I have been running for about 3 years. I have doctor prescribed inerts in my shoes due to over pronation. I have run several 5 K and 10 K races and two 1/2 marathons. On my last half marathon (early November), I developed huge blisters on the bottom of one foot where I have never had a problem before. Now, every time I run more than a couple miles, I develop blisters on that one foot. I have tried running with moleskin, double socks, vaseline feet, and various combinations, but still have a blister by 4 miles (even under the moleskin). I was hoping to run my first marathon this year. Any advice? Thanks!
The weird thing about blisters is that the usual approach to pad under them sometimes makes the problem worse. It depends on whether your blisters are due to excess motion, unequally distributed pressure, or contact with portions of your shoe. It could be all of these in some cases, which means the padding might be more helpful in another place. It depends on the structure of your foot.
Just for fun, find a shoe department or drug store that has one of those foot analysis stations you can step on to see a graphic of where the pressure points are on the bottom of your feet. This gives you a look at what a doctor might be seeing. If the pressure is concentrated in a particular area, padding there may be counterproductive. It turns out that padding sometimes needs to be placed where there isn't enough pressure, in order to distribute the impact better. This is often the case with a "Morton's" foot, which may look normal, but has 1st metatarsals that are shorter than the 2nd, throwing some of the pressure onto smaller, weaker bone(s).
Pressure should be divided pretty evenly across the forefoot, and the ends of the toes should follow a fairly straight curve, for most shoes to work well as sold. While some inserts may help you adapt to slight variations in pressure, some will make it worse. This is the case with many custom orthotics and arch supports, despite the good intentions behind them. It is also often the case that a running shoe that is the same size as your street shoe may not account for variations in the shape of your foot, that only seem to matter after the repetitive motion of running. It's a good idea to size up by at least a half-size or more. I usually size up by at least one full size unless I can get the shoe in widths.
To answer more, I'd have to know more about where these blisters are, and what kind of insert you were prescribed.
Thanks for the information and insight. The original reason I got the inserts was because of a stress fracture in my right shin. I have been using them for two and a half years and have had no further problems with that. However, the blister problem area is on my right foot, just between the ball and arch. I never had problems there before this last 1/2 marathon in November. Now, it is everytime I run more than 2-3 miles. I have changed shoes. Both the pair I am using now and the previous pair were purchased at running stores where they did put me on the "running/pressure point" machine. As for the kind of insert I was prescribed, I don't know (how can I tell). I was sent by the orthopedic doctor to the Sports Medicine doctor where I stepped into some styrofoam like material that made and impression of each foot. Then the designer (?) made the inserts from the impressions. It's really frustrating that this is so recent. I wish I could pinpoint what has brought this on...a change in my form maybe?
Glad you said that BOSNPM, I totally agree...James always has prompt, helpful and accurate responses. We are all blessed for his kind influence. His answers are very detailed and always reliable. Thank you for the opportunity to share the appreciation.
I experienced a similar problem between ball and arch with my first pair of Nike 360s, an expensive shoe at the time. I attributed it to my sizing up, but I hadn't experienced the problem with other shoes. Obviously I got over it, because I went on to put over 1,500 miles on that amazing pair of shoes before the soles began to separate (I glued them and use them for cutting grass now).
What is surprising is that you are experiencing the problem with a form-fitted orthotic. If they have any material in it that reinforces the arch, it may be too far forward for long distance running, and is irritating that area just before the ball. Sometimes I believe that the arch of the foot was not really meant to contact anything, or it would not be elevated off the ground!
A custom orthotic probably does more to stabilize the lower leg while standing than anything else, because it is somewhat restrictive for LD running. I've read many posts here from people who have been disappointed by them. If it came from a sports doc, there are different levels of sports orthotics, depending on how serious an athlete you intend to be. Some are made from very strong but lightweight materials optimized for an athlete's special needs, and can be very expensive. I'm willing to bet these are more pedestrian since you had not been running long when they were prescribed. Might be time for a re-evaluation, just like periodic eye exams.
Then again, the topic of the day seems to have been short 1st metatarsals, which would run up against an arch support like mine did. It's pretty common, but often goes unnoticed until an athletic demand is placed on the foot. My left is worse than my right in this regard. If the shoe or orthotic design is unforgiving of this trait, I could see how an arch support could produce the problem there.
A common solution I have shared often, is to elevate the ball of the foot slightly with a small pad under the orthotic or insert, right under the ball of the foot, and about the same size. This can get that painful area out of trouble and even reduce lateral pressure on the leg and ankle. Some shoes build this in, but most don't. The orthotic, if form-fitted, is probably neutral in that respect. The idea is to start small, and increase thickness as needed later, because too abrupt a change could be painful in other ways.
Another thing to check is your Tibialis Posterior muscle, deep in the center of the rear calf under two larger muscles. If you can relax the calf in a neutral (unflexed, unstretched) position, some massage to the rear calf will soften the larger muscles enough to penetrate and work some circulation into the TP muscle. It has a tendency to give out when it is tired, and stay that way, allowing the arch to slowly collapse. This you can expect more when the problem is one-sided and there is a history of trauma in that leg.
Another possibility is strain to the TP tendon causing a similar symptom, but I would expect the pain to be farther rearward in that case. Check to see if your arch height has changed over the years. You can check yourself by seeing how much of a finger (lengthwise, or to which joint) can be placed under the arch on each side.
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