Barefoot Heat Blisters and How to Measure Barefoot Readiness

He was trying to act casual as he came in the door, but the awkward walking on his heels combined with the reflexive grimacing gave him away. He knew he would be “in trouble,” because living with me he should have known better. But he also had a reasonable explanation. One that you can learn from.

Let me back up to his running history, so that you can see that this was not a wild, careless experiment. The man has been running for years. He has run many, many miles, often times in the heat of the day. He likes the heat, but, also, running at lunch time is also a good option for him, so it became normal. He has run a few marathons, a number of half marathons, and a variety of other races. He always places well.

Recently he had shoulder surgery, probably the most major health issue he has had, which set him back in the running department. When he started a running effort again, he developed some knee pain. With all his running experience, working out injuries is not new, but the idea of using barefoot running to help is relatively new. He has watched me enjoy learning about it the last 3 years, after he introduced me to the idea, but he has not tried it very much. Just a mile here and there on asphalt.

He has run with fairly flat shoes for a while and worked on form that is similar to barefoot running, so the mechanics of what he was doing this day were not foreign. Maybe not learned as well as they can be when running totally skin to ground, but still that aspect of transitioning was not going to be as dramatic for him as for people who are used to built up shoes.

Most importantly, he was thinking about only running a relatively short distance in bare feet, even on this day. He knew he needed to build up his soles. He was even thinking about how hot the street surface might be and trying to feel if it was too hot for his feet. This is the key point for you to take away: It was not evident until the run was over that damage had been done.

He warmed up his running muscles with ¾ of a mile of running in his shoes. Then, he took off his shoes and tried to gauge how hot the pavement was feeling to his bare feet. The daytime air temperature was working it’s way to 94°F, so it was close to that at his run time of 1 PM. But at that point, the pavement didn’t feel too hot to his feet. He proceeded to run a mile.

The asphalt was a bit pointy, so that is what he thought he was feeling toward the last part of the mile. He had felt tingly feet before and it didn’t strike him as anything unusual. However, as soon as he stopped running, he immediately felt the need to lay down his t-shirt to step on. Then, he noticed the blisters.

 

 

Both balls of his feet became incredibly tender and all his toes had some sort of blister forming as well. Only the pad on his left foot was beginning to visibly fill with fluid, but the right foot felt nearly the same. He was now about 1 and ¾ miles from his car, so he put on his shoes and ran about 1.5 cringing miles. He needed to get back to work. Finally, he stopped to walk, being concerned that he was doing more damage. (click on any photo to enlarge)

 

 

 

When I saw him about 3 hours later, he was in a lot of pain. The blisters continued to grow. He soaked his feet in an ice water bath a couple of times. At bedtime, he decided that piercing the blisters with a clean pin would bring pain relief by relieving some of the pressure. He washed his feet, then carefully and slowly pushed the pin into the largest blister on the ball of his left foot. Oddly, he said he didn’t hurt to do this. But also oddly, it didn’t gush. He poked a few more holes in it, each time only being rewarded with a flow of fluid that resembled a single tear drop. We postulated that the blister was multi-chambered. He also released fluid from his toe blisters.

 

The main lesson in this is not how to take care of heat blisters on your feet. It is that a barefoot runner needs to be be extremely gradual about trying new surface temperatures. Sole stimulation from just running bare on surfaces you are not accustomed to often does not fully show results for 24-48 hours for the new barefoot runner. Effects of different temperatures do not manifest themselves immediately either. Not immediately enough to make good decisions about a single run.

If you are not used to walking or running on fairly warm surfaces, do it for just a couple of minutes the first time AND at temperatures that are not greatly higher than previous temperatures that have been successfully managed. Then, give your feet time to adapt to the stimulus. It took me a few weeks to build up my soles to heat this summer. It is the first summer I have tried, and I don’t know how it will carry over the winter, but now I find myself walking out on the asphalt in the heat of the day without thinking much about it.

You need to always keep in mind that the blacker asphalt can be surprisingly more heat retentive than  more medium colored asphalt. Don’t assume that because you can handle one sort of surface at a certain temperature, that you can handle any surface. Don’t let the fun of being barefoot lull you into carelessness or a cavalier attitude. Be careful with your feet.

4 Days Later: All of the toes except one look like nothing happened. The one where the blister can still be seen is healing well. The large blister on the left foot is shrunken. There was some blood in the fluid and it has turned dark. It appears that his method of a few careful, small pin pricks to just relieve the pressure, but leave the skin intact has worked. The holes seem closed at this point, as evidenced by the fact that there is no pealing or loose skin on the toes; plus, there is still some fluid in the large blister. Happily, there are no signs of infection, even though he spent the last 2 days of the holiday weekend boating on Lake Lowell (taking the kids wake boarding) and the Snake River (fishing for 10 hours). He has been barefoot in the house, but mostly wearing some sort of foot covering outside. He has washed his feet after all adventures.