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What do you risk when you ignore blisters and carry on walking?

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The blisters can be very painful. If you walk further, you should expect it won't be easy and pleasant. And the blisters may get worse.

But what do you risk, except from pain and getting more blisters, when you decide to walk anyway? If you want to train long-distance walking and you decide to go on 30 km (approx. 18 Miles) walk, ignoring the fact that you have painful blisters on the feet?

Is there a risk of serious infection or permanent damage to skin? Or it's just about the pain endurance?

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It depends in part on how you got the blisters, but from the question I think we can take it to mean that they're from friction.

In order of what you can expect

  • They will get worse and larger.
  • They will pop.
  • The friction that you haven't dealt with will continue. It is now rubbing on much softer skin. It will literally rub away skin (I've had this happen).
  • Sweat, dirt, and bacteria will all be against and open wound in a warm damp environment (your shoe). You will get an infection.
  • Because feet don't heal quickly or well, the infection will get worse. Eventually you'll have to see a doctor to remove the infected tissue (this actually happened to AWOL, which he describes in his book).
  • Should you be insane enough to continue (this would usually take days) then you'll get a blood infection.

Is that an extreme end result? Yes. It never happens really because "walking through the pain" at that point would be nigh impossible and take an extreme level of willful disregard for your health.

Regarding long term effects, you could have long term effects from even your 30km walk. At about stage three (direct friction to raw skin) you could easily get scarring. I have a scar on a toe from a blister I ignored on a shorter walk. It's a permanent annoyance because it now causes blisters on the adjacent toe very easily.

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It might act like a pressure sore. From what I understand, the whole reason why pressure sores normally only affect physically disabled people is that anyone else would stop putting pressure on that one spot. An untreated pressure sore will result in gradual breakdown of the layers of the skin, until you have a big nasty open wound that gets infected really easily. Pretty nasty stuff.

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I will share what I know about Blisters and what I could do to suffer least from them. Blisters are mainly due to wetness, let it be through Actual wet shoes and socks, or let them be due to Sweat. These are the few things that I follow and since I have started doing those things, I have managed to make the suffering too far less frequent, even if I trek for around 5 days in Indian Forests, say for about a 80-90 km trail.

  1. Select your socks in accordance with what suits in your terrain and type of shoe. Avoid Nylon socks, because they do not soak water. Cotton suits to almost every type of terrain. In case cold regions you can try wool.
  2. Try and keep your shoes tied on till you finish entire hike for that day. Taking off shoes for every now and then actually hampers the practice that legs (specially toes) and skin adapts to shoes.
  3. Before putting on the socks, dust the toes with medical dusting powder, this minimizes the chances of sustaining blisters to a noticeable extent. Many of the us in India prefer coconut oil over the dusting powder. But in that case, your socks end up in a condition that you will have to use them only for trekking purposes :P
  4. Carry a pair of floaters (only if you are not hiking in cold areas) that you could use when you know that You are not going to put-on shoes for a long time now, say when you camp somewhere in the night.
  5. Applying Coconut Oil Before wearing is of your choice, but after removing shoes, before you sleep is a Good practice.
  6. These all are the things that can avoid blisters, but still if you sustain blisters, try not to play with them, try not to prick them up with something like a medicated needle or something like that. Try not to rub them off with cotton, cloth.
  7. You can dust them with powder, and if you have big-enough vessel that you can keep your legs in it, then get some hot water and put your legs into it. Sounds like things to do when you are done for the day?
  8. If you are walking, and still there are hours to go, then you can change the socks, dust them (I know this dusting thing is coming far too frequent for an answer, but that is what you can do with blisters), And, please avoid walking barefoot, Or even without socks.

These all things have made me suffer from Blisters less frequent, Probably once in say 10-12 Hikes of about 80-90 km. So, at least its working out good for me, in the Terrain and Weather that one usually come across in Indian Subcontinent: Majorly Rain-forests, Jungles of Western Ghats, India. Temperature in the nights gets close to 8-9 Degree Celsius here. I am not knowledgeable enough to tell you about what you can do in Cold areas.

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The risk is that the blisters will get worse and worse, and continue to interfere with your hiking experience. They can get larger, more painful, and eventually tear open and risk getting infected. This process can happen fairly quickly - from the first time you notice pain in your feet, blisters can develop in < 15 minutes. I haven't personally tried to hike on them longer than that, but I don't think it would take very long (a single day, if you have enough rubbing) for a blister to rupture. Once you have an open wound, infection becomes a continual risk unless you can keep it clean and dry, which is hard to do with your feet while you're hiking. (And, to address your question, all infections are very serious.)

Long distance walking

You mentioned a 30km hike... I'd recommend that you start with short hikes, and add distance slowly over a period of weeks or months. This will give you a chance to:

  • Find a set of socks and shoes (possibly including "liner socks") that work for you.
  • Break those shoes in.
  • Develop first hand experience identifying and treating blisters (with moleskin or duct tape) during the hike.
  • Toughen up your feet gradually.
  • Get in shape (if you weren't already).

I don't know that you were specifically planning this, but going "off the couch" to a 30km hike without any other preparation is setting you up for a variety of overuse injuries (in addition to blisters, you could develop knee or ankle problems) that could be avoided by a more gradual training experience.

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On the topic of popping blisters. There are the two contradicting opinions out there, of course. My understanding is as follows.

Do not pop a blister if you can avoid it. If walking significant distance is needed, pop it with a clean needle, squeeze out the liquid, and put an antibiotical bandage over it. The gains are twofold:

  • The blister won't pop in your shoe, under harsher tearing stress
  • The bandage will protect the wound at least a little - from mechanical stress and rubble inside the boot.

As others have pointed out, moisture and friction are the causes for blisters.

I should note once again that the topic is controversial. In a recent discussion a doctor disagreed that blisters should ever be popped, while a long-distance runner did the above procedure to be able to walk home without too much pain.

Note: I have found that wearing footcloth is a definite solution. It has the advantages of

  • Several layers of protection where you most need it
  • When it gets wet, re-wrap it. Now the wet part is against your ankle and is drying while you walk.
  • Drys rapidly in the sun or just in the wind.
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