You may have seen the news articles either in your newspaper, or on Facebook, or on TV. Let me paint you a word picture of some of the headlines and quotes:
- Blister sparked tears
- “I got a really bad blister.”
- “My mind was ‘blocked with pain’ of a blister.”
- Pain and tears
- Blister caused meltdown
Marin Cilic let the tears come midway through the second set after calling for medical attention for a nasty blister on his left foot. The former US Tennis Open champion had tried to play through the pain, but couldn’t stop Federer from winning the tournament. Cilic said, “I got a bad blister in the semi-final against Sam Querrey. Fluid just came down under my callous in the foot.” The medical staff helped him over a period of 30 hours and did as much as they could. He said, “I still felt the pain. Every time I had to do a reaction fast, fast change of movement, I was unable to do that.” Cilic was challenged emotionally because of everything he had gone through in the months before Wimbledon. “It was very, very difficult to deal with it. It didn’t hurt so much that it was putting me in tears. It was just that feeling that I wasn’t able to give the best.” Here’s the full story.
What did this cost Cilic? It cost him the championship at Wimbledon and the fame and fortune that goes with it. Putting it into language that athletes would understand, If this had been you, it could have cost you a completion of a hundred mile race, an adventure race win, a marathon win, a through hike, and more.
So here’s what happened. We know that Cilic had a callus on the ball of his left foot. A blister developed under the callus, and then popped. A fluid filled blister hurts and when it’s on a pressure point area of the foot, it hurts even more. Then with the fluid removed, the blister’s roof moves against the inner layer of raw skin, causing even more pain. Movement, especially when doing sudden pivots and push-offs, as required in tennis, becomes impossible. That’s it. One blister. But a blister in a vital spot – at the head of the metatarsal at the base of the large toe on the left foot can ruin your day – or your chance for the 2017 Wimbledon trophy.
In the picture you can see white stuff on the bottom of Cilic’s foot. That’s tape residue from the layers of tape they put on his foot. The residue builds up into a sticky mess and can become an irritant. Look closely and you’ll see a callus or blister just under the ball of his big toe. That’s a typical callus area too and I’d bet he had a thick callus there. Cilic mentioned fluid that came out from under the callus. Try as they could, the doctors and medics were unable to patch his foot so he could play the way he needed to play. Since his play was compromised, he ended up losing.
So what’s the lesson here?
- Callus buildup is bad. It’s one of my main things I talk about. Calluses. Spend the time it takes to reduce your calluses. If Cilic did not have a callus, he might not have developed a blister.
- Treat it right from the start. We can only speculate what treatment Cilic received. How did they lance the blister? Did they get all the fluid out? Did it refill? What did they put over the callus and blister? Did the blister extend beyond the callus? What kind of tape did they use? What did he do to his foot during the 30 hours? How many times did they try to tape it. Why didn’t they remove the tape residue?
- Was this a recurrence? In other words, had he had a blister in the same place before?
- What was the surface of his insoles like? Coarse and rough? Smooth? Did they change insoles?
- What kind socks was he wearing? Did he change to a different pair as the injury progressed?
What would I have done? My treatment is based on what I read through the news stories and saw in the pictures.
- I would have checked his insoles and if they had a rough surface, I would have replaced then with a pair that had a smoother surface.
- I would have put a large ENGO Blister Prevention Patch on the insole under the callus and ball of the foot. This would have reduced the friction dramatically.
- If the callus over the blister is rough and coarse skin, I’d file it down to remove some of the coarseness and bulk.
- I would have made sure there were at least three lanced holes in the blister, in spots were pressure through the foot strike would have forced fluid out. And made sure all the fluid was out.
- I’d put a small dab of antibiotic ointment over the blister and apply a strip of kinesiology tape over the whole ball of the book, making sure the skin was clean, with a tincture of benzoin base and an added strip of benzoin to the tapes edges.
- I’d then add two figure 8s from Hypafix or Coverall tape between the toes to anchor the forward edge of the kinesiology tape at the base of the toes.
- Finally, roll the socks on the foot to avoid pulling any edges of the tape loose.
- Optionally #1, If the pain was almost unbearable, I would have applied cushioned adhesive felt over the ball of the foot and then the kinesiology tape over that.
- Optionally #2, I would have the athlete wear a double layer sock or two light weight socks to allow for movement between the two socks layers and reduce pressure on the ball of the foot.
Over the years, I have found most doctors, nurses, physical therapists, and even podiatrists, do not know how to patch blisters on athlete’s feet in order to get them back into the race or event.
I know I was not courtside, and don’t know what Cilic’s medical people saw. But the above treatment plan is still what I would do regardless of other things. You are welcome to weigh in on what you think.