Although blisters are one of the most
common sports injuries, they should rarely hinder your training.
Blisters are characterized by an oval-like elevation of the skin
containing clear fluid between layers of the epidermis. They are
commonly caused by friction and shearing forces on the skin. In
some cases, if pressure or friction to the area continues, there
can be bleeding into the blister. Common areas of involvement
are the toes, the ball of the foot and the back of the heel.
Extremes of dryness and moisture tend to decrease friction,
whereas moderate moisture increases friction. Therefore,
prevention strategies include using powder to reduce friction,
socks that wick away sweat and properly fitted shoes. Avoid
cotton socks as they retain moisture so that it feels like
running in a soggy rag.
Another area of prevention involves the shoes. Keeping the
shoes as dry as possible and using moleskin or padding around
bony prominences will help reduce pressure. To avoid developing
blisters, gradually increase your activity, and don't ever do a
race in new shoes or socks. Many people experience mild swelling
in the feet in the afternoon. Therefore, this is a good time to
buy your shoes to help assure a proper fit. Try them on with the
type and thickness of socks you'll be running in.
As an additional form of prevention, some people apply a dab
of Vaseline to the hot spot. Bodyglide is another excellent
product that reduces friction, and the company now also produces
Footglide. For hardcore chafing, the old standby -- zinc oxide
ointment -- will act as moisture barrier.
Treatment
Treatment includes draining the blister, the application of a
small amount of an antibiotic ointment and a band-aid or gauze.
The top, or roof, of the blister should be maintained as it
serves as protection for the tender skin underneath. It is the
body's natural band-aid. Therefore, deroofing the blister can
lead to more irritation and inflammation, as well as the risk of
secondary infection. Laymen often heat up a needle until it’s
red, let it cool a bit and then perforate the blister near its
edge. Apply gentle pressure to allow the fluid to drain. If
possible, perforate the blister several times around the
periphery to help prevent recurrence. This also allows the roof
to adhere to the skin, resulting in less discomfort and faster
healing. A small blister often heals by itself and may not need
to be drained.
Those with diabetes, impaired circulation or difficulty
healing should not treat themselves; they require professional
care.
If you do drain the blister, be aware of signs of infection:
pain, redness or red streaks, heat, swelling and pus. Of course,
seek professional care if these signs are present. As a
precaution, blisters should not be confused with small
fluid-filled bubbles (called vesicles) that are commonly
associated with athlete's foot. If it itches, think possible
fungal infection and try anti-fungal cream and powder.
With proper precautions blistering should not be a hindrance
to your training. If a blister does present itself, careful
treatment will quickly alleviate the problem.
Good luck,
Dr Jay