First timer tips afterwards - blister

[ndb175]

Hey everyone. Just wanted to post something blister related since so many topics helped me so much preparing for my first Camino.

I’ve suffered with blisters since day 2 all the way to the end. Nothing better then blisters to keep you ‘in the moment’ right? It sure was painful and still is although I’m already home for 1,5 weeks.

Some things that helped me:
- Don’t be too scared of using a thread. I started late with this, because the idea scared me, but it’s been really helpful. You can buy a set at the pharmacy for like 3,50 euros. Weights nothing, might be worth taking it with you in your blister kit.
- Spend money on podiatrist visits when your not sure what to do. I’ve visited one in Logrono and in Leon. Both have been super helpful in giving advice and managing pain. Both cost me about 30 euros and they were the best euros I’ve spend on the Camino!
- You can buy pink padding in the pharmacy with adhesive on it which can really help managing pain. Highly recommend this for your blister kit!
- Ask for help! My heel blisters were so uncomfortable to take care of since I couldn’t really reach them myself without twisting my spine. It took me 4 weeks to finally ask a friend to help me. Don’t be like me and do it earlier, you’ll be surprised how helpful everyone is.

 

[trecile]

Don’t be too scared of using a thread. I started late with this, because the idea scared me, but it’s been really helpful. You can buy a set at the pharmacy for like 3,50 euros.

I'm sorry, but I think that this is bad and dangerous advice. Leaving thread inside a wound creates a super highway for bacteria to enter the wound. I don't see any advantages to using this approach vs opening up the blister and letting it drain, then covering it with appropriate bandaging.
I know that @Purple Backpack posted once about using the needle and thread method and had disastrous results.

 

[peregrina2000]

Here is what @Purple Backpack once said about the threading method in a now deleted thread:

Ugh. The only time I threaded a blister was on England’s Coast to Coast. It was a wicked one, huge, under a nail and impossible to walk with. I carefully disinfected it, the needle and even dipped the thread in alcohol and left it threaded overnight. Got the worst possible infection…nasty muddy trail through sheep poop all day, every day. Took weeks to heal with hefty antibiotics. Never again. I’m a Compeed fan but don’t tell anyone.

As others have noted, there is a huge difference between threading a blister, on the one hand, and carefully cutting open a blister and removing enough skin so that roof doesn’t re-form. Like @trecile says, the former creates that “super highway for bacteria”, while cutting off the roof leaves your blister just like any other skin injury that you can treat with a good washing, antibacterial cream, bandaging, etc.

I think that many people jump to the conclusion that any human interference with blisters is likely to cause infection, but it seems to me that there’s nothing special about the skin under a blister. It’s just like the skin that is exposed when, for instance, you take a bad fall, top layers of skin are ripped off, and you have lots of open scrape wounds. I have met several groups of Dutch pilgrims who carefully cut the entire roof off, but I have modified that approach to cut enough off to make sure that there is a good sized hole so that the roof won’t reform. Just enough to make sure that I can properly wash the whole thing, put on some cream, and bandage it up.

Though I rarely get blisters now that I’m walking in trail runners, I think that cutting it open works best if you do it when the blister is small. If left unattended, at least based on what I’ve seen, small blisters are likely to become big blisters if you put the same shoes back on and keep on walking.

So my bottom line, though I have many Spanish friends who swear by the thread method, is that it’s just not the best approach!

 

[gloria lowe]

I'm sorry, but I think that this is bad and dangerous advice. Leaving thread inside a wound creates a super highway for bacteria to enter the wound. I don't see any advantages to using this approach vs opening up the blister and letting it drain, then covering it with appropriate bandaging.
I know that @Purple Backpack posted once about using the needle and thread method and had disastrous results.

I do agree with you. As an ER nurse I cringe every time I read about it. That thread is a super highway for bacteria. If you say something people love to respond with Well you never see anyone saying they got an infection. Of course you don’t, they’re too embarrassed to admit it. And if you think you can disinfect a needle with a flame you’d be wrong. Maybe a blow torch. Buy a sterile needle at a pharmacy and just drain and treat. Prevention is the start.

 

[peterhore]

Do you know, please, the commercial name of this "pink padding in the pharmacy with adhesive on it"
Thanks

 

[trecile]

Do you know, please, the commercial name of this "pink padding in the pharmacy with adhesive on it"
Thanks

It sounds like moleskin or similar.

 

[Pam57]

Do you know, please, the commercial name of this "pink padding in the pharmacy with adhesive on it"
Thanks

FELT PADS WITH HYPOALLERGENIC ADHESIVE 9,5X50 CM 1 UNIT

Felt pads with hypoallergenic adhesive for protecting the foot.

www.mypharmacyinspain.com

This is one I used on the 3 Caminos I walked having notoriously blister prone feet. There are a few similar to this.

 

[peterhore]

Thank you

 

[Kirkie]

I think it is time for rule 15: no more threads about blisters.

 

[iloveagoodadventure]

FELT PADS WITH HYPOALLERGENIC ADHESIVE 9,5X50 CM 1 UNIT

Felt pads with hypoallergenic adhesive for protecting the foot.

www.mypharmacyinspain.com

This is one I used on the 3 Caminos I walked having notoriously blister prone feet. There are a few similar to this.

I would also like to make clear that you need to cover the blister with a regular or cut to fit flexible adhesive bandaid…before putting the moleskin or plaster on. This way it will allow any liquid to drain/protect the blister, without ripping the entire blister off. Sounds like common sense, but many pilgrims just stick it on for relief and forget that it will have to come off later. It’s sticky stuff! Just my 2 cents Buen Camino!

 

[C clearly]

FELT PADS WITH HYPOALLERGENIC ADHESIVE 9,5X50 CM 1 UNIT

Felt pads with hypoallergenic adhesive for protecting the foot.

www.mypharmacyinspain.com

This is one I used on the 3 Caminos I walked having notoriously blister prone feet. There are a few similar to this.

Yes, that looks like "Moleskin." Yes, it is good for padding but not as a dressing for a wound.

Don’t be too scared of using a thread. I started late with this, because the idea scared me, but it’s been really helpful. You can buy a set at the pharmacy for like 3,50 euros.

I'm not quite sure what it is that you bought at the pharmacy. Another technique is to open the blister with a sterilized scalpel or even scissors. That will leave an opening large enough to continue draining, whereas a needle poke will close up quickly. You still need to be concerned with contamination and infection, but at least you don't have the dangling thread superhighway.

 

[Thyme_Is_Running_Out]

Moleskin is already in my backpack although I don't leave for another 6 weeks. I learned about it from family members who were in the military and had to hike long distances.

EDIT: I should add that I'm also bringing a pre-threaded needle. LOL

 

[trecile]

EDIT: I should add that I'm also bringing a pre-threaded needle. LOL

Hopefully in case you need to sew on a button or mend a hole in your clothing.

 

[Thyme_Is_Running_Out]

Hopefully in case you need to sew on a button or mend a hole in your clothing.

LOL Sure, why not!

 

[Rachel from Seattle]

Hey everyone. Just wanted to post something blister related since so many topics helped me so much preparing for my first Camino.

I’ve suffered with blisters since day 2 all the way to the end. Nothing better then blisters to keep you ‘in the moment’ right? It sure was painful and still is although I’m already home for 1,5 weeks.

Some things that helped me:
- Don’t be too scared of using a thread. I started late with this, because the idea scared me, but it’s been really helpful. You can buy a set at the pharmacy for like 3,50 euros. Weights nothing, might be worth taking it with you in your blister kit.
- Spend money on podiatrist visits when your not sure what to do. I’ve visited one in Logrono and in Leon. Both have been super helpful in giving advice and managing pain. Both cost me about 30 euros and they were the best euros I’ve spend on the Camino!
- You can buy pink padding in the pharmacy with adhesive on it which can really help managing pain. Highly recommend this for your blister kit!
- Ask for help! My heel blisters were so uncomfortable to take care of since I couldn’t really reach them myself without twisting my spine. It took me 4 weeks to finally ask a friend to help me. Don’t be like me and do it earlier, you’ll be surprised how helpful everyone is.

I’m a threader, too. It works for me but I let others make their own decisions.

 

[Rachel from Seattle]

I think it is time for rule 15: no more threads about blisters.

Blisters are one of the biggest problems on the Camino. If you’re tired of reading about it just scroll on by.

 

[Dani7]

FELT PADS WITH HYPOALLERGENIC ADHESIVE 9,5X50 CM 1 UNIT

Felt pads with hypoallergenic adhesive for protecting the foot.

www.mypharmacyinspain.com

This is one I used on the 3 Caminos I walked having notoriously blister prone feet. There are a few similar to this.

I used this same tape for my recent Camino to put on my heels. Extremely effective to protect against hot spots and blisters and or calloused blisters. Used it every day.

 

[SarahTheKiwi]

This is what I used in the military in New Zealand. It was a gel sheet, cut to size, put over the offending blister, then a bigger plaster put over the top. The cooling gel was very pleasant on hot spots and stopped the blister from drying out and cracking. I don't seem to be able to find this product in NZ anymore.... maybe it is in Spain? Would recommend.

Second Skin

 

[Wayfarer1]

Also, you might see little green Compeed plasters. These are great for putting over closed or open blisters. It protesters it from further rubbing, and if it's open it stops infection getting in. It also gives some padding to make it easier to walk on. My advice, put the compeed on as soon as you are aware of the blister, then have a couple of normal plasters round the edges. I found that with all the waking the compeed edges sometimes rolled.

 

[KJFSophie]

I'm sorry, but I think that this is bad and dangerous advice. Leaving thread inside a wound creates a super highway for bacteria to enter the wound. I don't see any advantages to using this approach vs opening up the blister and letting it drain, then covering it with appropriate bandaging.
I know that @Purple Backpack posted once about using the needle and thread method and had disastrous results.

I’m a nurse and use the needle a thread method to wick drain the blisters instead of just piercing or cutting or pulling blister skin off. Infection can happen with any method and that is the part of blister treatment that requires the most attention. I wipe the threaded needle and thread beginning with tip of needle to base of the thread with an alcohol wipe. then wipe the exterior of the blister with alcohol and let both dry completely before piercing the skin, I leave the wick overnight but cover my foot with a lightweight breathable white low cut sock. Keeping everything clean is essential.

Keeping the treated blister clean and dry afterwards is also important. I can’t tell you how many people I’ve seen walking around in dirty sandals with strings hanging out of their feet. Or wearing dirty socks on treated or burst blisters, or prolonged use of dirty bandages/ plasters.

 

[Damico Walking]

The best way to deal with blisters is to prevent them in the first place. I tend to get blisters in the same places, I assume it is because of my personal stride and knee issues. So before I start my walk I put a double layer of Kinesiology Tape on those areas. It stays on for quite a long time even through showers etc. It stops the blisters from forming by allowing the tape to absorb the rubbing rather than my skin. The tape is very thin and I forget it is on after about 4 minutes. Same works for my wife. But of course we all are different so what works for me may not work for others.

 

[lettinggo]

Hola

If you have blisters under your foot or on the side you can try to bandage the foot if you got enough space in your shoes.
You can use this mehod before you get the blisters as it will protect your foot and make it less painful to walk if you already have blisters.

Regarding using or not using a tread, I am always bewildred by people who state their view as a fact.

The fact is that different people use different methods with their own result and just because something doesn't sound good for you, it doesn't mean it can't be good for another person.

Buen Camino
Lettinggo

 

[Kirkie]

Hola
If you have blisters under your foot or on the side you can try to bandage the foot if you got enough space in your shore.
You can use this mehod before you get the blisters as it will protect your foot and make it uh less painful to walk if you already have blisters.

Regarding using or not using a tread, I am always bewildred byu people who state their view as a fact.

The fact is that different people use different methods with their own result and just becsusde something oesnt sound good for you, it doesnt mean it cant be good for another person.

Buen Camino
Lettinggo

Although I had decided to keep my mouth zipped, i will respond here. I have my view, and my experience. I have not, lately, shared either of those.
Your last paragraph is so true.
edit: in my opinion

 

[kelleymac]

On my first camino, I got nasty blisters and I threaded them, and yes, some got infected. On the other hand, some healed faster. So... I don't recommend threading.

I do recommend getting larger shoes that fit --and if you often get blisters in one place use some leukotape or at least a bandaid to protect that place before you get a blister. As soon as you realize you're getting a hot spot-- stop walking and put some protection on that spot.

Concerning moleskin. Great stuff. It's not meant to cover the blister. Cut out a hole so it's not sticking onto the blister itself. Or cut strips of moleskin to put around the blister, building a protective wall around the damaged skin. Moleskin is to keep the shoe or sock from rubbing on the blister or hot spot.

 

[kelleymac]

Another thought and memory. When my feet got a lot of blisters, I didn't want to look at them. That ended up with me not changing the bandaging often enough, and not washing my feet enough (I was embarrassed and tired). I had blisters on the bottom of my feet and the sides, and I damaged my toenails (lost two later). I just pretended I didn't have feet. I suspect this led to the infections as much as the threading at night. When I arrived in Santiago, I was limping and a fellow pilgrim asked me if I'd like him to take a look. I said no, as my feet were pretty ugly. Then he told me was a doctor -- That was actually surprising to me as we'd been walking at about the same pace, and run into each other a few times. I guess our professions were never part of our conversation. -- He recommended washing/soaking my feet two times a day in a betadyne solution, and gave me some antibiotic ointment to use. -- And he recommended I see a doctor if the blisters weren't mostly healed in a week.

 

[peregrina2000]

I’m a nurse and use the needle a thread method to wick drain the blisters instead of just piercing or cutting or pulling blister skin off. Infection can happen with any method and that is the part of blister treatment that requires the most attention.

Thanks for this explanation. I have many Spanish friends who use this method, never with bad results. Can you explain why you prefer this method to cutting off a piece of the top of the blister? I realize, as you say, that there is a risk of infection with any blister treatment method. But I would have thought that the risk of infection would be lower with a piece of the top cut away to give easy access to the raw skin underneath for cleaning and continuing to disinfect. Also, I cover the open blister after putting on anti-bacterial cream, with gauze and tape, as I would for any other small wound. Do you cover the threaded blister? How do you treat it after the thread is inserted? I know you said it is important to keep it clean and dry, but I am wondering how you do that.

I’m not challenging what you say, just curious to hear a bit more about why you use this method, and what your follow-up is once the thread is inserted.

I have long thought that the majority of people in an entire country would not continue to use a method if it produced large numbers of infections!

 

[Walkalong]

Great advice.

Omnifix or similar dressing retention tape in a 30 cm wide roll is versatile as a preventive measure, or to hold bandage, gauze, gel pads in place or to reduce that curling edge on some bandages and things like hydrocolloid bandages (compeed). Very versatile.

For me, prevention starts with good quality socks (Features, Darn Tough, Smart Wool) as snug/tight as possible without cutting off circulation in a loose fitting light shoe to allow the foot to splay properly, and ENGO blister patches applied to know friction points.

Engo Blister Patches are applied to custom orthotics made by a very experienced padorthist worked for me.

Thanks to Rebecca Rushton and Dave Bugg for excellent advice. Rebecca Rushton's videos are extremely informative. Thanks you, and thank you Nurses!

 

[ndb175]

What an interesting welcome to the forum..

 

[David Tallan]

As others have noted, there is a huge difference between threading a blister, on the one hand, and carefully cutting open a blister and removing enough skin so that roof doesn’t re-form. Like @trecile says, the former creates that “super highway for bacteria”, while cutting off the roof leaves your blister just like any other skin injury that you can treat with a good washing, antibacterial cream, bandaging, etc.

For what it is worth, when my son was treated for terrible blisters at the podiatry clinic in Astorga, they did not cut off the roof of the blisters. Instead, they made slits in the side, drained, and washed with antiseptic (squirted inside with a syringe) and then covered with a bandage. For the worst, they used a "doughnut bandage" that was thicker around but not on top of the blister location, to reduce the pressure on the blister.

I think the idea of not de-roofing the blister was not directly exposing the very sensitive skin underneath. I know that my son could walk again almost immediately (although we did take a rest day for additional healing, that wasn't their initial instructions) whereas @DoughnutANZ, who had a blister de-roofed on his Camino de Madrid was told to stop walking for several days afterwards.

On the other hand, making a slit on the side keeps the protective skin above and every step continues to push out any liquid that may be collecting inside. We were told to change the bandages and re-apply the disinfectant regularly.

I am not a doctor and this is not medical advice. It is just what I observed at a podiatry clinic and what worked for my son. Other podiatry clinics (as @DoughnutANZ found) do things differently.

 

[C clearly]

I have long thought that the majority of people in an entire country would not continue to use a method if it produced large numbers of infections!

I don't think there are large numbers of infections, but there are some.

There are many "traditional" practices that are not recommended now, because of newer knowledge.

Threading a blister is not high on my list of dangerous practices, but I think there are probably better ways to go.

 

[DoughnutANZ]

For what it is worth, when my son was treated for terrible blisters at the podiatry clinic in Astorga, they did not cut off the roof of the blisters. Instead, they made slits in the side, drained, and washed with antiseptic (squirted inside with a syringe) and then covered with a bandage. For the worst, they used a "doughnut bandage" that was thicker around but not on top of the blister location, to reduce the pressure on the blister.

I think the idea of not de-roofing the blister was not directly exposing the very sensitive skin underneath. I know that my son could walk again almost immediately (although we did take a rest day for additional healing, that wasn't their initial instructions) whereas @DoughnutANZ, who had a blister de-roofed on his Camino de Madrid was told to stop walking for several days afterwards.

On the other hand, making a slit on the side keeps the protective skin above and every step continues to push out any liquid that may be collecting inside. We were told to change the bandages and re-apply the disinfectant regularly.

I am not a doctor and this is not medical advice. It is just what I observed at a podiatry clinic and what worked for my son. Other podiatry clinics (as @DoughnutANZ found) do things differently.

And to add, I had no further problems or blisters.

 

[KJFSophie]

Thanks for this explanation. I have many Spanish friends who use this method, never with bad results. Can you explain why you prefer this method to cutting off a piece of the top of the blister? I realize, as you say, that there is a risk of infection with any blister treatment method. But I would have thought that the risk of infection would be lower with a piece of the top cut away to give easy access to the raw skin underneath for cleaning and continuing to disinfect. Also, I cover the open blister after putting on anti-bacterial cream, with gauze and tape, as I would for any other small wound. Do you cover the threaded blister? How do you treat it after the thread is inserted? I know you said it is important to keep it clean and dry, but I am wondering how you do that.

I’m not challenging what you say, just curious to hear a bit more about why you use this method, and what your follow-up is once the thread is inserted.

I have long thought that the majority of people in an entire country would not continue to use a method if it produced large numbers of infections!

@perigina2000
A few things to consider when answering your question: 1) the liquid inside of the blister ( serum) is actually beneficial towards healing, so you don't want to completely drain, nor dry out the blister quickly. 2) opening up the skin opens the blister to infection, whereas simply threading it through allows a wicking outlet that keeps chances of introducing infection to a minimum ( of course as previously discussed, needle, thread and outside of blister need to be wiped with alcohol and air dried ) 3) releasing some of the fluid in the blister helps with the pain, especially if one needs to continue walking 4) trying to clean the exposed 'raw skin' underneath is not as beneficial as leaving the natural skin on top. 5) if you dry out the skin, you now have hard calloused dry skin to tend with with raw/fresh skin beneath...likely to reblister as protection is gone. 6) I cover the threaded blister loosely at night to keep it clean with a thin white sock to let it breathe 6) in the morning when I clip the thread and pull it out, i do put a dot of triple antibiotic ointment on the puncture holes and put a clean bandage on it 7) if the blister was exceptionally deep/large, I have used the Compeed blister care bandages as they are somewhat padded and maintain a good seal. I don't recommend placing Compeed over any large blister undrained as you can develop a blister underneath an existing blister. 8) there is no need to 'treat it after the thread is inserted' ...the purpose of the thread is to act as a wick to drain most ( not all) of the serum and try to keep the skin intact as a protective cover...all you need do is keep clean.

I hope I haven't muddied the process even more! I've literally treated hundreds of blisters on pilgrim's feet on my 9 walks ( as many as 22 in one day! )

but again, everyone has their own method based on experience, medicine or wive's tale...
( I was an ER nurse for a few decades, pilgrim for a few long walks ...)
Hope this helped

 

[Bob Howard]

#ndb175, what shoes were you wearing? Did you wear them the whole time?

 

[marigold]

@perigina2000
A few things to consider when answering your question: 1) the liquid inside of the blister ( serum) is actually beneficial towards healing, so you don't want to completely drain, nor dry out the blister quickly. 2) opening up the skin opens the blister to infection, whereas simply threading it through allows a wicking outlet that keeps chances of introducing infection to a minimum ( of course as previously discussed, needle, thread and outside of blister need to be wiped with alcohol and air dried ) 3) releasing some of the fluid in the blister helps with the pain, especially if one needs to continue walking 4) trying to clean the exposed 'raw skin' underneath is not as beneficial as leaving the natural skin on top. 5) if you dry out the skin, you now have hard calloused dry skin to tend with with raw/fresh skin beneath...likely to reblister as protection is gone. 6) I cover the threaded blister loosely at night to keep it clean with a thin white sock to let it breathe 6) in the morning when I clip the thread and pull it out, i do put a dot of triple antibiotic ointment on the puncture holes and put a clean bandage on it 7) if the blister was exceptionally deep/large, I have used the Compeed blister care bandages as they are somewhat padded and maintain a good seal. I don't recommend placing Compeed over any large blister undrained as you can develop a blister underneath an existing blister. 8) there is no need to 'treat it after the thread is inserted' ...the purpose of the thread is to act as a wick to drain most ( not all) of the serum and try to keep the skin intact as a protective cover...all you need do is keep clean.

I hope I haven't muddied the process even more! I've literally treated hundreds of blisters on pilgrim's feet on my 9 walks ( as many as 22 in one day! )

but again, everyone has their own method based on experience, medicine or wive's tale...
( I was an ER nurse for a few decades, pilgrim for a few long walks ...)
Hope this helped

So do you take the thread out in the morning and cover it with a guaze dressing? Then do the threading again after walking? I never had any blisters on my caminos thank goodness, but I saw many people who had terrible ones - everyone used the threading method and I was always curious...

 

[KJFSophie]

So do you take the thread out in the morning and cover it with a guaze dressing? Then do the threading again after walking? I never had any blisters on my caminos thank goodness, but I saw many people who had terrible ones - everyone used the threading method and I was always curious...

The blister should drain with the thread wick overnight, then remove the thread in the morning. I recommend cotton white thread. I pull the thread in the morning ( make sure it was kept clean thru the night with a light sock or a breathable dressing ) and cover with a fabric bandage. It should be able to breathe and not retain moisture. There should be no reason to thread again after walking if it was sufficiently drained and left to dry a bit. If you are developing more blisters on drained blisters, you need to assess why. ( ill fitting footwear? Sweat/wet? Sock seams? etc ) Ideally, you stop and take your shoes off every now and then to dry your socks, clean out any debris that may have made its way into shoes, assess your dressings if any.