A blister is a small pocket of fluid that forms between the skin layers. It’s like a cushion that helps protect the skin from further damage. However, they can be painful, increase injury risk, and affect performance. Marianke van der Merwe investigates the pathology and provides recommendations on blister prevention and management.
London Marathon - Netherlands’ Sifan Hassan reacts as she crosses the finish line to win the elite women’s race REUTERS/Andrew Boyers.
Blisters on the feet are among the most common medical issues encountered by individuals who participate in weight-bearing activities, such as long-distance hikers, marathon runners, triathletes, and military personnel(1,2). Perspiration, friction, and shear forces cause the separation of the epidermal layers, causing blisters(2,3). These blisters impair the individual’s concentration and cause gait alterations, leading to musculoskeletal injuries and decreased activity enjoyment(1,2).
Mechanical separation of the epidermal cell layers occurs due to the shearing, scraping, and compression forces between the sock and foot(2). The shearing forces result from repetitive tangential forces applied to the skin (see figure 1)(1).
The shear forces lead to cellular distortion, cell disruption, and necrosis in the stratum spinosum layer of the epidermis. Serum-like fluid or blood fills the cellular disruption (see figure 2)(1,2).
The four main components that cause friction blisters are high friction force, moving bone, skin characteristics, and repetitive shear events(1,4). These four components are all interlinked. Friction is the most apparent factor affecting the formation of blisters(1). Friction is the tangential force resisting the relative motion of two surfaces against one another(1). The four underlining factors that help explain how friction causes blisters are skin moisture, particulate matter, skin lubrication, and normal force at the skin (see figure 3).
Our international team of qualified experts (see above) spend hours poring over scores of technical journals and medical papers that even the most interested professionals don't have time to read.
For 17 years, we've helped hard-working physiotherapists and sports professionals like you, overwhelmed by the vast amount of new research, bring science to their treatment. Sports Injury Bulletin is the ideal resource for practitioners too busy to cull through all the monthly journals to find meaningful and applicable studies.
*includes 3 coaching manuals
Get Inspired
All the latest techniques and approaches
Sports Injury Bulletin brings together a worldwide panel of experts – including physiotherapists, doctors, researchers and sports scientists. Together we deliver everything you need to help your clients avoid – or recover as quickly as possible from – injuries.
We strip away the scientific jargon and deliver you easy-to-follow training exercises, nutrition tips, psychological strategies and recovery programmes and exercises in plain English.