Another Horrific Blister Story

January 28, 2018 by
Filed under: blister care, Foot Care, Footcare, General, Health, Sports 

Last July I wrote a blog post about The Year’s Best Blister Horror Story. I told how Marin Cilic was unable to continue in his championship tennis match at Wimbledon against Roger Federer—because of a blister that formed under a callus on the ball of his left foot.

Before you decided to skip reading this post because it’s about a tennis player, please know there is an important lesson here for any athlete. Fast forward to a couple of days ago, to the Australian Open where Roger Federer is playing against Chung Hyeon in a semi-final match. Here’s the headline: Australian Open: Hyeon Chung reveals the extent of blister that forced him out of semi-final with Roger Federer. The same thing happened! A blister. Chung had to withdraw from the tournament because of a blister on his left foot. Depending on the news source, he had one blister on the left foot or blisters on both feet. Above is a link to the story.

Federer won over Marin Cilic in the championship on Sunday. They had said that this would be a repeat of last year’s final day at Wimbledon. But no mention was made about how a blister affected the outcome of that match too.

Photo 1 – What’s on his foot?

I have a few photos of Chung’s foot and blister and will give my interpretation of what I see and then what can be learned from the incident.

In this first photo, I can’t tell what the white stuff is on Chung’s foot. It could be some kind of cream, zinc oxide, or even tape residue from that that was removed. It appears to spread across the whole ball of the foot. I would love to know what this is.

Photo 2 – Some kind of tape patch/covering

In the second photo, some kind of tape patch is being applied to the whole ball of the foot down into the arch area. Would love to know what this stuff is.

Photo 3 - Fully patched foot

Photo 3 – Fully patched foot

The third photo shows Chung’s fully tapes and wrapped foot. It could be Coverall, or HypeFix, or what is Australia is called Fixomull, a thin soft cotton type tape. Unfortunately they did not put one or two figure 8 pieces of tape between the toes from bottom to top to anchor the forward edge of the tape and keep it from rolling. I would have loved to have seen the patch job when they removed his socks.

Photo 4 - Deep blister on left foot

Photo 4 – Deep blister on left foot

The fourth photo shows the blister. It’s hard to tell whether this is a fully deroofed blister going down several layers of skin, or a blister that split open and foot strike pressure opened it even more into a gaping wound. I see tape residue on the skin and the tapes mentioned above do not leave such residue, so something else was used. Maybe white athletic tape or Leukotape P. There appears to be a small blister in the arch of the foot too.

Watching a championship tennis match with the world’s best payers, you can see the way their feet move. There is an extreme amount of side-to-side shear, and front-to-back shear, as well as rotational shear. Compounding the shearing movements is that they are made as the foot is landing on the court surface. It’s instantaneous under a lot of pressure. Unlike runners when a foot is planted and moves through its foot strike, tennis players subject their feet to much more shear and it can change each time the foot lands.

So the question is what can we learn from this?

Go back to my post from last year about Marin Cilic’s feet to see what I would have done for him. Not much would have changed here. I would have filled the open blister with a cut and shaped wound care pad. Even though I have years of experience patching feet, I would have patched Chung’s feet based on what I saw, customized for him. I also read that this problem started to develop a day of two before. It’d be nice to know what they did than as a preventive measure.

So what’s the lesson here?

It goes without saying that we are each responsible for our own feet. When you rely on others for their expertise, or lack thereof, and their supplies, or lack thereof, you sometime win and sometimes lose. A lot of questions should be directed at Chung’s coach and trainers. Did they follow best practices in their treatments? Who worked on Chung’s feet, both in the days leading up to this and at the final event? Did they have the knowledge and skills, and the materials to do the best patch job possible?

It’s just like running into an aid station at a 100-miler, and needing foot care, you get what’s there. It could be pot luck. That said, I know all the people I’ve seen work on feet try their best and I am not suggesting Chung received less than stellar care. But I do know from experience that patching a blister on a runner in a ultramarathon or multi-day race takes a certain amount of knowledge and skill. More than most medical people have. I still vividly remember many years ago at WS100, watching two podiatrists wrap a runner’s foot with half a roll of white athletic tape in a feeble attempt to patch him up. They were doing what they knew from their experience.

Maybe it’s time to raise the bar in regards to what doctors, podiatrists, nurses, and other medical people should know. What’s taught in podiatry school to patch blisters? Is what they learn the best way? My guess is the trainers at the Australia Open were well-trained and good at what they do. Maybe in Chung’s case it was the perfect storm type of situation.

Maybe it’s also time to raise the bar on what athletes should know in regards to foot care and blister prevention and treatment. Many enter a race and expect someone to be there to patch their feet. That’s not fair to race directors and volunteers. Many races are required by law and insurance regulation to have medical people at their event or on stand-by. But that doesn’t mean that know how to patch feet. I have seen excellent patching done by volunteers who have taught themselves.

What do you think?

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