Jenny Heesh yesterday posted her first part of her account of her time on the Camino administering first aid to pilgrims.
Here is the 2nd of the three part series, entitled Blisters.
For those interested in walking the Camino, or for anyone who wants to walk long distances, there is some very handy information in this post.
PART II – BLISTERS
Jenny Heesh
The day after Mike’s departure David and I began the first aid work in earnest.
Our first stop was at Puente la Reina at Albergue Santiago Apostol. It is a large albergue – with dormitory accommodation, smaller rooms for those wishing to minimise the sounds of the “snorechestra”, a restaurant, bar, laundry and a pool.
It also has a powered campsite for caravans and motor homes, plus an area for tents.
We had our own albergue on wheels – a two-berth caravan with kitchen and bathroom facilities – which meant we could be self-sufficient wherever we were.
We stayed at Puente la Reina for several days and gradually got into a routine of providing first aid at the albergue from late afternoon and into the evening. We met many injured pilgrims there – it was a great stop for first aid, being a few days’ walk from St Jean, the starting point of the Camino for many pilgrims, and people were beginning to experience problems.
The first night at the albergue we worked for over four hours straight, treating blisters and handing out first aid supplies.
During the evening we treated an Australian pilgrim, Jane, who had a “trifecta” of first aid problems. She had blistered feet, sore knees and a bad cold. David treated the blisters, gave her anti-inflammatory gel for the knees and Olbas oil for her blocked airways.
We met up with Jane again in Los Arcos two days later and she was to become instrumental in the help we gave to a Swedish pilgrim, Kerstin, a couple of weeks later.
During the day we walked into the centre of town and would chat with pilgrims as they passed through. Often David would open the first aid pack and give out supplies such as band aids etc. We also drove out to various villages on the Camino in the area to help anyone who needed it.
We found a lot of the problems that pilgrims had could have been prevented. We saw dozens of pilgrims with blisters which had formed from wearing the wrong sized boots, badly fitting boots, or simply not treating a hot spot as soon as it formed.
Boots were often laced too tightly. David rearranged the lacing on many pairs of boots – loosening the front section of the laces, with his fist stuffed inside the boot to spread it out, from the front to the third eyelets and then tying a half knot at those eyelets, and finally loosely lacing up the rest of the boot.
He showed pilgrims how to put the boots on correctly. He told them to kick the heel right back into the boot, tie up firmly so that the rear of the boot is held firmly with the foot, and, with the half knots at those mid eyelets, the front of the boot never tightens up but stays more open, allowing the toes to move freely.
We also found that many pilgrims would lace their boots up tight in the morning and leave them untouched until they finished walking at the end of the day, ignoring the increasing pain – some did not even know that their feet became larger during the day.
David recommended stopping at least every two hours, to take the boots and socks off and have a break, to put their feet up, then put the socks back on alternate feet (so that seam pressure points are moved) – for many this was the end of their daily discomfort or pain.
David always treated the blisters by draining them. The blisters become larger if they’re not drained. Firstly, he made sure the foot was clean, after which he used a disposable scalpel to make two tiny V-shaped cuts which allowed the blister to drain completely.
He would then spray antiseptic to get into all the crevices and inside the cut sections, and then covered the blister with fabric plasters. These adhered much better than waterproof plasters and also allowed the skin to breathe.
The treatment worked really well – almost instant pain relief for most pilgrims he treated. We also gave pilgrims a supply of plasters to keep them going until they could get to a pharmacy.
We saw many pilgrims with knee problems and shin splints. The only sure cure for this problem is to stop walking which obviously was not an acceptable option for most pilgrims. These problems were difficult to treat – all we could do is recommend the RICE method – rest, ice, compression and elevation.
David gave out sample-sized quantities of anti-inflammatory gel and showed pilgrims how to massage the ligaments and tendons gently but deeply to help with pain relief and recovery. We never handed out pills of any kind – we would always recommend that the pilgrim consulted a pharmacist for oral medications.
We showed pilgrims how to walk with half-length steps, to minimize joint and muscle strain, standing as if they weren’t carrying a backpack and they felt better instantly. We also stressed the importance of walking at their own pace – not that of their friends, and not to overdo the daily distances – and to use a hiking pole or staff for stability.
PGS - The Way 
Thanks so much Bill for your wonderful presentation of my post and the photos – I really appreciate it.
If it weren’t so cold I would love to be back at Puente la Reina now! It was a wonderful spot and the owners of the albergue were so welcoming and supportive of the work we did there.
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Jenny thanks for these great tips on boots and blisters. I’ve always laced mine loose at the front and firmer at the ankle but never thought to put the half knot in. I’ll have to go and re-lace my boots now.
Do you have your own blog? I’m really enjoying reading your story.
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Thanks Donna for the great feedback. That half-knot idea is a great one, isn’t it? It really does make a big difference.
I don’t have my own blog but I’m thinking of doing one later this year when I’m back on the Camino. I’ll ask Bill if I can do an announcement on PGS so our PGS family knows.
I have 16 days from 1 August volunteering at Refugio Gaucelmo (the CSJ refugio) at Rabanal. After the duty at Rabanal I’m meeting up with David at Logrono where we will be walking as pilgrims, staying in albergues, and walking small distances each day so we meet a different crowd each day. As with last year, we’ll help pilgrims on the paths during the day and at albergues in the late afternoon and evening.
The one thing I did not do last year was take photos of David treating blisters etc. I was busy being the nurse, so to speak, and didn’t even think that some photos would have been useful to have. That said, we have a couple of absolute cracker photos in part 3!
I think that a blog of the hospitalera and first aider time would make for interesting reading.
Best, best wishes to you –
Jenny xxx
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Had to chuckle a bit Jenny, the every 2 hour rest, without shoes and socks and airing out the feet.. is my Camino mantra to everyone who will listen to my advise. Just like the draining of blisters… I have seen some aweful stuff.
So in awe of what you did, I had no idea, Girl how did you manage to keep all this from me… oh yeah… I was on the Camino too…..lol .
Looking forward to installment 3! Hugs
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Hi Ingrid –
You’re absolutely correct about the need to rest each two hours, take those boots and socks off, have a toe wiggle for around 10 minutes and then swap the socks before putting the boots back on. Take the opportunity to have some water and a snack – trail mix etc – sit back and admire the gorgeous landscape … those big Spanish skies … sigh!
I have seen some shockers in the blister sense – in 2014 one of the Forum members ran into problems with blisters from badly-fitting boots and she decided to walk across the Meseta in flip flops! Bad mistake – she developed massive blisters under her toes and on the balls of her feet. She ended up in hospital in Leon for three days and had to finish her camino there. The only compensation was that the doctor who looked after her was a dead ringer for McDreamy from Grey’s Anatomy! We hung out together in Santiago with two other Forum members – BiarritzDon and AJ – her feet her healing well but yoicks, they were a mess.
I was under the radar a fair bit last year because of the cycling accident and once I got to the Camino we were very busy – that, plus limited access to free Wi-Fi – meant that I dropped off keeping up with everyone for a bit. I’ll be much better this year!
I hope you like instalment 3 Ingrid. It’s my favourite and it is what first aid is all about …
I also wanted to take this opportunity to thank you for all your hard work and effort with Camino Gifts last year – I really loved reading all the posts and the friends in the group are so wonderful. I loved your New Year message to Bill, Susan and me – it really touched my heart – thank you. xo.
Hugs and love to you –
Jenny xxx
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Hi Jenny. We must have been typing at the same time. Have a great day. 😀
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Hi ladies. Does the every two hour thing work? I found if I took my boots off my feet hurt more when I put them back on and I found it much harder to get going. I’m happy to learn from the wise ones! Do you change socks or just put them on the opposite feet? And do you double sock? Thanks.
Donna
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Hi Donna –
The two hour thing definitely does work and not only on your feet. It gives you the opportunity to sit and reflect on how you’re feeling, how your day is going, and to be in the moment – just looking around and appreciating your surroundings.
The same socks/fresh socks is a matter of preference. Give both methods a go and see what works best for you.
I’ve found with most pilgrims I’ve spoken with that the double sock is the best way to go. I like to double sock. It minimises friction between the foot and sock which causes the blisters.
Do you apply Vaseline to your feet in the morning before the day’s walking? That’s another thing that really helps and it keeps your heels soft and crack-free.
Cheers Donna –
Jenny xxx
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Donna l always do double socks…works for me
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Thanks Jenny for your most interesting posts on walking and blisters because blisters sting so badly!! My question is about whether vaseline affects your socks at all, like make them oily etc. This is the reason I have not put on vaseline on my feet when walking.
Angie
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Hi Angie – thanks so much for your great feedback – I really appreciate it.
I’ve found that the Vaseline does make your socks feel a little greasy if you really slather it on, but it does wash out when you do a proper wash in a washing machine. Weeks of only hand washing hiking gear gives another ‘life’ to your all your gear that you don’t really want to know about – you can never get your gear REALLY clean and you find that there’s a build-up of soap powder/liquid that only a proper wash and the rinse and spin cycles of washing machines can remove. No amount of rinsing and wringing clothes out with your hands does the job well enough, I’ve found.
Cheers and best, best wishes –
Jenny xx
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Wow, Jenny, a blog of your own … will be interested to see it happening 🙂
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Cheers Britta! I could call it “The Accidental Way” …! As you well know, I have been rather accident-prone since I decided to do a Camino!
Abrazos y besos –
Jenny
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