How to Prevent and Treat 7 Common Thru-Hiking Foot Problems

Have you ever noticed that thru-hikers have an awful lot in common with zombies? Both are prone to shuffling glassy-eyed through the woods at strange hours. Both have large appetites and—cough—unusual diets. And there’s no denying that both zombies and thru-hikers have similarly disgusting feet, complete with gnarled toenails, off-color skin, and a putrid odor.

From blisters to trench foot, lost toenails to plantar fasciitis, all hikers will experience foot problems at some point. By taking action to prevent and treat these common issues, you can save yourself a lot of discomfort and avert hike-ending injuries. Read on to find out how you can avoid getting zombie feet on the trail—and how to deal with it if you do.

Ed. Note: We are hikers, not doctors. This advice is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of a qualified health care provider with any questions you may have regarding a medical condition. 

1) Plantar Fasciitis

Zombie level: Low. Your feet probably look normal on the outside even though they’re screaming on the inside.

Do your heels feel like they’re about to explode with every step? If so, you might have plantar fasciitis, an inflammation of the connective tissue in your arches. Stretch and massage your arches once or twice a day to prevent and treat this condition, and invest in a good pair of insoles such as Superfeet. Try massaging your arches with a golf ball on the trail. You can also buy special sleeping socks designed keep your plantar fascia moderately extended all night long.

2) Heel Spurs

Zombie level: Low, though the pain might give you the zombie shuffle.

Heel spurs are bony growths on the underside of the heel that sometimes cause pain and inflammation. They’re caused by repeated strain on the foot muscles and are often associated with plantar fasciitis. To help prevent this, be sure to stretch and massage your feet frequently. Choose good shoes and insoles for hiking. If you develop heel spurs, your doctor may recommend custom orthotics, over the counter pain relievers, or cortisone injections.

3) Bunions

Zombie level: Low to moderate. Your feet are more intriguing than horrifying.

A bunion is a lump of bone or tissue on the side of your big toe joint that can cause the toe to be pushed out of alignment. Bunions are usually caused by too-narrow shoes and by gait issues that put excessive pressure on your big toe joint when you walk. Custom orthotics, bunion pads, toe separators for overnight wear, and toe socks can alleviate pressure on the bunion and keep your toes properly aligned.

Look for a hiking shoe that feels comfortable and has a wide toe box. You don’t want the side of your shoe putting pressure on the bunion. For the ladies: if you’re having a hard time finding a wide enough hiking shoe, consider looking at men’s shoes instead, as they tend to be wider. If you’re still experiencing pain, talk to your doctor about getting cortisone shots or having the bunion surgically removed (though this is typically a last resort).

4) Blisters

Zombie level: Moderately to severely disgusting feet.

Wet feet are a recipe for blisters and myriad other foot problems.

Wet feet and poorly fitted shoes cause blisters. Pack spare socks on your next trip so that you can change into a clean, dry pair if your feet get wet. And before you hit the trail, take the time to find a pair of hiking shoes that fit you well. You may need to try out several different styles and sizes before you find the perfect pair. Some hikers also swear by liner socks from a brand like Injinji for blister prevention. They’ll give your feet a little extra cushioning and protection, especially around the toes.

Carry supplies for blister treatment in your first aid kit in case your preventive measures fail. I like Leukotape for this purpose. It’s an extremely sticky athletic tape that gives your skin just enough added protection to prevent blisters. When you feel a hot spot starting to form, stop and tape the affected area before it becomes a full-on blister. This stuff is adhesive enough to last several weeks, so it’s perfect for long trips.

If a blister does develop, it’s better (in my nonmedical opinion) to pop it intentionally rather than have it burst in your already-nasty socks during the day and risk infection. Sterilize a needle or the tip of a knife with rubbing alcohol and carefully pierce the blister. Apply antiseptic to the site after draining and cover it with a Band-Aid. Keep your feet as dry as possible during the day to reduce the risk of infection.

5) Abrasions

Zombie level: Textbook zombie feet.

 Abrasions are closely related to blisters. Sometimes when you’ve been hiking in dirty water, fine sand and silt can wash into your socks. This essentially turns them into sandpaper, rubbing your poor tootsies raw with each agonizing step. Again, clean, dry socks are the best way to prevent this from happening. If your feet are already abraded, clean them, sterilize with alcohol or antiseptic, and cover them up with gauze and Leukotape.

6) Toenails

Zombie level: The sight of your feet could make a grown man cry.

We’ve all heard stories about hikers experiencing the dreaded loss of some or all of their toenails on the trail. Lost toenails are actually entirely preventable in most cases, even if you plan to hike a long distance. Not to brag, but I didn’t lose a single toenail on my thru-hike. Granted, my pinky toenails did become weirdly gelatinous and bendy, and some of the others were temporarily reduced to crushed, blackened shadows of their former selves, but that still counts, right? Right?

Toenails become a problem when they’re constantly bumping up against the front of your shoe. This probably means your shoe doesn’t fit quite right. Make sure your shoe fits well and your foot doesn’t slide around on inclines. Look for a style with plenty of room in the toe box. If you’re still having trouble keeping your toes from bumping the front of your shoe, try the heel lock method when lacing.

Once your toenails have died and fallen off, there’s nothing to do but wait for them to grow back on their own. You may feel a pang of loss each time you see that tragically empty nail bed. If it’s any comfort, know that your nails should eventually grow back after you finish hiking.

7) Trench foot

Zombie level: * Barf *

If your feet have been cold, wet, and dirty for a prolonged period, you’re at risk of developing trench foot. You’ll know that’s what it is because your feet will feel like they’re on fire and full of broken glass with every step you take. Another clue is that the soles may start to look like cottage cheese that’s been sitting in the back of your fridge for the past six months. Thick chunks of skin may slough off altogether. Yes, I’m speaking from personal experience.

If you suspect that you have trench foot, it would be wise to get yourself to an urgent care. Trench foot can become extremely serious—amputation serious—in its advanced stages. That said, there are steps you can take to treat mild cases yourself, even on the trail.

First, keep your feet as dry as possible at all times. Take breaks throughout the day to remove your shoes and socks and let your feet air out. Next time you’re in town, buy enough spare socks that you can change into a clean, dry pair at least once a day. Don’t wear socks to bed. Let your feet breathe overnight.

It’s important to keep your feet clean when you have trench foot, because your risk of infection is higher than normal. Wash them every night with soap and water. If you can, heat the water up on your stove first, as you want to keep your feet as warm as possible. As an added measure, wipe them down with rubbing alcohol to further sanitize them. Finally, take ibuprofen to reduce any swelling you might be experiencing.

Let your shoes, socks, and insoles air out whenever you can.

Your feet are arguably your most valuable possessions as a hiker. They’re capable of carrying you thousands of miles through all kinds of conditions, and all they ask in exchange is a little TLC. Don’t find yourself hobbling zombie-like down the trail, wincing in pain with each step. Take good care of your feet and they’ll look after you in return.

What actions have you taken to prevent and treat foot problems on the trail? We’d love to hear about them in the comments.

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Comments 16

  • Jennie : Apr 3rd

    Excellent summary! Being an avid hiker, I’ve suffered from plantar fasciitis for a while and what works for me these days is compression socks or compression ankle sleeves. I personally use azengear brand from Amazon but there are lots of other options out there.

    Reply
    • Kelly Floro : Apr 6th

      Thanks for reading, Jennie! I’ve been interested in compression socks for a while now… maybe it’s time to finally give them a try!

      Reply
  • Tim Barton : Apr 3rd

    How TO prevent……..

    Reply
  • Kevin Sweere : Apr 3rd

    Friction Blisters form when the outer skin ‘sticks’ more to something outside than it does to lower layers of skin and separates (or delaminates). Adhesion between layers is increased by dryness, adding a strong layer like Lukeotape, etc . There are many, many ways to reduce friction outside – dry, duct tape, slippery liner socks, not cotton socks, foot powder, Trail Toes & other lubricants, etc.

    Reply
    • Kelly Floro : Apr 6th

      Thanks for reading, Kevin. Great point about the cotton socks. A big no-no on the trail! I’ve had some success with Body Glide but I’m not familiar with Trail Toes. Appreciate the recommendation.

      Reply
  • Jane Cobb : Apr 4th

    I wish I could wear men’s shoes. Unfortunately most start at sizes far too big for many women and this oft-repeated advice is infuriating.

    Reply
    • Kelly Floro : Apr 6th

      Sorry to hear this advice doesn’t work so well for you, Jane, but thanks for commenting and contributing to the dialogue. Bunions are certainly a tricky challenge with no one-size-fits-all solution. If you wish, feel free to share any tactics you’ve found more effective in dealing with bunions as a hiker.

      Reply
  • TaoJones : Apr 4th

    I’ve suffered from plantar fasciitis in the past and I wish I could say that it’s something that gets better or goes away in a short time. That’s not my experience, however. For me, it took two full years. Plantar fasciitis is inflammation of the connective tissue in the bottoms of the feet that is caused by micro-tears in the plantar fascia. Sometimes, though, it can be a partial tear of the platar fascia or even a complete tear. These are much more serious conditions, the pain experienced is acute, and the healing process is prolonged. There’s a good article here: https://www.runnersworld.com/health-injuries/a20790842/the-best-recovery-for-partial-plantar-tear/

    TJ

    Reply
    • Kelly Floro : Apr 6th

      Thanks for reading and commenting, TJ. Oof, two years is a long time! Great point about partial and complete tears-a much more severe injury that we should all be mindful of when we hike, especially those of us who are prone to PF to begin with.

      Reply
  • Eric Wade : Apr 4th

    Trench Foot tip:

    In the Marines occasionally we knew we were going to have wet feet/boots for an extended period.

    Starting with dry feet, rub Vaseline liberally over your feet and ankles. Then put your socks on over your now gooey feet.

    When you finally have a chance to take your boots off your feet will be in good shape. At this point you MUST wash and dry your feet completely. If all goes well your feet should show no ill effects.

    Reply
    • Kelly Floro : Apr 6th

      Eric,

      Thanks for your service and for the awesome Vaseline tip. I’ll have to try it next time!

      Reply
  • Todd Gray : Apr 4th

    Tremendous write up. I suggest older hikers – those over 40 maybe, do the preventive stuff for Plantar Fasciaitus 3-4 weeks prior. TJ (read above) is right – it can become a serious injury. Trust him/me on this. As an ultra runner and hiker, PF will end your adventure. Once in the grips, takes weeks/months to work through. It doesn’t just go away or get better. Those socks work during the recovery phase, but you don’t get used sleeping in them. But they work!

    Bunions: if you have bunions, go see your podiatrist. They can prescribe a cream that will minimize the pain and allow you to push through. Toss it in your pack and save it for a bad day. Then apply it in the morning before you get going, most days you will be ok, put some on at camp and you can survive. Cold streams are soothing. Real orthotics, those from a podiatrist because the measure stuff, will also be a game changer.

    I am 52 and on the waiting list (for a foot donor – my organs are fine).

    Reply
    • Kelly Floro : Apr 6th

      Thanks, Todd! I do agree that you can set yourself up for success by being religious about your stretches and exercises well before (and during, and after!) hitting the trail. As with many things in life, consistency is key. Thanks for the info on the bunion cream, as well. I’ll have to remember that one.

      Reply
  • Preacher Man : Apr 5th

    Sound good advise not only for the trail, but for everyday, I’M a retired U.S.Army Infantry Solider , and I can tell you from the many years of humping a 40-80 lb. ruck on speed marches and well as long range marches, being places you don’t need to know about, without proper aid that this is good foot care advise,plus carry plenty of socks wash out the one you have worn and air dry them from the outside of your pack,changing them twice a day is just good business and having a little foot power and mole skin is a must, Always elevate your feet when stopping so you slow blood rush to your feet thus helping to cut down on Hot spots. P.W.D.

    Reply
    • Kelly Floro : Apr 6th

      Thanks for your service, Preacher Man. So true about elevating your feet. At the end of a long day, I always look forward to putting my feet up against a tree or shelter wall for 10-20 minutes.

      Reply
  • TBR : Apr 11th

    Whoa, trench foot! I had no idea, and I hope I never do.

    I was plagued by blisters. Finally learned (i.e., a hiker showed me) to put tape on my heels. I used what used to be called ripstop nylon tape, which I happened to have with me for repairs, in case there was a tent or pack eruption.

    I will run down some of that Leukotape before I head out again.

    Great, if kinda creepy, report!

    Reply

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