These blisters can be located all around the edge of the heel, inside, outside and at the back, a bit like a horseshoe area around the heel. The skin gets pinched between two surfaces of the shoe. Sometimes a blister can appear further up the heel but is actually caused by the pressure at the edge of the heel.

What causes these blisters?

Footwear

mainly sandals are the cause of these blisters. If the skin of the heel over hangs the sole of the sandal creating a pinching pressure on the edge of the heel, causing a blister and more often than not, a blood blister.

Moulded (shaped) sandals or shoe soles can have the same effect especially If the heel of the foot is bigger than the heel cup of the shoe this will create pressure from the edge of the footwear and the skin will blister. 

If the insole in the shoe has creased, cracked or moved, this can easily cause a blister due to the rough edge that will in turn irritate the skin. 

Shoes do have a lifetime and we often see patients wearing well-worn shoes that are changing the way they walk, which then causes edge blisters 

Orthotics

that are either prescription or off the shelf ones can cause pressure if the lip of the orthotic is slightly too small for the heel. Sometimes this could be due to the casting of the foot being taken early in the morning when the foot was cold? Most feet expand by the end of the day with temperature changes and increase in fluid. This can apply to the `off the shelf` ones from a shop or the internet too, best to try at the end of the day, if your feet have a tendency to do this.

What helps to prevent these blisters?

Footwear

Make sure you have the right size shoe or sandal, maybe an ½ shoe size increase in the summer shoes, when feet can often become more voluminous during hot weather. Fit is just as important, too loose can be just as bad as too tight. Check inside the heel area of your shoe to make sure that the material isn’t fraying or splitting. Have a look at the shoes from behind, making sure there isn’t excessive wear on the outside edges of the heel counter as well as the sole. Otherwise, the foot could be walking at an angle. 

Get a family member or friend to video you whilst walking in the shoes that are causing blisters. This way it might be obvious that the feet or legs might not be symmetrical and why there are blisters on one foot only

Lace Locking

keeps the foot retained in the shoe to prevent excessive movement in the heel area of the shoe.

Orthotics

If the orthotics are prescription made, then ask your podiatrist if they can adapt them themselves or send them back to the lab to have them teased out slightly at the heel area.

Engo Patches- these can make a huge improvement at the junction of the insole with the shoe and on the orthotic itself, which reduces the friction at this area, it may be enough?

Taping

is not always successful on this area but worth a try because this might be the solution for you. Rigid or soft taping, or both together.

Armaskin liner Socks

Armaskin liner socks have worked really well for this area as they will reduce the friction at the insole- shoe junction but they always need another sock as an outer layer

Darntough socks

Darntough socks are cushioned underneath the sole which again will help with reducing the high friction areas