Every so often you capture one of those pictures that are perfect for a teaching opportunity. This is one of those pictures. There are actually two pictures, both from the same runner. These are from last July’s Badwater race in Death Valley.
In the first picture, the first thing you notice is the blisters. Three of them. All are fluid-filled. The middle one appears to have a tinge of blood in it. The one on the large toes is just starting to drain—notice the drop of fluid going down the foot.
They are all different in how they present on the toes. The large toe blister is lateral to the back of the toenail. The second toe’s blister encompasses the whole toenail, very swollen, and stretching the skin. The third toe’s blister is from the inside edge, behind the toenail, and around to the space between the next toe.
All three will challenge anyone wanting to drain and dress them. Once drained, the skin will not suddenly go back to its normal condition. The extra skin will have to be carefully handled so it does not tear. You cannot put tape directly on top of the blister’s surface.
Then you notice that is that the toenails are not in the best condition. I’d bet the large toes nails have been lost several times at least. There also appears to be some fungal infections on the nails.
Then next thing you notice is that the runner has Morton’s toe or Morton’s foot. This is where the second toe is longer than the large toe.
The second picture is of the left foot showing a nice second toe blister. I think it too had some blood in the fluid. You can see the toenail surrounded by fluid.
What Would You Do?
So my questions for you are several.
- What would you do to drain and dress these blisters if the runner wanted to continue running?
- What supplies would you need?
- What questions would you ask the runner to try to determine how to prevent this from happening again?
- What should the runner have done to try and prevent these blisters from happening in the first place?