Can Paper Tape Prevent Blisters On The Feet?
A recent published study by Lipman and colleagues has provided interesting insight into the use of an inexpensive intervention to prevent foot blisters in runners.1 The study found that applying paper tape to blister prone areas of the feet of the study participants had a significant effect in preventing friction blisters in runners.
The participants and location of this study were unique. This randomized prospective trial studied 128 participants in the 155-mile, six-stage “Racing the Planet” ultramarathons in 2014 in the Jordan, Gobi, Madagascar and Atacama deserts. If there were ever a running event to study friction blisters in the feet, this would be the best option.
Indeed, 83 percent of the participants developed blisters in their feet but the use of paper tape reduced blister risk by 40 percent.1 The methodology of the study basically compared the incidence of blisters in areas covered with paper tape to areas of the foot that were not taped.
A previous study by the same lead author compared blister rates when runners in this same event wore paper tape on one foot in comparison to the contralateral foot, which was not taped.2 This study did not show any significant difference in the rate of blistering in either foot. The researchers speculated that the methodology of this study had flaws and thus performed their subsequent study to evaluate blisters under the paper tape in comparison to other untaped areas of the same foot.1
Runners have long sought remedies for the so-called “enemy of the feet” of the runner and hiker.3,4 As I pointed out in 2010 in my review of this subject in Podiatry Today, no studies had verified that application of moleskin, tape or tincture of benzoin had any preventive effects of blisters on the feet.5 Research has shown the use of petroleum jelly, a longtime favorite blister prevention treatment, actually increases friction on the skin of athletes and probably causes an increased risk of blistering.6,7
Therefore, insight gained from a well-designed randomized prospective study can provide welcome validation of a long recognized intervention to prevent blisters in runners. Paper tape is inexpensive and easy to apply to any area of the foot. The toes appear to be the most common location of friction blisters.8-10 Paper tape may be the easiest protective barrier to apply to the toes. The thin profile of this material is less likely to increase pressure or create other irritation, which is more likely with moleskin or Band Aids.
The question remains: Should runners apply paper tape to all their toes before running a marathon? The Lipman study, which measured the benefits of the intervention, focused on paper tape only on “blister prone” areas of the feet of the study participants.1 This would make more sense than covering all toes or other areas of the feet, which may not be blister prone. In fact, the original study conducted by Lipman and colleagues concerned the application of paper tape to all the digits of the foot and the results did not show any benefit in comparison to the untapped foot.2
Ideally, any runner or hiker will have reduced or eliminated all of their “blister prone” areas of their feet during training. Properly fitted shoes, wearing socks with appropriate fiber composition and minimizing moisture content on the feet will go a long way to preventing blisters with or without preventive taping.5
References
1. Lipman GS, Sharp LJ, Christensen M, et al. Paper tape prevents foot blisters: a randomized prevention trial assessing paper tape in endurance distances II (Pre-TAPED II). Clin J Sports Med. 2016; epub April 11.
2. Lipman GS, Ellis MA, Lewis EJ, et al. A prospective randomized blister prevention trial assessing paper tape in endurance distances (Pre-TAPED). Wilderness Environ Med. 2014; 25(4):457-61.
3. Scheer BV, Reljic D, Murray A, et al. The enemy of the feet blisters in ultraendurance runners. J Am Podiatr Med Assoc. 2014;104(5):473-478.
4. Lipman GS, Scheer BV. Blisters: the enemy of the feet. Wilderness Environ Med. 2015;26(2):275-276.
5. Richie D Jr. How to manage friction blisters. Podiatry Today. 2010; 23(6):42-49.
6. Nacht S, Close J, Yeung D, et al. Skin friction coefficient changes induced by skin hydration and emollient application and correlation with perceived skin feel. J Soc Cosmet Chem 1981;32(2):55-65.
7. Knapik JJ, Reynolds KL, Duplantis KL, et al. Friction blisters. Pathophysiology, prevention and treatment. Sports Med. 1995;20(3):136-147.
8. Krabak BJ, Waite B, Lipman G. Evaluation and treatment of injury and illness in the ultramarathon athlete. Phys Med Rehabil Clin N Am. 2014; 25(4):845-863.
9. Boulware DR, Forgey WW, Martin WJ II. Medical risks of wilderness hiking. Am J Med. 2003;114(4):288-293.
10. Mailler EA, Adams BB. The wear and tear of 26.2: dermatological in- juries reported on marathon day. Br J Sports Med. 2004;38(4):498-501.
