Blisters are localized accumulations of fluid between layers of skin.

Mechanism of Injury

They are usually caused by friction on the skin due to:

• poorly fitting soccer cleats, or new cleats
• improper taping on the foot
• overuse during long training sessions
• harder ground surface during pre-season training and games

A "hot-spot" (warm reddened area) is the precursor to a blister. Continued friction and irritation leads to the formation of a serum-filled (clear fluid) blister, or less commonly, a blood-filled blister.

Signs and Symptoms:

• Swelling, fluid underneath skin
• Redness
• Pain

On-Site Management

Unruptured blisters causing discomfort are best drained using the following method:

Wash and Cleanse the Area. Thoroughly cleanse with warm, soapy water or Savlon. Next, apply an alcohol swab over the area.

Drain. A sterile needle should be carefully passed into the blister along the bottom half of the blister. Gently remove the fluid using a sterile gauze pad. Leave the skin covering intact as a protective cover until the raw skin underneath begins to heal. Only clear, serum-filled blisters should be drained. Blood blisters should only be drained by a physician under sterile conditions.

Protect. Cover the blister with "Second Skin" or a Telfa Pad. This protective covering should be slightly larger than the blister itself so that the skin covering is not torn off when the tape is removed. It is important to secure the pad; otherwise it will shift, and lead to further irritation. Use "adhesive knit" or elastic tape to firmly secure the pad in place.

Apply Lubricant. Vaseline or skin lube should be applied liberally to the covered area, sock, and inside of the shoe to further reduce friction.

Prevention

The time to prevent blisters is in the early soccer season when equipment is new and skin is soft and uncalloused.

• Keep skin clean and dry. Wet feet, for example, can lead to increased friction on the skin surface and dirty feet increase the chance of infection in areas of skin breakdown.
• Wear appropriate clothing. For example, socks should be worn that allow moisture to be wicked away from the skin and absorbed by a second layer. A polypropylene sock under a cotton sock effectively achieves this. Two pairs of socks tend to reduce friction on the skin better than a single pair.
• Wear properly fitting clothing and equipment. Soccer cleats that are too large allow the foot to move around inside. Cleats that are too small place undue stress on the skin of the cramped feet. Bulky socks tend to fold inside the shoe and create friction points on the skin.
• Treat friction areas before they develop into blisters by applying a skin lubricant to reduce friction. Also, trim large calluses with an emery board or callus file. Apply ice over skin hot spots. Rub the pressure points of feet with a bar of soap before putting on socks. Perspiration will cause the soap to lather and reduce friction.

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