Injury Case Study: Australian Open – Hyeon Chung (Blisters)
Roger Federer’s amazing achievement of winning his 20th grand slam was aided somewhat by the retirement of his semi final opponent, Hyeon Chung, due to severe blistering on his Left Foot. The young Korean was forced to retire after 2 sets with his foot in a bad way.
This is not the first time that blisters have determined the outcome of a tennis match, but why are they are issue in sports (and tennis in particular) and what can be done to prevent them?
What are Blisters?
Blisters are most commonly caused by excessive friction to an area of skin. The repetitive forces eventually cause the top layers of the skin to loosen and fill with fluid as the body responds to the trauma. If not managed, the blister can increase in size and fill with blood and pus. Blisters can also form a layer of hard skin (callus) over the top, when they occur in high pressure areas of the foot – this is what happened in Hyeon’s case.
Why are blisters a problem in sports?
During sports, the body and feet are subject to higher forces than when walking or relaxing. In tennis in particular the repeated impact and shear (sideways) forces on a hard surface put continued strain on the layers of skin. Think of the forces Novak Djokovic puts through his feet when returning a fast serve
Add in the heat, sweat and multiple matches day-after-day and you can see how the problems build up!
The problems from blisters in sports can be reduced through taking a few simple steps.
It’s vital that the shoes you wear are a good fit for the foot – particularity during exercise where they can expand due to heat and the loosening of connective tissue. While you would hope pro tennis players have well fitting shoes, a good test for anyone is to draw an outline of your foot on a piece of paper. Then take the insole out from your shoes to assess how well the shape matches. If you are not sure, a good running store or podiatrist will be able to advise you.
High pressures under a particular part of the foot can make it more prone to blistering, even if you wearing good footwear. If you keep getting hard skin and corns under a certain point the pressure can be managed through a combination of padding, insoles, exercises and soft tissue therapy. The Australian Open Physio tried to use a donut pad (like below) to reduce the pressure on Hyeon Chung’s blisters.
Basic fixing tape (e.g. Hypafix, Fixomaull) can be purchased from a chemist and does a great job in reducing friction when exercising. It’s most commonly used around the toes, under the forefoot, and at the base of the heel. Fixing tape is soft on the skin and can be easily cut to suit any foot shape.
The use of lubricants is a common way that people prevent chaffing or rubbing during exercise. A specialist product like Bodyglide is gentle on the skin and able to withstand long periods of exercise without drying out or going grainy.
In spite of all these steps, sometimes blisters can occur. In terms of management there are two options:
Don’t Treat The Blister – If the blister causes minimal/no pain and is not in a high pressure area, the best treatment is to leave it. Over time the skin will repair and the blister will heal by itself. You can use lubricants or dressings/tape to protect the site whilst exercising. Blister plasters/second skins may provide some initial relief but stick strongly to the blister and when removed can tear the skin away causing pain and delayed healing.
Treat The Blister – If the blister is painful and is in a high pressure area, I recommend draining the fluid from it. Use a sterile needle to make a small incision in the side of the blister and then push the fluid out without tearing the skin on top. Removing the blistered skin is not recommended as it will cause an increase in pain. Following treatment, the area should be covered with a simple sterile dressing. If you are uncertain about blister treatment, see a podiatrist. Incorrect management can lead to delayed healing, increased pain and possible infection.
I hope you are better informed about blisters and how they can affect the world’s biggest sport stars. If you have any questions feel free to contact me. Here’s to comfortable blister free feet the next time you exercise!
If you have any questions about school footwear or your child’s feet I can be contacted at South Yarra Spine and Sports Medicine on 9826 1244 or by email at firstname.lastname@example.org
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John Charles graduated with honours in Podiatry from the University in London, and has since worked in both public and private practice. Additionally, he has completed additional training in dry needling and sports massage, and regularly employs these therapies in his podiatry practice. He has extensive experience in video gait analysis, fitting of athletic footwear, and prescribing orthotics and insoles.