Blisters. Hot spots. Trench foot. 

They don’t sound dramatic — until they stop you moving. 
 
When you’re operating far from help, foot care isn’t comfort. 
It’s risk management. 
 
This is the difference between finishing the route… and becoming the casualty. 
 
Out feet carry us to some amazing views, I remember how much foot care was drilled into me during basic training in the army. How I ignored it and how I suffered. 
 
Feet need to be looked after, and it isn't that hard. 
Looking at mountain view passed feet.

Why foot care matters more than you think 

On expeditions and long days out, your feet take repeated load, friction, moisture, and pressure. 
 
Research shows that foot injuries are one of the most common preventable issues in military and endurance settings (Knapik et al., 2016). 
 
And once skin breaks down? 
 
Infection risk increases 
Walking mechanics change 
Fatigue rises 
Decision-making suffers 
 
It becomes a downward spiral. 
Walking in mountains

1. Get the basics right (before you even leave) 

This is where most problems start. 
 
Boot fit 
 
Enough room in the toe box (toes shouldn’t hit the front on descents) 
Secure heel (minimise movement = reduce friction) 
Try them on late in the day when feet are slightly swollen 
 
Socks matter more than people think 
 
Use moisture-wicking materials (e.g. merino wool or synthetic blends) 
Avoid cotton — it holds moisture and increases blister risk 
Consider a liner sock + outer sock system for longer days 
 
Break boots in properly 
 
Short walks first 
Gradually increase load and distance 
Don’t test new boots on expedition 
 
Simple. But often skipped. 

2. Manage moisture and friction 

Blisters are not just friction. 
They’re friction plus moisture plus pressure. 
 
Reduce any one of those, risk drops. 
 
Practical steps: 
 
Change socks when wet 
Air feet during breaks 
Use foot powder or antiperspirant if prone to sweating 
Apply lubrication (e.g. petroleum jelly) to known hot spots 
 
The goal is simple: 
Keep skin dry. Reduce rubbing. 

3. Spot and treat hot spots early 

A “hot spot” is your early warning system. 
 
Ignore it… and it becomes a blister. 
 
What to look for: 
 
Warmth 
Redness 
Tingling or rubbing sensation 
 
What to do immediately: 
 
Stop 
Remove footwear 
Dry the area 
Apply protection (blister plaster, tape, or padding) 
 
This is one of the simplest interventions that prevents bigger problems. 
 
And yet — it’s the one people push through. 

4. Blister management in the field 

If a blister forms, your aim is to protect and prevent infection. 
 
General approach (within first aid scope): 
 
If intact and not limiting movement → protect it 
If large and painful → consider draining (clean technique, sterile needle, leave roof intact) 
Cover with appropriate dressing 
Reduce further friction 
 
Red flags: 
 
Increasing pain 
Redness spreading 
Pus or heat 
 
At that point, you’re managing more than a simple blister. 

5. Understand immersion foot (trench foot) 

Prolonged wet exposure can lead to non-freezing cold injury (NFCI) — often called trench foot. 
 
This is not just discomfort. 
It can become serious. 
 
Early signs: 
 
Pale, wrinkled skin 
Numbness or tingling 
Cold, swollen feet 
 
Prevention: 
 
Keep feet as dry as possible 
Change socks regularly 
Allow feet to dry and warm gradually 
 
Management: 
 
Remove from wet conditions 
Dry slowly (not direct heat) 
Avoid re-exposure 
Muddy wet feet.

6. Build foot resilience over time 

If you want happy feet, by conditioning your feet they will be stronger and cope better. 
 
Gradually increase distance and load 
Train on similar terrain to your objective 
Strengthen lower legs and ankles 
Look after nails (trimmed, not too short) 
 
This isn’t just fitness. 
It’s durability. 
Feet painted as happy clowns

Practical foot care kit (keep it simple) 

Blister plasters (e.g. hydrocolloid) 
Zinc oxide tape or similar 
Small scissors 
Antiseptic wipes 
Needle (sterile) 
Foot powder or lubricant 
 
Lightweight. High value. 

Final thought 

Most foot problems don’t come from bad luck. 
They come from small things ignored. 
 
A hot spot missed. 
Wet socks left too long. 
Boots that never quite fitted. 
 
Outdoors, those small things compound. 
 
Look after your feet — 
and everything else becomes easier. 
Walking boots

References 

Knapik JJ, Reynolds KL, Duplantis KL, Jones BH. Friction blisters. Pathophysiology, prevention and treatment. Sports Medicine. 1995. 
 
Knapik JJ et al. Injury rates and injury risk factors among US Army personnel. Military Medicine. 2016. 
 
Centers for Disease Control and Prevention (CDC). Trench Foot (Immersion Foot). 
 
NHS. Blisters – Treatment and Prevention. 
 
Wilderness Medical Society Practice Guidelines for the Prevention and Treatment of Frostbite and Nonfreezing Cold Injuries. 
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