Blister 1 Introduction

When mobility in the field can mean the difference between success and failure, we all understand the need for a reliable means of transport.  The foot is to the infantry what the tank is to the Royal Armoured Corps.  Yet tanks get a much better deal.  They are overhauled regularly, inspected for damage and are run on high class fuel.  The foot however is brought unsuspectingly into the military, thrown into boots, deprived of oxygen and asked to perform miracles.  It is no wonder that the feet can suffer from all sorts of damage and cannot live up to expectations.

So what can you do to get the best out of your feet?  How can they be prepared and trained properly so that they will carry you where you need to go?

General Care in Camp

The routine of foot hygiene must be established in camp or barracks and should become a habit.  Everyone has different foot hygiene needs, which must be discovered before going into the field, by which time it is probably too late.

Washing

Feet must be washed at least once a day.  If this is not done, then the dead cells (which the body constantly sheds) will build up and will become food for all the nasty bacteria.  Smelly feet will then be the least of your worries and you will be fighting athlete’s foot as well as the enemy.

Drying

After washing you must dry properly, particularly between your toes.  This prevents the skin becoming soggy and allowing all those bacteria to penetrate your natural defences, and then inviting in some of their friends.

Sweaty Feet

The same principle applies to sweaty feet.  The sweat has the same effect as not drying your feet.  So if you suffer from this naturally, then you have even more work to do.  After washing and drying the feet, an ‘astringent solution’ should be applied.  Surgical spirit has a good drying effect and is an excellent way of reducing sogginess.  If even this fails then, as a last resort, powder may be used sparingly.

Footwear

Boots or shoes that have been used all day should not, if at all possible, be worn the next day.  This is to allow them to dry out fully before adding another day’s puddle.

Socks must never be used two days running.  Anyone who manages on one pair for a week should have the offending articles pegged over his/her nose to see how s/he enjoys the smell that others have to endure.

Nail Care

Toenails must be in good condition before you leave camp because acute nail problems can be extremely painful in the field.  Cutting them too short will result in in-growing nails and leaving them too long will end in bruising or complete shedding.  Cut nails level with the top of the toe and follow its natural shape.

Preparing the Foot and Leg for Marching

Before leaving camp on a long march, or on field exercises, toughen your feet so that they do not blister.  As well as the normal daily washing and drying, wipe your feet with surgical spirit every night.  When the spirit is dry then pat on some more and let it dry.  This treatment will toughen your feet and help them withstand the extra stresses that are going to be applied to them.

For a long march or an exercise you must have the correct footwear.  This does not mean just boots but also socks.

Blisters 3Boots

Make sure that your boots fit properly.  Any movement of the foot inside your boots can cause a blister.  Your foot must therefore be held firmly back into the heel of your boot so that it does not slop around.  The toes however, should have room to move and at no time should the boots press on them.  This would prevent the toes working properly and make it more difficult for you to walk freely.

Socks

Never, march without socks.  In fact use two pairs when marching long distances.  Make sure that there is still room in your boots for both pairs of socks and your feet.  They can be either two pairs of medium thickness or one thin and one thick pair.  With two different thicknesses, put the thin pair next to your skin.

Sock Fabric

On the march your feet will sweat.  Wear socks made from natural fabrics such as wool or cotton.  These will allow sweat to pass through and keep your feet drier.  Man-made fibres, such as nylon, do not absorb the sweat and after a few miles you will find your feet swimming in perspiration inside your boots.  This is not just unpleasant but can also make your skin soggy and much more likely to blister.

If you know you have to go out on an unusually long march give your feet one last thought.  Put a small amount of soap flakes into your socks, not too many or you will look like a bubble blowing machine.  This last minute precaution against blisters is little known but has been used for many years with good effect.  It forms a slippery layer and allows the foot to move with reduced friction.

In the Field

General care:  In the field wash your feet when possible, if not, then wipe them over with a cloth especially between the toes.  Use surgical spirit and powder to reduce friction.  Take your boots off when you sleep, or change into training shoes, and elevate the feet to prevent swelling.  Change socks every day and put on a dry pair.

Dry off wet socks by putting them over your shoulders under your combat jacket.  Be careful when you put on your dry socks that they are lying flat on your feet because any rucks will rub during the day and cause blisters.

When you stop for a rest, during a march, loosen the bootlaces over the instep area and elevate your feet.  This will allow the blood to circulate freely and help to reduce fatigue and swelling.  Do not tighten the laces around your ankles too much or they will act as a tourniquet, preventing blood from getting to your feet and reducing their efficiency and resistance to cold.

First Aid in the Field

Blisters

Sterilise a needle and pierce the blister near the edge.  Do not remove the skin as this will act as a protection.  Cover the area with a dry dressing or plaster.  Try to find and remove, what has caused the blister.

Bruised Nails

Severe bruising under the nail is extremely painful and can lead to permanent damage and deformity.  There is nowhere for the blood to go so the pressure under the nail must be released.  This will give immediate relief from the pain.  Treatment is as follows:

  • Push the blunt end of a needle into a piece of cork or something similar.
  • Hold the sharp end over a flame until it is red-hot.
  • Place the tip of the needle into the nail, over the bruising, and press very gently.  It should be the heat of the needle and not the pressure, which penetrates the nail.
  • When the needle has cooled a little, heat again and press gently until the blood releases.  Blood may spurt out and relief is immediate.
  • Cover with a dry dressing.

In-growing Nails

If the nail has been damaged and it is starting to in grow, the skin along the sides of the nail can become painful.  The problem, which should have been spotted in camp, may be relieved by the following simple procedures:

  • Remove any torn pieces of nail.
  • Push a piece of cotton wool down the side of the nail so that it lies in between the nail edge and the nail groove.  This will act as a protection as the nail grows back and will keep it from penetrating the surrounding skin.

The chances of a full and very painful in-growing toenail may also be prevented.  Seek treatment from a medical specialist on return to camp.

Foot Inspection

Foot inspection should be carried out after any strenuous training with a medical orderly in attendance.  Ideally inspections should take place:

  • After any long period out in the field.
  • At the end of BCFT, ACFT and any other route marches.
  • As part of other regular inspections.

For Commanders and fitness instructors.  If you notice someone has a problem look at his/her feet more closely at subsequent inspections.  You will soon know who to scrutinise and who to glance at.  Remember that serious injuries start as small ones.  Luckily the body has a defence against things getting too bad and that defence is pain.  Pain is never normal and must always be investigated.  No one likes to admit to weakness so try not to conduct group inspections, rather talk to each individual.

What To Look For

  • General cleanliness:  Lack of cleanliness means neglected feet and a lack of awareness of possible problems.  Abnormal colour is a sign that something is wrong, for example:
    • Red, infection or damage.
    • Blue, bruising or lack of blood in the area.
    • White, cold injury.
  • Blister 2Sogginess:  Sogginess can be seen as white wrinkled skin.  When you leave a plaster on your finger for a couple of days the skin underneath will be soggy when you take it off.  Soggy skin on the feet means lack of drying or ‘unattended’ sweaty feet, and the possible onset of athletics foot.
  • Blisters:  Blisters are the result of rucked socks, badly laced or incorrectly sized boots, poor drying or poorly toughened and prepared feet.
  • Nail length:  Bruising, in growing toenails or shedding of the nail may occur unless nail lengths are correct.
  • Corns and callous:  Callous or harder skin is formed as a protection against stress and therefore should be encouraged.  However, a corn is not normal.  It shows that a particular area is taking too much load.  Corns must never be cut out with scissors or a knife but should be referred to a medical specialist.
  • Rub marks:  When shoes or boots press onto areas that should not be bearing a load, red rub marks result.  Such marks can be caused by improperly fitted boots or shoes, or by bad foot function.  Rub marks can develop into scores so the cause should be sought.
  • Painful areas:  Pain means that there is something wrong and painful areas must always be investigated to prevent future injury.
  • Swelling:  After a long march or run, some swelling, which is a sign of overuse, is only to be expected.  However, localised swelling when it is associated with pain should not be ignored and its cause should be found and treated.  Make a point of asking if there are any particularly painful areas.

Preparations for Physical and Fitness Training

The feet and legs can only perform well if they have an adequate supply of oxygen.  This is provided by the heart and lungs so general preparation is essential when any part of the body is asked to perform to its maximum efficiency.  Ask too much too soon and the result will be injury and wasted time.

Muscles, ligaments and bones must be strong enough to withstand the tasks asked of them.  This strengthening takes time and it cannot be hurried, it must be graded progressively.  Only then can the body structures withstand and tolerate physical stress.  It is a misconception that you should exercise until it hurts.  By avoiding stiffness there is less chance of damage, so that the training programme can proceed quicker.  Tired muscles and tendons take time to recover.  Try to plan for an ‘easy’ day to follow a ‘hard’ one.  If time is short then exercise different muscle groups, for example, a ‘running’ day followed by a ‘gym’ day.

The foot has evolved to carry man over uneven ground so it does not function well for long periods of repeated activity on hard unyielding surfaces.  Initial training should take place on grass or tracks.  If used too early on hard surfaces, any weakness in the foot will be multiplied by the number of strides taken and injury will result.

Remember, every time the foot hits the ground it produces a force approximately equal to two and a half times the body weight so proper training shoes (not cheap “look-alikes”) are designed to absorb shock and to support the foot in its best functional position.  Running should therefore start in training shoes not boots.  Numerous lower leg injuries will occur if boots are used on the unprepared foot.

Boots are heavy and the muscles of the leg will take time to adjust to them.  Do not expect to be able to run the same distance in the same time when they are introduced.  This phase in training means a step backwards before you can improve again.

Those of you who are ‘old soldiers’ probably think that all this only applies to recruits.  The same principles apply to your fitness training as well.  A crash training programme to pass a fitness test will result in the same crop of lower leg injuries if running is done day after day in boots and on roads.  Even the fittest and strongest body cannot withstand such punishment!

Related Articles

Advertisements

3 thoughts on “Foot Care: Overview

  1. Just letting you know that there is new polymer based technology in preventing blisters. It is like a second skin that covers your whole foot. It works by gripping the skin (similar to applying tape) on the inner side whilst absorbing friction (similar to a liner sock but smoother) on the outer side. Check them out http://www.armaskin.com Money back guarantee if you get blisters whilst wearing this anti-blister second skin socks.

Leave a Reply