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The Advanced Guide to Blister Prevention Chapter-1

Chapter 1 – The Problem Of Foot Blisters

In this chapter

  • Blister incidence
  • Blister prone
  • What is needed from here

Blister incidence

Blisters are one of the most common injuries in running, sport and everyday life. Their incidence has been measured in runners, hikers and the military.

  • 2% of male marine recruits during initial training
  • 16% of runners during a 10 mile race
  • 20% of marine recruits over 32 weeks of training
  • 22% after a 5-day 21km cross-country hike
  • 29% of long distance hikers in Vermont
  • 33% of soldiers during Operation Iraqi Freedom
  • Up to 39% of marathon runners
  • 42% of military cadets during initial training
  • 48% during a 21km cross-country hike
  • 57% during 6 weeks of basic military training
  • 77% of military recruits during training
  • 95% of college students on a 580km road hike

Blisters are not just a common injury – they often rank as the number one injury. Research into distance running, hiking and military injuries regularly find foot blisters are more common than musculoskeletal injuries of the knee, back, ankle and foot.

In fact blisters are so common we tend to not take them seriously, even when they’re exceptionally painful and limiting. What happens next is blister treatment becomes the focus – not prevention. This is not acceptable. As an athlete, you should not be satisfied with this. And as a sports medicine professional, you should be even less satisfied with this approach.

It’s not that blisters are an insignificant injury. But it seems that because they’re an injury of the skin rather than the musculoskeletal system, they tend to be relegated to an injury of lesser importance. “With such a high incidence and potential for disability, one would think that the prevention of friction blisters would be better understood… many myths continue to be propagated regarding the prevention and treatment of friction blisters.”

Blister prone

Research has shown that there is such a thing as being blister prone. Blisters form quicker in some people compared to others when the same rubbing force is applied to the skin. Just look at the results of the three pieces of research below from Naylor,² Sulzberger³ and Hashmi.

foot blister - time to blister

Figure 2: The large individual variation in time to blister (Refs 2, 3, 109)

What is needed from here

With foot blisters being so common, there needs to be a better understanding of:

  • what causes blisters
  • where opportunities for blister prevention exist
  • how each blister prevention strategy works … and doesn’t work!
  • where there are gaps in our knowledge

There is an alarming amount of bad information available about blisters. It results in poor management practices. The right information is available: there’s a lot of good material that has come from military research; there’s some really good information in diabetic foot and prosthetic limb skin management literature; and there’s a lot of research from the field of tribology (the study of friction). But there’s nothing that has taken information from all of these sources, applied it specifically to foot blisters and made it easy to understand and freely available.

This guide bridges that gap. It is the easy-to-understand and freely available resource you can use to improve your blister prevention outcomes, whether you’re an athlete or a sports medicine professional. And it comes from someone who knows about feet and foot function and who is blister-prone herself.

Please feel free to share this with your friends and colleagues.


  1. Blisters are one of the most common injuries in running sport and everyday life.
  2. There is a large individual variation in blister susceptibility.
  3. You should not be satisfied with relying on blister treatment.
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