The Australian Open 2013
In competitive sport, it’s a shame when injury decides the outcome of a tournament. When that injury is a foot blister, it’s even harder to accept.
Andy Murray insists his blister was not an issue in his defeat by Novak Djokovic in the final of the 2013 Australian Open last night. But, anyone who saw the footage of the on-court medical attention he received, might find that difficult to believe.
Murray's foot required attention at the end of the third set to a deroofed blister under the big toe knuckle of his right foot. The medic applied a combination of cushioning, taping and powder. Without it, Andy wouldn’t have been able to continue. His skin was raw! The commentators suggested he was taking painkillers or anti-inflammatories, but neither were going to take that pain away.
The Australian Open
Notable blister casualties of the Australian Open alone include Roger Federer (2005), Maria Sharapova (2006) and now Murray (2013). That's just a few of the big names from one tournament in the last few years. It’s difficult to understand how something like foot blisters can continue to be a major issue for elite professional tennis players. These players have their own support teams that travel around the world with them. They have access to the best products and most current technology. They go to extraordinary lengths to prevent injury. And yet foot blisters continue to strike down even the best at the most important moments.
I can tell you why...
The mainstream understanding of what causes blisters (and therefore how to prevent them) is out of whack.
Get this wrong and you can't expect to be successful in blister prevention. The answers to these questions may surprise you:
- What is the mechanism of injury for blisters?
- Are blisters really a burn?
- How does preventing taping work?
- Are powders and lubricants a good idea for blister prevention?
Let's look at the relevant factors to foot blisters in the game of tennis:
1. The mechanical demands on the feet
Tennis is a game of sudden accelerations, decelerations and changes of direction. This causes the bones under the skin to move back & forth and side to side to an excessive degree. This creates extreme skin shear - the mechanism of skin damage in blisters. Shear causes micro-tears within a specific layer of the skin which precipitates a blister. Continued high frictional forces cause the blister to deroof.
2. High friction
In-shoe friction is relatively high at the best of times. But a moist environment, like sweaty feet in shoes and socks while playing tennis, increases the level of friction further: at both the skin-sock and the sock-shoe interfaces. This makes these three surfaces grip together. And so the bones move further in relation to the skin surface to cause more micro-tears.
3. Shoe fit
You would assume that elite tennis players are fitted with the most appropriate tennis shoes, such that inadequate shoe fit is not a contributing factor. Read more about the optimal fitting of shoes for blister prevention here.
Similarly, we can assume that elite tennis players are assessed to the nth degree in regard to relevant structural and biomechanical factors that may predispose to foot blisters. And that these factors are minimised with the use of orthotics, innersoles, paddings and cushioning materials within the shoe. These would be in place at every game and training session.
So the medic came and did what he could, and Murray was at least able to continue the game. I noticed he had a double-sock system in place. That is, he was wearing a thin inner sock and a thicker outer sock. This is an attempt to add an additional interface (the sock-sock interface) which grips less than the other two interfaces. Unfortunately, this strategy wasn’t enough for Murray on the night.
Where to from here?
For foot blisters in tennis
I suggest the following:
- Watch this video to see exactly what causes blisters (it's not just rubbing) - watch here
- Think again about what friction really means for blisters (and what to do about it) - read this
- Reassess the pros and cons of each blister strategy (there are 14 of them) - start here
- Revisit what is known about how blister taping works (and doesn't work) - learn more
Written by Rebecca Rushton
Rebecca is an Australian podiatrist with over 20 years experience. She has spent a lifetime dealing with her own blister prone feet in her sporting and everyday life. Rebecca specialises in helping athletes and sports medicine professionals figure out how to manage foot blisters with ease. And for kicks, she enjoys providing blister care at multiday ultramarathon events.
Rebecca is the founder of Blister Prevention and author of "The Blister Prone Athlete's Guide To Preventing Foot Blisters".