"Many myths continue to be propagated regarding the prevention and treatment of friction blisters... Physicians, coaches and athletic trainers continue to advocate the use of petrolatum jelly and skin powders to prevent blisters while the scientific literature suggests these measures may actually increase the chance of blistering on the feet." Doug Richie Doctor of Podiatric Medicine (2010)

Blisters are caused by too much skin stretch.

Not rubbing, not friction, not moisture or heat.

When the skin stretches (shears) too far and for too long, the connections between skin cells fatigue and break. These tiny tears under the skin surface are the start of the blister injury. Fluid fills the injured area and thats when it starts to look like a blister.

Shearing is a parallel sliding of connected tissue layers across one another. Shear happens internally where the skin/foot is fixed to the shoe surface and the bones rub on the inside, whereas rubbing happens to the surface of the skin. When skin shear is excessive and repetitive, blisters form.

The following four factors (occurring at the same time) cause foot blisters.

- High pressure and friction

- Type of skin

- Moving bone

- Repetition

High friction levels cause the skin, sock and shoe to stick together for a bit longer and because the bones continue to move inside your foot, the skin is made to stretch and the microtears happen and a blister begins.

Some people have tougher skin, some are blister prone. Skin is weaker if it’s excessively sweaty or allowed to be damp for a long time. A build-up of too much callus can reduce your skins flexibility.

A hot spot (red, warm spot) is a warning sign that a blister is on its way. You only have a very short time to change the shearing forces or you will end up with a full on blister. If it has started to sting it’s too late, the micro-tears have started.

Aim = reduce the risk of skin shearing and not get hot spots in the first place.

Our top tips:

1. Check your shoe fit and change your lacing technique to minimise excessive movement within the shoe.

2. Moisture wicking socks enable the skin to stay drier and stronger and better able to resist shearing forces. Double socks (a thin sock inside your normal sock), allows the socks to glide and not your skin. The more time your in your shoe, the more soggy your skin gets, and the risk of blistering will rise. Change your before you go for a run, or play sport (even at half time) if it’s a hot day and you are blister prone.

3. Taping can act like a second sock but must be applied carefully, (absolutely no wrinkles or gaps!) and the correct tape must be used. How long the tape is on will limit the effectiveness of this technique, eventually it becomes waterlogged which will weaken the skin and will increase the risk of blistering again.

4. ENGO blister patches are awesome.

These are a Teflon like patch that reduces shear forces. They last about 500kms, stick to the inside of your shoe, are unaffected by sweat and only .38mm thick. You can target blister prone areas on your feet with these patches to prevent “hot spots”. If you have a blister you will be able to carry on playing more comfortably as the patch on the shoe liner will allow gliding of the dressing in the shoe and not add to the shear force friction already there.

Lakeside Podiatry is a proud stockist of ENGO blister patches.

For more advice on prevention and management of blisters, taping techniques and lacing techniques book an assessment with one of our Podiatrists: click here

We would like to acknowledge Podiatrist Rebecca Rushton (the blister guru and inventor of ENGO blister patches www.blisterprevention.com.au ) as a resource for this article.

Leonardo Di Vinci once described the human foot as “a masterpiece of engineering and a work of art”. This is due to the complexities involved with each foot possessing 33 joints, over 100 muscles and 26 bones which are all integral to proper foot function and contribute to numerous leg, foot and ankle conditions. These complexities often make pathologies affecting the lower leg, foot and ankle difficult to solve. Put your trust in our Sports Podiatrists, whose four year degree specifically focuses on the leg, foot and ankle.

When should I see a Sports Podiatrist at Lakeside Podiatry?

Lower limb sports injuriesKnock knees, jumpers knee etcShin splintsGrowing painsStress fractures of the lower leg and footAnkle sprains, instability or ‘weakness’Ankle painHeel painForefoot pain“Fallen arches” or flat feet

Treatments your local Sports Podiatrist can provide:

Visual gait analysis and biomechanical assessmentDry needlingTailored rehabilitative exercise programLeg, foot and ankle massageOrthotic therapyFoot and ankle mobilistation/manipulationFootwear assessment and advice

To read more about the team at Lakeside Podiatry their interest areas click here.

If you’re still not sure whether you need to see a sports Podiatrist, phone Lakeside Podiatry on 03 5821 3006 for a chat. Book an assessment via our website www.lakesidepodiatry.com.au or phone 03 5821 3006.

The best basketball players change direction quickly with explosive bursts and are able to keep on their feet without slipping or tripping. Your basketball shoes need to be able handle multi-directional footwork, provide shock absorption and grip.

FIT

Make sure your shoes fit well. Your foot should not hit the end of the shoe when you put on the brakes! Incorrect shoe fit can cause blisters, callus, corns on the toes, ingrown nails and bruising under the nails.

Check if you slip in your shoe. Your shoe needs to hold on to your foot, not the other way around! Lace ups are best; they help keep your foot securely back into the heel of the shoe which helps with stability. Laces also hold the tongue of the shoe in place which prevents friction of the laces over the tendons on top of the foot and ankle. Decent lace systems will not allow the laces to loosen up or come undone during play. There are many ways laces can be tied to adapt to differences in foot shapes, eg high arch foot vs a skinny heel. Laces can be woven in a way to allow more room for bony prominences or stop your heel from slipping in the back of your shoe.

Some shoes have a liner almost like an extra sock that is attached to the inside of the shoe to help keep your foot secure in the shoe. On the outside, the saddle is a reinforced mesh or other material that works with the eyelets and laces to tightly wrap the midfoot. If the saddle isn't snug the heel won't lock in place and the foot will move inside the shoe, causing blisters.

Hard heel counters (the area that cups the back of the heel) can irritate tendons and create blisters as well. A “saddle”counter applies a force to stabilize the heel from above rather than below within the shoe, which has been shown to be more effective than a rigid heel counter for in shoe stability.

OUTSOLE

The outsole (the rubber bottom of the shoe), is most important for grip and for supportive protection of the bottom of your foot. The outsole typically wraps around the sides of the shoe and around the toe box. Its function is to hold your foot stable on top of the sole. Running shoes don’t have this feature as you don’t have to quickly change different directions in running. We do not recommend running shoes for Basketball for this reason. Instability can lead to ankle sprains or fractures, and other lower limb injuries.

It preferable to have outsoles with contoured or rounded edges, check out the Kyrie 3 from Nike. Its designed to increase stability and efficiency when cutting, as no matter how the player plants his foot on the court, the bottom edge has more contact with the surface. In a traditional flat soled basketball shoe the sidewall of the shoe is basically a right angle to the ground, it has no contouring at all. If you are landing on a corner of a square edged sidewall of the shoe, you won’t get enough of the shoe in contact with the ground which leads to instability and that leads to loss of power. Changing direction quickly while balancing on a skinny edge can potentially lead to ankle injuries.

The shoe should flex at the ball off the foot, nowhere else.

Make sure your shoes are in good condition. Make sure the sole of the shoe is not bald or worn. Check if you slip on the court when you do a jump stop.

Uneven wear or rapid wearing out may indicate incorrect loading patterns from foot mechanics right through to poor ankle or gluteal muscle functioning. NBA players don’t wear a pair of shoes for more than 7-10 days! Generally, 65 hours of playing will wear out basketball shoes. It is no different to a runner clocking up 560-800km (66 hours running) in a pair of running shoes. (This figure can vary a little if you are a child or LeBron James.)

The shoe midsole allows for shock absorption, usually foam EVA/PU and Air. Over time the material slowly compresses due to the repetitive nature of stop start during play. This usually results in the shoe losing its supportive strength and allows more rotational movement of the foot within the shoe which is a risk for ankle sprains. If you are playing many games/ training sessions a week it may be worthwhile having 2 pairs in rotation to keep the wear consistent over a longer time.

HIGH, MID OR LOW CUT?

The cut of basketball shoe you wear is a personal preference. There is a weight difference of the shoe to consider, as well as restriction of movement and playing position on the court. There is no evidence to support high cut as a preventative measure for ankle sprains, in some cases a lower cut allows more room for player to fit an ankle brace.

Finally train in the shoes you play in. Training allows your body to adapt to the demands you are asking of it. Managing biomechanical load is the key to being injury free. Show your feet some love by checking your shoes regularly.

If you need further advice about footwear, or are suffering from foot and ankle pain you can book via our website, or phone the clinic on 03 5821 3006

Welcome to the NEW Lakeside Podiatry blog!

This blog will be regularly updated with the latest clinic news, foot facts, health tips and fitness advice.

Stay tuned for more.....