Blisters are painful lesions in response to shearing forces on the skin such as repetition of the seams of a baseball on the finger of a pitcher, handle of the bat in the hand of a hitter, and new cleats on the feet of a runner. Without proper treatment, these injuries can become burdensome throughout the course of a season, just look at the injury history of Rich Hill and Aaron Sanchez. If you’ve played competitive sports or have been relatively active in your life you probably have had, or know someone whose had blisters. If you’ve played competitive baseball you probably know someone whose dealt with these over the course of a season or a career. It is important to understand why these injuries occur and how to decrease their likelihood but then also how to properly treat these injuries when needed throughout the course of a season.
These injuries are especially common early in the season before the skin has had time to grow accustomed to the repetitive stress of pitching, hitting, or running. The aim to prevent blisters should be handled similar to how we would aim to prevent muscle strains. This means graded exposure and proper dosing to meet the demands of the sport. In short, the same way you wouldn’t place 500 pounds on the bar and try to bench press, you shouldn’t be throwing 80 pitches in your first live throwing session, or taking 100 swings in a hitting session your first time out. Over the course of an off season you should gradually build up tolerance to throwing pitches at max intensity or taking many swings. During your offseason preparation, you should be throwing with the same type of ball that you will be throwing with during your season. Even small variations in seams can cause irritation that may have been unexpected.
With proper graded exposer, a callus may build over time, which is a good thing if it is managed properly. Callus are a thickened response to prolonged friction for protection of the area. Developing a callus means the skin has been adequately prepared for the friction forces that are being placed on it. Uneven thickness distribution of the callus and cracks should be monitored. Cracks could open the area to infection and should be covered if noticed. To assure an even distribution of thickness along the surface of the skin, it would be appropriate to ‘file’ the callus down so it is even.
What if I get a blister?
Intact blisters can be treated by cleansing the blister and then using a sterile needle or scalpel to drain the blister. This can prevent tearing or expansion of the blister. Leaving the upper layer of the skin in place and protecting it with a pad to prevent infection. Ideally, you would then allow 2-4 weeks for the blister to heal and begin a graded exposure to throwing, hitting or running again.
This protocol is feasible for the off season but probably unrealistic for dealing with blisters during the season. Dealing with a blister during the season where you will inevitably need to play every day or pitch every 5thday is slightly different. The precautions may include varying the ball used for you bull pen, limiting moisture to the area between starts, using protective gels and creams, applying covering or pads to prevent infection, and varying/limiting amount of pitches that increase irritation. If the blister is on the foot from a new pair of cleats, you may require frequent sock changes during a game or practice, wearing additional (2) pairs of socks, and placing a friction decreasing bandage on the area.
The best treatment for a blister is to try and prevent that from happening. Just how proper training decreases the likelihood of injury, a properly planned pitching, hitting, running program can decrease the likelihood of a blister.
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(Inside of Fitness by Erica)
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