Agony of the Feet

Taking care of the athlete 's bane - blisters.

I used to run 5-plus miles regularly, but I started developing large blisters on my feet. I've tried bandages, moleskin, polypropylene liners beneath my socks and several different brands of running shoes.

Eventually large callouses form with blood blisters under them. What should I do?

S.R.
Hartford, Connecticut

A. Blisters develop when friction separates skin layers, permitting fluid and sometimes blood to accumulate. The feet usually toughen up after a week or two and the problem lessens.

However, when large callouses develop over an area that has previously blistered, they cause more friction between the callous and underlying skin and blood vessels, resulting in the blood blister that you describe. Ongoing blister and callous problems are generally caused by either improperly fitted shoes or abnormal foot function.

First, check your shoe fit. Women's feet are narrower in the heel and broader in the forefoot than men's feet. Women's shoes are often too tight in the forefoot. If your shoes fit well, you may have a biomechanical problem.

Check the wear pattern on your shoes. If you wear the shoe out under the ball of your foot, your foot may be rolling inward too much (pronation). Excessive supination (rolling the ankle out) causes problems on the arch and outside of the foot. Both problems might be solved by wearing a more stable shoe.

Women are also prone to bunions, a bony prominence on the joint between the big toe and the forefoot. This problem might be alleviated in the early stages by wearing a shoe with a wider forefoot.

What should you do if you think your blisters are caused by a biomechanical problem?

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