned from Anna Beetham. There are all sorts of different tapes used in blister prevention. None of them are really made for blisters, they’re made for other purposes: Fixomull Stretch is the one I generally use – it’s the one in the video. We sell it from our online store if you can’t get it elsewhere.

5. Lubricants

Lubricants reduce friction. However, research shows that after a while (around 90 mins), they actually increase friction above baseline measures. So to remain successful, ongoing reapplication is required by athletes. There are a few downsides to lubricants. My favourite lubricant isn’t a greasy one – it’s a powdered one called 2Toms Blistershield Powder. You can get that from us below.

6. Toesocks

Toe-socks add a little more bulk to the interdigital space so they work a bit like an interdigital wedge by cushioning. They also work like a double-sock system by forming an additional interface (sock-sock) at the interdigital space. But double-socks rely on different materials being used for friction-reducing properties and this is not the case with toesocks – it’s the same material on each side. But this small difference may be enough to stop blisters. A common brand of toe-socks is Injinji. While toesocks can reduce interdigital blisters, it’s not difficult to understand how they can cause the shoe to get too tight in the toebox and cause additional pressure and more blisters to the outside of the big and little toe.

Toesocks cushion the interdigital space to help prevent blisters

7. Engo patches on toesocks

This would be an expensive but effective treatment for a blister between the toes. If an interdigital blister already formed, you’ll have a hard time getting much relief. I don’t like using gel toe protectors once a blister is already there. Maceration will compound the blister itself.

The best relief I’ve managed to get with runners who wear toesocks (which didn’t prevent the blister) where we apply strips of an ENGO Patch (rectangle) to the toesocks, much like the picture below. Wrap it around the sock so that the ends meet on the top. Don’t apply any compression around the toe, just in case your feet swell! Just lay it on and press to adhere. By applying one strip to the 2nd toe, I’ve got protection for both the 1/2 and 2/3 interdigital spaces here. If I’d put the other strip on the 4th toe, I’d have protection for all interdigital spaces with just two strips of ENGO! This is a great way to reduce friction levels if you’re in a pinch. The only problem is it won’t last like ENGO usually does where you put it on the shoe or insole.

An advanced technique to prevent and treat blisters between toes
The best relief I’ve managed to get was with a runner who was wearing toesocks (which didn’t prevent the blister) and we applied strips of an ENGO Rectangle patch to the toesocks, It was an expensive way around the problem, but we were both surprised with the relief it gave.

What causes soreness between my toes

Interdigital blisters are one cause of soreness between toes. But their are others. Tinea is a common cause of pain and itchiness, especially between the two smallest toes. Tinea is a fungal infection of the skin. Fungal infections thrive in a warm moist environment, which is exactly what exists between the toes – they sit cramped together all day and this makes it difficult for the sweat to evaporate to allow it to dry. An anti-fungal cream or spray is required.

Similarly, the inability of sweat to evaporate from the interdigital space can caus maceration. Maceration is a fancy way of saying soggy skin. Soggy skin is weakened and can easily split, causing pain between the toes.

You can also get soft corns between the toes. Soft corns are just like hard corns but again, the skin is soft an macerated, hence the name. Soft corns can become very sore between the toes and require treatment from a podiatrist.

Conclusion

Blisters between toes can be the most painful blisters of all – and they’re common. It’s no wonder when you consider the anatomy and function of toes and the micro-climate of the interdigital spaces. Prevention is easier than treatment! While one will you choose? Or will you choose a combination of strategies?

Rebecca Rushton

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

No Comments
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  • Rebecca Rushton
    21 July 2015 at 11:40 am

    That’s definitely worth a try Amy (ENGO on tubefoam). You’ll have to let me know how that goes, and how long it lasts. And having the blue ENGO surface against the skin is fine. I know a lot of ladies who wear it in their fashion shoes (without socks or stockings).

    Another thing I use in race situations and when the shoe is saturated is ENGO on a dry blister dressing (the dressing is on the skin, as usual, and the ENGO patch is on top of that). It’s only going to be a short term fix. But when the shoe is wet, the ENGO just won’t stick.

    Good on you for thinking outside the square, Amy!

  • Jennifer martin
    3 April 2016 at 7:15 am

    This is so helpful. I am a ultra marathoner and continue to have issues with pinch blisters on my pinkie toes. I swear my pinkie toes hate me. What silicon gel toes sleeves do you recommend? I want to try them. Thanks so much

  • Rebecca Rushton
    4 April 2016 at 6:20 am

    I use the Silipos brand. Although I think it’s the best, I’m sure any of the others will do the trick, Jennifer.

  • Theresa
    14 April 2016 at 1:24 am

    I just got silicon gel toes sleeves from a podiatrist for my pinky toes after she scraped away my painful Lister’s corns. They are uncomfortable & it feels like my pinky toes are being squeezed. Is this just something I have to get used to or can you suggest a better solution to keep these corns from reforming?

  • Rebecca Rushton
    15 April 2016 at 2:47 am

    Hi Theresa. It’s a bit difficult to say without seeing your toes and your shoes. I think you’re a bit unlucky because the silicone gel toe sleeves will usually give relief for this exact complaint. But at the same time, if your shoes are bordering on too tight to start with, the extra bulk of the device could cause undue pressure. I think you should go back to your podiatrist and get them to advise Theresa, for the most appropriate advice.

  • Heather
    9 June 2016 at 1:49 am

    I keep getting blisters on the same toe. I never had this before. I have worn a toe ring on this toe for over 10 yrs. I had surgery about 6 months ago and had to take my toe ring off. I have not been able to wear it since because I keep getting a blister. Why?

  • jae
    14 September 2016 at 2:18 am

    Thank you so much for this, literally for me, life saving information. I just went to a podiatrist and did not recieve the information that you have so wonderfully explained. Thank you so very much !!!! You are a lifesaver!

  • Ally
    17 January 2017 at 3:54 am

    Thanks so much for this super helpful article! I’m not a runner, however, I work in a warehouse on my feet, walking, pulling Jack lifts, etc for 8-10 hours a day. My feet are really sore at the end of the week and I thought some spots would just have to callous over for it to so hurting. I’m excited to try these new ideas and boost my productivity!

  • Wayne from Arizona
    7 July 2017 at 5:12 am

    Thank you both Dr. Rushton and Amy in California. Due to your well written, informative article, Dr. Rushton, I finally understand that what I’ve been dealing with for many years is a pinch blister and what I need to do to prevent it in the first place. Thanks to Amy’s post, I just ordered foam toe sleeves and expect this will alleviate my problem. Since my pinch blister was only an intermittent problem, I just dealt with the pain and with rest it would resolve itself. Now I understand why it’s happening and how to prevent it from reoccurring. Again, thank you both!

  • Mark Freeman
    9 May 2018 at 2:02 am

    Brilliantly useful information – thanks Rebecca.
    Cheers, Mark

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