These blisters develop quite quickly as the skin is slightly more delicate than elsewhere on the foot and the progression to the roof off blister can be quicker too!
They are caused by Hammer, Mallet or Clawed toes
Which when the toes retract like this it they easily catch on the top on the top of the shoe Why do toes change shape like this? Could be for a few reasons really.
- Inherited – you inherit your foot shape from parents and grandparents, sometimes you can inherit an incorrect toe formula. What that means is your lesser toes can look too long in comparison to the big toe but actually it is probably the metatarsal shaft of the big toe that is too short making the lesser toes look longer. However that doesn’t really help you! When buying shoes the shoe manufacturers make shoes with a toe bow shape for the perfect toe formula ie Big toe is the longest the 2nd to 5th in descending order. In practice, feet rarely present like that. With those statistics, the longer lesser toes touch the end of the shoe first before the big toe and they buckle and retract, like the pictures above. By doing this the depth of your toes ( ie looking at your feet from a sideways angle) has increased and touch the top of the shoe.
- Biomechanics- if the foot is unstable at certain parts of the gait cycle ( in biomechanical terms) then a the toes will retract and grip in an attempt to try and keep the foot more stable, again by retracting, the depth of the toes has increased and touching the top of the shoe, which then increases the pressure on the toes.
- Tendon dysfunction- this is where one set of tendons become stronger than another set and consequently this affects the balance of the toes sitting straight, a bit like a pulley system of ropes.
What will help stop these blisters from forming?
shoes, boots with more depth in the toe box, a softer material and no seams in the front area of the shoe
Darntough socks are my choice as they wick the moisture away from the skin, cushioning which will also reduce the shear and have a lifetime guarantee
keeps the foot from moving around in the shoe and creating more repetition slipping ,which increases shear- and then blisters.
these are made to prop the toes from underneath and straighten them and are better if they are made by a podiatrist as they will be a custom made fit to your feet
Biomechanical assessment with a prescription of orthotics
to establish the cause of the retracted toes.
on the underside of the toe box of the shoe where the toes are touching it, this will reduce the friction on this area but I have to admit they are tricky to put in at that point and if the shoe gets wet, then the patches won’t attach for as long, if the shoe was dry.
decrease the shear on all of the toes
are ok for one toe but can be too bulky with any more than one in the shoe.
Epitact toe tip protection
for hammer toes cover the top of the toes with a 1mm of gel protecting the toes from pressure and friction
2toms blister powder
which will reduce the friction to that area
Taping of the toes
taping is tricky to do yourself but like everything else it gets easier the more you do it. It is very important that there are no creases in the tape as that in itself can cause blisters! and the type of tape, the rigid tapes disperse the shear more but creases easily, so I always prefer hyperfix, which is a medical tape, we as podiatrists use all the time as we can manipulate it with minimal creasing. You can use Kt pro and Kt blister prevention tape. For tape to stay in place it is better prepped with skin tac, which keeps it in place longer, even when the foot sweats.