Conquer the Course, Not the Pain: Your Ultimate Guide on How to Treat Hot Spots on Feet During an Ultra Marathon

Running an ultra marathon is a testament to human endurance, a journey that pushes physical and mental boundaries. You’ve trained for months, dialed in your nutrition, and prepared your mind. But there’s a small, insidious enemy that can derail even the most prepared runner: the dreaded hot spot on your feet. That tiny area of friction and heat can quickly blossom into a race-ending blister if not managed correctly. Knowing how to treat hot spots on feet during an ultra marathon is not just beneficial; it’s a critical survival skill.

This guide will delve deep into understanding, preventing, and, crucially, treating hot spots while you are out on the course. We’ll cover everything from pre-race prevention strategies to the exact steps you need to take at an aid station (or even on the side of the trail) to keep your feet moving forward.

Understanding Hot Spots on Feet: The Genesis of Ultra Marathon Foot Pain

Before we dive into treatment, let’s understand what a hot spot is and why it’s such a common problem, especially in ultra marathons.

A hot spot is the initial stage of a blister. It’s a localized area of skin that becomes irritated, inflamed, and feels warm or hot due to excessive friction, pressure, or shearing forces. In the context of an ultra marathon, several factors conspire to create the perfect storm for hot spots:

1. Friction: The repetitive motion of running, mile after mile, causes your feet to rub against your socks and shoes. Imperfections in sock seams, shoe fit, or debris inside the shoe exacerbate this.
2. Moisture: Your feet sweat. A lot. Especially over 50 or 100 miles. Wet skin is significantly softer and more prone to damage from friction than dry skin. Add creek crossings or rain, and moisture becomes a major factor.
3. Pressure: Ill-fitting shoes, foot swelling (common during long distances), or abnormalities in foot structure can create specific pressure points that are ripe for hot spot development.
4. Heat: Friction generates heat. Combined with the body’s metabolic heat production during intense exercise and potentially warm ambient temperatures, the inside of your shoe can become an incubator for foot problems.
5. Shearing Forces: This occurs when layers of skin slide over each other. Imagine your foot bone moving slightly inside your skin as you land and push off. This internal stress can cause fluid buildup between skin layers, leading directly to a blister, often starting as a hot spot.
6. Duration: Ultra marathons are long. The sheer amount of time spent on your feet multiplies the effects of friction, moisture, and pressure exponentially.

Ignoring a hot spot is like ignoring a small fire in a dry forest. It will escalate. The inflammation worsens, fluid accumulates under the irritated skin layer, and soon you have a painful blister that can alter your gait, cause compensatory injuries, and potentially force you to DNF (Did Not Finish).

Prevention is Paramount: Minimizing the Need to Treat Hot Spots on Feet During Your Ultra Marathon

The absolute best way how to treat hot spots on feet during an ultra marathon is to prevent them from occurring in the first place. While complete prevention is challenging in such demanding events, meticulous preparation can drastically reduce their likelihood and severity.

Mastering Footwear: Your First Line of Defense Against Hot Spots on Feet

• The Right Fit: This is non-negotiable. Your ultra marathon shoes should be professionally fitted. Consider:
  • Length: Allow about a thumb’s width between your longest toe and the end of the shoe.
  • Width: Your foot should not be squeezed, nor should it slide side-to-side excessively. Ensure the toe box is wide enough to accommodate natural toe splay and swelling.
  • Volume: The shoe should comfortably hold your foot without excessive pressure on the instep.
• Break-In Period: Never wear brand-new shoes for an ultra. Run significant mileage in them (including long runs) to ensure they work for your feet over distance and to soften any potential stiff spots.
• Consider Swelling: Many runners go up half a size for their ultra shoes compared to their daily trainers to accommodate foot swelling over long distances. Test this during your longest training runs.
• Shoe Rotation: If possible, having a second pair of the same (well-broken-in) model available in a drop bag can be a game-changer, especially if your first pair gets soaked.
• Drainage: For potentially wet courses, choose shoes known for good drainage to help minimize the time your feet stay waterlogged.

Sock Selection Savvy: Critical for Preventing Ultra Marathon Hot Spots

Socks are the interface between your foot and your shoe, making them vital in the fight against friction.

• Material Matters: Avoid cotton at all costs! Cotton absorbs moisture and holds it against your skin, creating the perfect environment for hot spots. Opt for:
  • Synthetic Fabrics: Polyester, Nylon, Acrylic blends are excellent at wicking moisture away from the skin.
  • Merino Wool: Naturally moisture-wicking, temperature-regulating, and antimicrobial (resists odor). Many runners swear by wool or wool-blend socks.
• Proper Fit: Socks should fit snugly without wrinkles or bunching, which cause friction points. Ensure the heel and toe pockets align correctly.
• Double Layering? Some runners find success wearing two thin pairs of synthetic socks. The theory is that friction occurs between the sock layers rather than between the sock and the skin. Experiment in training!
• Toe Socks: These encase each toe individually, preventing toe-on-toe friction, a common source of hot spots and blisters. They require an adjustment period and may not work for everyone, but are worth trying in training.
• Change Your Socks: Carry spare pairs in your pack or drop bags. Changing into dry socks at aid stations is one of the most effective ways to reset your foot environment and prevent hot spots, especially on wet or long courses.

Lubrication and Powders: Reducing Friction to Prevent Hot Spots on Feet

Creating a slippery surface can significantly reduce friction.

• Anti-Chafe Balms/Sticks: Products like Body Glide, Squirrel’s Nut Butter, Trail Toes, or even Vaseline can be applied liberally to known problem areas before the race and reapplied during. Focus on toes, heels, arches, and the balls of your feet. Be generous!
• Foot Powders: Antifungal or talc-based powders (like 2Toms FootShield or Zeasorb) can help keep feet dry by absorbing moisture. Some runners prefer powder, others lubricant, and some use a combination (e.g., powder inside socks, lubricant on skin). Experiment during training to find what works best for your skin and sweat rate. Reapplication during the race is key for powders as well.

Proactive Taping Strategies: Shielding Vulnerable Areas to Prevent Hot Spots

Taping potential hot spot zones before the race can provide a protective barrier.

• Identify Your Problem Areas: Through your training runs, you should know where you tend to get hot spots or blisters. Common areas include the heels, balls of the feet, sides of the big and little toes, and the arch.
• Choose Your Tape:
  • Kinesiology Tape (KT Tape, RockTape): Flexible, breathable, and generally stays on well, even when wet. Its elasticity allows for natural foot movement.
  • Zinc Oxide Tape: Less flexible but very durable and sticky. Often used for more rigid support but can work for prevention.
  • Leukotape P: Extremely sticky and durable, a favorite among many ultra runners. It has minimal stretch.
• Application Technique is Crucial:
  • Apply to clean, completely dry skin hours before the race (or even the night before) for best adhesion.
  • Round the corners of the tape pieces to prevent them from catching on socks and peeling off.
  • Apply smoothly without wrinkles. Wrinkles create friction points.
  • Use anchors: Start and end the tape on stable skin areas.
  • Don’t tape too tightly, especially circumferentially around toes, as this can restrict blood flow.
  • Practice your taping technique during long training runs.

Foot Conditioning and Care: Toughening Your Feet for the Ultra Marathon Challenge

• Build Calluses (Wisely): Consistent running naturally builds calluses in high-friction areas. These thicker skin patches offer protection. However, overly thick or hard calluses can sometimes cause issues themselves (e.g., deep blisters underneath, painful cracking). Gently file down excessively thick calluses, keeping them smooth but robust.
• Skin Toughening Agents? Some runners use substances like Tincture of Benzoin or rubbing alcohol on their feet in the weeks leading up to a race, believing it toughens the skin. Evidence is largely anecdotal, and these can be very drying, potentially causing cracking. Proceed with caution and test well in advance if you consider this.
• Nail Care: Trim toenails short and straight across a few days before the race. Long nails can hit the front of the shoe (especially on downhills), causing bruising, black toenails, or blisters under the nail. Sharp corners can dig into adjacent toes. File any sharp edges smooth.
• Keep Feet Clean and Dry: Good daily foot hygiene helps maintain healthy skin.

Early Detection: Identifying Hot Spots on Your Feet During an Ultra Marathon

During the race, heightened body awareness is crucial. Don’t just zone out completely; periodically check in with your feet.

• Know the Feeling: A hot spot typically feels like a distinct, localized area of warmth, stinging, or rubbing before it becomes truly painful. It’s different from general foot fatigue.
• Don’t Ignore It: The absolute worst thing you can do is think, “It’s probably nothing, I’ll just push through to the next aid station.” That slight annoyance can become a major problem very quickly. The earlier you address a hot spot, the easier and faster the fix, and the less damage done.
• Listen to Your Body: If a specific spot starts demanding your attention, even subtly, assume it’s a developing hot spot and plan to address it at the very next opportunity.

The Core Skill: How to Treat Hot Spots on Feet During an Ultra Marathon – Step-by-Step

Okay, you’ve felt that tell-tale warmth or sting. It’s time for action. Whether you’re at a well-stocked aid station or alone on the trail between checkpoints, the fundamental principles are the same.

The Critical Decision: When and Where to Stop and Treat Hot Spots on Feet

• Stop ASAP: Don’t delay. Find a safe place to stop off the main trail. An aid station is ideal because you’ll likely have access to chairs, medical supplies, and maybe even volunteers. But if you’re miles away, stop where you are. Losing 5-10 minutes to fix a hot spot early can save you hours of pain or prevent a DNF later.
• Assess the Situation: Are you at an aid station with supplies? Do you have your own foot care kit? Is it raining? Prioritize getting yourself and your feet as clean and dry as possible.

Your Essential Ultra Marathon Foot Care Kit for Treating Hot Spots

Never rely solely on aid stations. Carry your own well-stocked kit. Contents should include:

• Antiseptic Wipes: Alcohol or BZK (Benzalkonium Chloride) based wipes for cleaning the skin.
• Sterile Gauze Pads: For cleaning and drying.
• Lubricant: Small tube/container of your preferred anti-chafe balm.
• Tape: Pre-cut strips of your preferred tape (Kinesiology tape, Leukotape P). Store them on release paper or folded onto themselves carefully.
• Blister Dressings:
  • Moleskin: Classic padding, cut to shape (donut shape around the spot is often best).
  • Hydrocolloid Dressings (Compeed, Duoderm): These form a gel over the wound/hot spot, providing cushioning and a moist healing environment. Excellent for developed blisters but can sometimes adhere too strongly or roll up.
  • Silicone Tape/Dressings: Gentler on the skin, good for sensitive areas or reapplications.
• Small Scissors: For cutting tape or dressings (ensure they comply with race rules if sharp). Nail clippers can sometimes substitute.
• Sterile Needle or Safety Pin: Only for potentially draining large, tense blisters if absolutely necessary (more on this later). Sterilize with an alcohol wipe or flame (let it cool!) immediately before use.
• Dry Wipes or Small Pack Towel: For thoroughly drying your feet.
• (Optional) Tincture of Benzoin: Small vial or swabs. Applied to skin around the hot spot (not on it) can make tape adhere much better, especially in wet conditions. Allow it to become tacky before applying tape.

Step-by-Step Guide: How to Treat Hot Spots on Feet During an Ultra Marathon

Here’s the process when you stop to treat a developing hot spot:

1. Sit Down and Remove Shoe and Sock: Get comfortable and elevate your foot if possible. Carefully remove your shoe and sock. Inspect your sock for wrinkles or debris that might have contributed.
2. Clean the Area: Use an antiseptic wipe to clean the hot spot and the surrounding skin thoroughly. If your feet are very dirty or muddy, use multiple wipes or even water (if available) and gauze first, then finish with an antiseptic wipe. Ensure you clean a larger area than just the hot spot itself.
3. DRY THOROUGHLY: This is critical for any adhesive to stick. Use gauze pads or your dry towel. Pat gently but ensure the skin is completely dry, especially between the toes. Air dry for a minute if needed.
4. Assess the Hot Spot:
   • Is it just red and irritated? This is the ideal stage for intervention.
   • Has a blister formed? Is it small and stable, or large and tense? This affects treatment choices (see blister section below).
5. Treat/Protect the Hot Spot (No Blister or Small, Stable Blister):
   • Option A: Lubricate and Go: If it’s very minor and you caught it extremely early, sometimes thoroughly cleaning, drying, and applying a generous amount of lubricant might be enough. Reassess frequently.
   • Option B: Tape Application: This is usually the most effective approach.
     • (Optional Adhesion Boost): Apply Tincture of Benzoin to the dry skin around the hot spot (avoiding the irritated center). Let it air dry until tacky (15-30 seconds).
     • Cut a piece of your chosen tape (Kinesiology, Leukotape) slightly larger than the hot spot. Round the corners.
     • Apply the tape directly over the hot spot, ensuring it lies completely flat with NO wrinkles. Smooth it down firmly from the center outwards.
     • For extra security or larger areas, you might use additional strips, slightly overlapping, ensuring all edges are smooth.
   • Option C: Moleskin Donut: If the spot is particularly tender, cut a piece of moleskin slightly larger than the hot spot. Then, cut a hole in the center of the moleskin piece that matches the size of the hot spot itself. Apply the “donut” so the hot spot is in the hole, relieving direct pressure. You might cover this entire setup with a larger piece of smooth tape (like Kinesiology tape) for better adhesion and friction reduction.
   • Option D: Hydrocolloid Dressing (Use With Care): Apply directly over the clean, dry hot spot. Ensure the edges are well sealed. Be aware they can sometimes roll or adhere too strongly, making removal difficult or painful later. Best tested in training.
6. Address Sock and Shoe: Turn your sock inside out and check for irritating seams or debris. Put on a dry pair of socks if possible. Check the inside of your shoe for stones, sand, or rough spots. Re-lace your shoe snugly but not too tightly, ensuring your foot feels secure without pressure points.
7. Get Moving (Carefully): Stand up and walk a few steps. How does it feel? If the tape is wrinkled or causing new issues, stop and fix it immediately. If it feels better, continue your race, but remain mindful of the area.

Treatment Techniques for Hot Spots on Feet: Refining Your Approach

• Tape Wrinkles are the Enemy: A wrinkle in your tape job will cause a new friction point, potentially worse than the original hot spot. Smoothness is key.
• Anchoring Tape: Especially for awkward areas like heels or toes, ensure your tape extends onto more stable skin areas to prevent peeling.
• Lubricant Over Tape: Some runners apply a bit of lubricant over the smooth tape surface to further reduce friction against the sock.
• Reapplication: Depending on the length of the race, conditions (wetness), and the tape used, you may need to repeat this process later if the tape peels or the hot spot persists.

The Blister Dilemma: Draining Hot Spots Turned Blisters During an Ultra Marathon

Sometimes, despite your best efforts, a hot spot progresses into a full-blown blister. Now you have a decision to make: to drain or not to drain?

• General Rule: If the blister is small, not overly tense, and not painful enough to significantly alter your gait, it’s often best to leave it intact. The roof skin provides a sterile barrier against infection. Treat it like a hot spot: clean, dry, and protect it with a dressing (moleskin donut, hydrocolloid, or smooth tape).
• When to Consider Draining: Drain only if the blister is large, very tense, and so painful that it’s significantly impacting your ability to run or walk properly. An altered gait can lead to other injuries.
• The Risk: INFECTION. Draining creates an open wound. Your hands, the environment, and your gear are likely not sterile during an ultra. Infection can end your race and lead to serious health complications. Proceed with extreme caution ONLY if necessary.
• How to Drain (Safely as Possible):
  1. Clean Thoroughly: Clean the blister and a large surrounding area with multiple antiseptic wipes. Clean your hands as well.
  2. Sterilize Your Needle/Pin: Wipe the needle/pin point thoroughly with a fresh antiseptic wipe. If possible (and safe), briefly pass the tip through a flame (lighter, match) and let it cool completely. Wipe it again with antiseptic after flaming/cooling.
  3. Make Small Punctures: Gently pierce the blister near its edge (at the side, not the top) in one or two spots.
  4. Drain the Fluid: Gently press the blister roof with a sterile gauze pad to encourage the fluid to drain out. Do NOT remove the blister roof skin – it’s a natural bandage.
  5. Clean Again: Apply more antiseptic to the drained blister area.
  6. Apply Antibiotic Ointment (If Available): A small dab can help prevent infection.
  7. Dress the Blister: Cover the drained blister completely. A hydrocolloid dressing is often a good choice here as it can absorb any further weeping. Alternatively, use non-stick gauze covered by tape, or a moleskin donut covered by tape. Ensure the dressing is smooth and secure.
  8. Monitor Closely: Check the dressing at subsequent aid stations. Watch for signs of infection (increasing redness spreading outwards, pus, excessive pain, heat). Seek medical attention from race staff if infection is suspected.

Advanced Strategies for Managing Severe or Multiple Hot Spots on Feet

• Full Foot Taping: In extreme cases, some runners might pre-tape large sections of their feet or need extensive re-taping during the race. This requires practice and knowledge of anatomical taping techniques.
• Shoe Modifications: Loosening laces in specific ways (e.g., skipping eyelets over a pressure point) can sometimes alleviate localized pressure.
• Gaiters: Essential for keeping debris (sand, grit, stones) out of your shoes, a major cause of friction points.
• Acceptance and Adaptation: Sometimes, perfect foot bliss isn’t possible. You might need to manage a certain level of discomfort, focusing on preventing it from worsening while adapting your pace or technique slightly.

Post-Ultra Marathon Foot Care: Recovering from Hot Spots and Blisters

Your feet have been through a battle. Post-race care is crucial for healing and preventing long-term issues.

• Immediate Care: As soon as possible after finishing, remove shoes and socks. Gently wash your feet with mild soap and water. Pat dry carefully.
• Assess Damage: Inspect all hot spots and blisters. Clean any open wounds gently.
• Air Them Out: Allow your feet to air dry as much as possible.
• Proper Blister Care: Treat drained or open blisters as wounds. Keep them clean, apply antiseptic or antibiotic ointment, and cover with sterile dressings. Change dressings daily or if they become wet or dirty. Leave intact blister roofs alone unless they rupture.
• Elevation: Elevating your feet can help reduce swelling.
• Monitor for Infection: Watch closely for signs of infection in the days following the race. Seek medical advice if needed.
• Rest: Give your feet adequate time to heal before resuming running.

The Mental Battle: Coping with Hot Spots on Feet During an Ultra Marathon

Foot pain during an ultra is not just physical; it’s a significant mental challenge.

• Acknowledge, Don’t Dwell: Acknowledge the discomfort, address it mechanically (clean, treat, tape), and then try to refocus your mind. Dwelling on the pain makes it worse.
• Problem-Solving Mindset: View the hot spot as a problem to be solved, not a catastrophe. Execute your treatment plan calmly and methodically.
• Focus on the Present: Concentrate on moving forward to the next landmark or aid station, rather than the immense distance remaining.
• Positive Self-Talk: Remind yourself of your training, your strength, and your ability to overcome challenges.
• Utilize Aid Stations: Aid stations are mental boosts as well as physical refueling stops. Take the time needed to properly care for your feet.

Recommended Gear for Preventing and Treating Hot Spots on Feet

While specific brands are a matter of personal preference tested in training, key categories include:

• Moisture-Wicking Socks: Brands like Drymax, Injinji, Balega, Feetures!, Smartwool offer various options.
• Anti-Chafe Lubricants: Squirrel’s Nut Butter, Trail Toes, Body Glide, Vaseline.
• Foot Powders: 2Toms FootShield, Zeasorb Antifungal Powder.
• Tapes: Leukotape P, Kinesiology Tape (various brands), Hypafix (gentler fixation tape).
• Blister Dressings: Compeed, Band-Aid Hydro Seal, Moleskin (Dr. Scholl’s or generic).
• Antiseptics: Individually wrapped alcohol pads or BZK wipes.
• Small, Reliable Scissors or Clippers.

Frequently Asked Questions (FAQ) About Treating Hot Spots on Feet During an Ultra Marathon

Based on common search queries (“People Also Ask”):

Q1: What causes hot spots on feet during running, especially ultras?

• A: The primary causes are friction (rubbing between foot, sock, and shoe), moisture (sweat or external wetness softening skin), pressure (ill-fitting shoes, swelling), heat (from friction and exertion), and shearing forces (internal skin layer movement). The extreme duration of ultra marathons magnifies all these factors.

Q2: How do you prevent hot spots when running long distances?

• A: Prevention involves multiple strategies: wearing properly fitted, broken-in shoes; choosing high-quality, moisture-wicking socks (synthetics or wool, NO cotton); using anti-chafe lubricants or foot powders; proactively taping known problem areas with kinesiology tape or Leukotape; ensuring proper nail care; and changing into dry socks during the race.

Q3: What is the best tape for preventing blisters (hot spots) on feet?

• A: Many ultra runners favor Leukotape P for its extreme stickiness and durability, though it has little stretch. Kinesiology tape (like KT Tape or RockTape) is another popular choice due to its flexibility, breathability, and good adhesion, allowing for more natural foot movement. The “best” tape is often subjective and depends on skin type, conditions, and personal preference – test different types during training.

Q4: Should you pop a blister (developed from a hot spot) during an ultra marathon?

• A: Generally, no, especially if it’s small and not causing significant pain or gait changes. The intact skin protects against infection. Only consider draining large, tense, painful blisters that are severely impacting your ability to move. If you must drain, do so with extreme attention to cleanliness (sterile needle, antiseptic wipes) to minimize infection risk, and leave the roof skin intact.

Q5: How quickly can a hot spot form during an ultra marathon?

• A: Very quickly. Under conditions of high friction, moisture, and pressure, a noticeable hot spot can develop in less than an hour, sometimes even faster, especially if debris gets into the shoe or socks get soaked early on. Early detection and treatment are therefore vital.

Q6: What should be in my foot care kit for an ultra marathon?

• A: Your kit should contain: antiseptic wipes, sterile gauze, lubricant, pre-cut strips of your preferred tape (Leukotape, KT Tape), blister dressings (moleskin, hydrocolloid), small scissors/clippers, a sterile needle (for draining only if essential), dry wipes/small towel, and possibly Tincture of Benzoin for enhancing tape adhesion.

Q7: Can I use duct tape to treat hot spots on my feet?

• A: While some old-school advice mentions duct tape, it’s generally not recommended. Duct tape is not breathable, its adhesive can be harsh on the skin, and it doesn’t conform well, often creating wrinkles that cause more friction. Purpose-made athletic tapes (Leukotape, Kinesiology tape) or blister dressings are far superior and safer options. Use duct tape only as an absolute last resort if you have nothing else, and apply it very carefully to be smooth.

Final Thoughts on Conquering Ultra Marathon Hot Spots on Your Feet

Dealing with hot spots is an almost inevitable part of ultra running for many athletes. While diligent prevention can significantly reduce their occurrence, knowing how to effectively treat hot spots on feet during an ultra marathon is a crucial skill for finishing strong.

Remember the key principles: meticulous prevention, heightened awareness for early detection, and prompt, methodical treatment focusing on cleaning, drying, and protecting the affected area. Master your foot care routine in training, carry the necessary supplies, and don’t hesitate to take those few crucial minutes mid-race to address a developing issue. Your feet carry you across incredible distances – treat them well, and they’ll be far more likely to carry you across that finish line.