These are really miserably, painful blister and quite capable of making you limp as they tend to be quite large in size.

What is the cause of these blisters?

These blisters usually present in people that are generally heavy heel strikers (the angle of the heel as it contacts the ground) 

This tends to happen when the stride length is increased when running or walking, the force going down your leg through the heel into the floor increases along with the ground reactive force returning back up into the foot. Force is pressure which can cause the skin to blister, the forces could be exaggerated by wearing a heavy backpack, which will increase the pressure down through the leg and foot.

The same effect can be achieved by wearing high heeled dress shoes, which definitely alters the way you walk and changes in forces going through the foot. I think we have all noticed how differently people walk in heels than without? Stiletto heels leave their mark in soft flooring, even wood, showing how much pressure can be going through the heels when walking.

Manufacturer labels in the sole of the shoes that are slightly raised in comparison to the surrounding area, which with the repetition of each step will increase the friction levels ultimately causing blisters. This an easy one to check out with your fingers feeling for any rough edges.

If the foot moves around a lot in the shoe, this repeated movement increase the levels of friction and pressure on the heel which then may blister the skin

Prevention of these Blisters.

Shortening your stride length slightly when walking or running will decrease the amount of pressure going through the heel. This will take time to implement and is not be tried before an event as this will change other structures in the body. Over time gently changing your technique will have a positive effect on reducing the pressure on the heel during heel strike. A physio, podiatrist or a sports trainer will be able to talk to you about retraining your stride length

Choosing footwear that has dedicated placement cushioning in the heel area of the shoe, this will help with increasing the shock absorption , helping decrease the pressure of heavy heel strikers

Putting a softer insoles, like poron in the shoe, this is a memory material designed to increase shock absorption during an activity. 

Podiatrists have used this material for years for the management patients who have Rheumatoid Arthritis and similar conditions, which leaves the joints inflamed and extremely painful, so decreasing the pressure applied to an area is what poron is designed for. Decreasing pressure decreases shear and therefore blister production. (Picture of poron) if there is not enough room for a full insole then it can be cut and just used in the heel area. Always put in both shoes, so the hips remain balanced.

Engo patches

on the heel area of the insole of the shoe, a small oval patch may be enough or if the blister covers a large area, then the whole of the heel part of the insole will need to be covered with a rectangle patch. These will also cover any manufactures labels that have rough edges. Engo patches reduce the friction under the heel very effectively preventing blisters

Lace locking

of walking boots and trainers- This retains the heel in the back of the shoe, preventing any excessive movement of the foot in the shoe. Which then decreases the amount of friction and pressure is applied to the heel.

Armaskin liner socks

Armaskin liner socks that sticks to the skin and prevent any friction that may be occurring between the socks and the skin. these rally do work well on this area of blisters .You would then wear your normal moisture wicking socks over the Armaskin sock.

2Toms blister shield powder

2Toms blister shield powder is also a great way of reducing friction levels on the skin under the heel , just apply a small amount to the area of the heel that is getting affected by blisters.

Moisture Wicking socks

these are socks that wick the moisture (sweat) away from the skin hence keeping the foot dry, which we know that wet feet cause an increase of shear which in turn causes blisters. Our favourite are darntough as they are cushioned underneath as well.

Taping

This another option to prevent blisters, Hypafix tape or KT pro tape, both are great at preventing blisters. Prepare the skin with Skin Tac which helps the tape stick to the skin and then apply the tape, always ensure the edges of the tape are rounded and there are minimal creases in the tape and then apply 2 Toms blistershield powder to the tape and the edges where the skin tac has been applied