Blisters suck — this we can all agree on. What most rowers and coxswains don’t know are the specifics of how and why they form, how to treat them, and how to prevent them.
One of my former coaches used to tell us that there was nothing more character-building in rowing than the blisters you get. A lot of the time you’re encouraged to just deal with them because they’re inevitable but a point in time comes when you have to stop just dealing with it and start taking the proper steps to protect the ones you already have and prevent more from occurring. Do not be careless when it comes to your blisters. There are few things more eye-roll inducing than rowers (novices) who are like “look at my hands, they’re completely torn to shreds, clearly this makes me the most badass rower ever!” Just … no.
What are they and how do you get them?
There are two kinds of blisters – your regular, run of the mill blisters and blood blisters. Regular blisters are pockets of fluid in between the upper layers of your skin. They’re most often caused by friction, which in rowing could be from overuse, having too tight of a grip, etc. The other kind of blister is a blood blister. These kinds form when blood vessels near the surface of your skin are damaged but the skin itself isn’t broken. There are two main causes for blood blisters. One is consistently rubbing the skin back and forth on or against something. The other, and more common cause, is the skin being pinched together (say, for example, when you’re rowing and suddenly the boat goes offset to one side and you smash your pinky in between the oar handle and the gunnel).
To pop or not to pop
There’s a lot of opinions out there on what you should do if you get a blister. Pop it, leave it alone, drain it, rip the skin off, sob quietly in the corner of the boathouse because your significant other will never want to hold your hand ever again, etc. I’m firmly in the camp of “leave it alone” if and when possible. As long as the blister isn’t having any kind of impact on your rowing you should aim to just let it be so as to avoid getting an infection in the open wound. This is one of those moments where you need to know the difference between pain and discomfort. Don’t deliberately mess with the blister if you don’t have to. If you develop a blister that has filled with fluid and is painful or disrupting your rowing though, you’ll want to drain it.
How to drain and clean your blisters
Before you do anything, wash your hands. It’s probably going to hurt but you never know what microbial nuisances might be lurking on your skin. Antimicrobial soap + warm water + at least 30 seconds per hand = acceptable. When you clean your blisters, especially the really bloody ones, try to avoid using peroxide if possible. Betadine is a better antibacterial alternative because it’s not as harsh on your skin and doesn’t hurt nearly as bad as peroxide does. Peroxide gets the job done quite well and there’s even some cool (read: gross) foaming action that happens with the really bad blisters but that being said, it hurts like a bitch.
As a pre-step to draining the blister you need to sterilize the needle or pin you plan on using. Don’t skip this step. It takes like, two minutes to do. You can sterilize whatever you plan on using by running it over a flame until it’s red hot and then letting it soak in peroxide for a few minutes.
When you’re ready to drain the blister, you’ll want to drain it from the side, not the middle as I’ve tried to illustrate below. To avoid creating a hole that would allow the skin to be easily ripped off it’s often suggested that you poke it with the needle from the top edge near your fingers. Keep the needle as close to your skin as possible.
Once the blister starts releasing the fluid, try not to let it run all over your hands. At the same time you’re poking it with the needle, hold a cotton ball or tissue on the blister so that the fluid can be immediately soaked up. Press gently with the pad of your finger to get the liquid out. Make sure that you’re actually pressing in the direction of the hole you just made too and do this until the blister is completely flat.
Once you’ve got the blister(s) drained you should put some Neosporin on them but keep them uncovered to give them an opportunity to dry out. NewSkin is another option but that seems to be a fairly hit or miss choice with most rowers. Some swear by it, others hate it. One thing that I’ve heard of people doing is rubbing Neosporin on a piece of sewing thread, putting it on a needle, and pulling it through the blister. Usually this is done before draining it but I don’t see why it wouldn’t be effective post-draining too. Doing this allows the medicine to get inside the blister and helps to prevent infections.
I’ve also heard about rowers using tea bags to help dry out and harden the blisters (via the tannic acid) – has anyone tried this? What have your experiences been? Another option is filling a bowl with epsom salts and warm water and allowing the salts to dissolve before soaking your hands for 20-30 minutes. This will help to dry out the blisters and keep them clean. Conveniently this process also allows you the time to catch up on all those TV shows you never actually have time to watch.
How to protect your hands
If you’ve already got blisters the next step is learning how to protect them while you’re practicing. Tape, band-aids, etc. are going to be your best friends if – if – you use them properly. Before anyone suggests it let’s get this out of the way right now: gloves = NO. You can’t get a good grip on the oar (yes, even with golfer’s or batter’s gloves) and your hands sweat inside them so much that you end up with way more blisters than when you started. You’re going to be tempted to ask your coach or coxswain if you can wear gloves but I’m here to save you from that embarrassment. Just don’t do it.
If you have blisters on your fingers, I recommend the knuckle band-aids since their little wing-like things allow them to stay more securely on your fingers. An additional option on top of – not instead of – the band-aids is to get those rubber finger protectors and slide one of those on. The rowers I’ve seen do it say that it holds the band-aid in place better so they don’t have to worry about it sliding around. If for whatever reason the blister starts bleeding, by having it in the protector you’ll avoid getting blood, bacteria, and who knows what else on your handle (and transferring whatever is on your handle into your open wound).
The issue that most rowers have is taping up the blisters on your palms and right below your fingers. If you just wrap the tape in a circle, about 1/3 of the way through your warmup you’ll notice that it’s starting to bunch up and expose your blisters to the elements. My recommendation is to wrap your hands similarly to how boxers wrap theirs. Obviously the tape wouldn’t need to be nearly as thick and if the blisters are only at the top of your palms you don’t need to wrap all the way down to your wrists but having the tape secured around your fingers though will ensure that it stays in place and you won’t have to worry about it.
Below is a video that you can use for reference. The loop that goes around your thumb (or whatever finger you choose) is what really secures your tape in place.
If you have a lot of blisters, buy your own tape and band-aids. Your coxswain is not a walking first aid dispensary. Anything that’s waterproof and flexible will be good since it’ll move with you and not restrict your movement.
You should be changing your tape and band-aids before and after every practice too because a) you need to clean your hands and get all the grunge off of them and b) the tape is going to be disgusting, rolled up on itself, and not effective at protecting your skin anymore.
How to prevent blisters.
Getting blisters as a rower is inevitable — it’s going to happen. You can limit the severity of them though simply by rowing with proper technique. Understand the difference between “relaxed grip” and “no grip” — “loose” does not literally mean loose as in flimsy, it means a happy medium between a death grip and no grip.
Avoid the death grip on the handle and instead keep the hands relaxed. On the recovery you should be able to freely wiggle your fingers while still maintaining control of the handle. You’ll know if you’re doing the death grip if your forearms and wrists are really sore and you’ve got hands that like they were rubbed on a cheese grater for a few hours.
Keep the towels that you use to wipe down your boats, oars, etc. clean too. At the beginning of the year it’s worth having everyone on the team donate an old rag or two to the team to use that way you’ve got an abundant supply. Also make sure the oar handles are being cleaned regularly too, especially if you’ve bled on them or had blisters open up during practice.
Know when a blister has festered into something more serious – and then get your ass to a doctor
MRSA. Sepsis. Cellulitis. Leptospirosis.
All of these are some of the potential consequences of bacteria coming in contact with your open wounds. All have been suffered from by rowers at some point or another. A prominent case that I remember reading about three or four years ago was the death of Andy Holmes, a several-time Olympian and gold-medalist from the UK, who died of leptospirosis after coming in contact with contaminated water. This resulted in British Rowing posting a notice on it’s website to rowers to remind them that good hygiene and proper care of blisters and track bites are crucial steps in not developing an infection, especially one that elevates to the severity that Holmes’ did.
It’s important for you to pay attention to any changes in the blisters themselves, the skin around the blisters, and most importantly, your overall health. If something looks or feels “off” don’t just suck it up — go to your local 24-hour urgent care facility and get someone to look at you. I know I say this all the time but I really mean it every time I do … better safe than sorry. Know how to separate discomfort or soreness from rowing from the symptoms of something more severe. If something feels off, tell your parent(s), coach(es), sibling(s), teammate(s), etc. so that someone else can keep an eye on you.
I’ve known three different people, two rowers and one coxswain, who developed MRSA as a result of not taking proper care of their blisters. On a scale of one to ten, two were probably at about a “six” with regards to severity and the other was at least a “nine”. That person got really sick and was hospitalized for about a week. This isn’t just stuff we make up to scare you into taking proper care of yourself, which you should be doing already. It can and does happen. Be proactive so it doesn’t happen to you.
Below is a quick rundown of each of the infections I listed above, in addition to their signs and symptoms.
Methicillin-resistant staphylococcus aureus (MRSA)
MRSA is a strain of bacteria that causes infections in the body and tends to be resistant to most commonly used antibiotics. It’s transmitted either through touching someone who already has it on their skin or by touching something (for example, oar handles) that has the bacteria on it. Signs of an infection include the skin around the initial wound being red, swollen, warm to the touch, more painful than normal, and potentially contain pus. Typically skin infections that are related to MRSA are mistaken for spider bites since spider bites look similar. If the infection spreads to the respiratory system, you could develop pneumonia and experience shortness of breath, a fever, chills, or a cough that you don’t otherwise normally have. If you go to the doctor and are given antibiotics, pay attention and see if you are actually getting better. If the infection continues to get worse, you develop a fever or the fever you have gets worse, or there are no signs of improvement after three(ish) days, go back to the doctor.
Sepsis (blood poisoning)
When bacteria enters the blood it’s known as a condition called “bacteremia”. Since the blood is typically sterile, the presence of bacteria is considered abnormal. Previous infections in the body’s organs can spread and lead to sepsis, which itself is a secondary set of symptoms, but it can also occur from bacteria entering through an open wound and being transported throughout the blood. Typically you’ll develop a rapid heart rate, a fever, and extreme chills, in addition to a rash that can appear in the form of skin discoloration or small red dots clustered across the body. Joint pain, disorientation, nausea, decreased blood pressure, vomiting, and clammy skin are additional symptoms you might experience if the infection progresses. At it’s most severe, your blood pressure drops to dangerously low levels which prevents your organs from getting the proper amount of oxygenated blood, leading to septic shock, which can cause (multiple) organ failure and death.
Cellulitis
Cellulitis, which is an infection of the connective tissues, is caused when bacteria (typically staph or strep) enters the body through broken skin (cuts, burns, blisters, etc.) and as it progresses, spreads to the deeper tissues, blood, and/or lymph nodes. The infected area will be warm and tender to the touch, red, and swollen. If it’s progressed to the point where the lymphatic system is involved you may notice that your lymph nodes are swollen and that you have streaking on the skin as the infection travels through the body. If the infection enters the bloodstream you will also most likely develop a fever.
Leptospirosis
This is a common bacterial infection transmitted between animals and humans. Typically we don’t come in contact with too many animals while we’re rowing but we do come in contact with a lot of water that presumably many animals have urinated in (another reason to work on splashing…). When you’re rowing and water from backsplash gets on your hands, legs, etc. that bacteria can enter your system through any open track bites or blisters you might have. Leptospirosis is a two-phase disease that starts with flu-like symptoms (headache, chills, muscle soreness, etc.), jaundice, red eyes, etc. before appearing to resolve itself. There’s a brief period where the person displays no symptoms before the second phase begins. Once that happens you get knocked out with illnesses ranging from meningitis to kidney and liver disease to full on renal failure.
The great thing though is that all of these conditions are preventable by taking proper care of any open blisters, cuts, etc. you have. I hope this helps answer some of your questions on how to handle blisters. If you’ve got a foolproof method that you turn to in dealing with your blisters, please leave it in the comments!
Image via // @petereed
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