Member Gen promotes knowledge sharing, with contributions welcome from Rob Roy Boat Club members

“Rowing is a repetitive-motion, non-impact sport; thus, rowers are unlikely to suffer sudden and unexpected injury, but more likely to suffer overuse injuries. Like other athletes in repetitive sports, the cause of these overuse injuries can usually be traced to a training
error in either volume or technique, or inappropriately sized or configured equipment.”
(Kristine A Karlson MD, The Physician and Sports Medicine- Vol 28, No 4, April 2000)

The image below is of the hand of a rower following completion of the 31 mile Boston Marathon head race. (Image found on The Tideway Slug website)

University of York Boat Club member Gary Nelmes posted memories on the internet of his despair 25 miles into his first marathon row.

‘By this point the River Witham became very straight with banks above head height so that we could see virtually none of the passing countryside. Our days of carb-loading began to prove insufficient. And when your hands stick like glue to the blade handles, which are stained red, you know you have some serious blister action going on.’

On 19 September 2010, Olympic gold medallist Andrew Holmes single sculled the Boston Marathon. He placed fourth in the MasD 1x event with a time of 4:36:56. On 16 October 2010 he was admitted into Kings College hospital, London following a scan showing brain haemorrhaging. He died on 24 October from multiple organ failure resulting from an infection of Leptospirosis. The disease is said to have entered his blood stream via blisters he sustained while completing the marathon. Holmes told hospital staff that he fell into the water during his race.

Death is a rare and extreme complication but blisters are a common, painful and unhealthy bi-product of rowing, so an important topic to consider.

Prevention

According to Rowperfect’s New Zealand-based consulting coach Raf Wyatt:

‘Rower’s blisters are caused by either friction forming a water blister or pinching forming a blood blister.’

Chris Covey of Robs Elite Men’s Squad offers some valuable advice:

 

‘Inexperienced rowers often suffer from bad blisters. This is not really caused by softer skin, although callouses built up by regular training do help. The tendency is for novices to miss the catch at the front-end and to start their drive as they place the oar in the water, which leads to very high initial handle loading. This mistiming, coupled with a tendency to grip too hard (perhaps due to lack of confidence), can lead to novices suffering from very bad blisters. A largely constant handle force (note – different to power) should be applied for the full arc of handle travel and novices rarely achieve this.’

 

Robs Elite Men’s Squad member Paul Wilkins lists some likely times to expect blisters:
– at the start of a season
– when switching from sweep to sculling or vice versa
– when moving to new or different grips/handles
– in sudden cold spells

‘If it’s cold,’ says Wilkins, ‘Wearing pogies can help prevent blisters. Your skin will stay warmer but, in addition, you’ll have better control of the handles so you’ll be less likely to start doing weird things that introduce fresh un-calloused bits of skin to the grips.’

 

‘Correct rowing/sculling technique avoids the onset of blisters,’ adds Covey. ‘When blisters do occur, they should be located along the inside pads of the digits and not on the palms if the oar grips are correctly placed and loosely held.’

Raf Wyatt offers good advice on how to grip the handles correctly. Below are images of correct hand positioning from her excellent e-book Rowing Blisters and Skin Injuries, which is available for purchase on the Rowperfect website.

http://www.rowperfect.co.uk/shop/rowing-blisters-and-skin-injuries-261.html

For sweep oar rowing, Wyatt suggests:

‘Good rowing hands work lightly and separately.’

She suggests that the outside hand should be maintained as a loose fist during the entire stroke with

‘…top knuckle horizontal with the wrist… and palm free of the handle…’  This avoids gripping too tightly. Wyatt says that the outside hand’s job is to apply enough pressure on top of the handle to:

‘Control handle height, place the blade in the water and to tap down to take the blade out of the water.’

The inside hand, also ideally kept in a loose fist around the handle, should make use of wrist action to turn the handle, feathering and squaring the blade at appropriate moments.

For sculling, Wyatt again suggests the use of a loose fist to avoid tensing the hands, but with thumbs placed on the grip ends. For squaring and feathering, the action involves rolling the grip out and back along fingers, accompanied by minimal wrist movement as necessary.

Wyatt’s  e-book also promotes the use of good hand and equipment hygiene to prevent the spread of infection due to broken skin.

-Diligent hand washing with soap or applying a small amount of alcohol to hands after every outing is suggested.

-Advice given in the book recommends a quick wash of the handles after every outing and a more thorough cleaning in a weak bleach solution once a week.

-Wyatt emphasises the necessity of ensuring that handles and grips are in good repair and are the correct size and material to best suit the user.
Tiarca.com, suppliers of the American product All Natural Daily Skin Care Cream ($26 plus postage from Milledgeville, Georgia), offer the following interesting testimonial on their website:

Blisters – Rower, aged 43. Male
Two members of a British rowing club were entered in the Boston to Lincoln marathon rowing race in a double sculling racing shell. One of the rowers, the stroke man, used All Natural Daily every day for three weeks during training leading up to the race. The other did not use any preparation. Halfway through the race the crew stopped while the rower who had not used the All Natural Daily put on gloves (a disadvantage for a rower) as the blood from his hands was causing the oar handles to slip in his grip. The other rower who had used All Natural Daily finished the race with bare hands and not even a blister.

The company claims that the

‘Design of All Natural Daily is focused on restoring and stabilizing the surface of the skin. Ingredients were selected to be all natural for compatibility with the body’s systems and for maximum effect. ‘Ingredients listed for the product are:

Plantago major, calendula officinalis flower, quercus alba, achilliea millefolium, coconut oil, shea butter, aloe juice, grapeseed oil, evening primrose oil, glycerin, vitamin C, vitamin E, water, xanthan gum, emulsifying wax, stearic acid and biovert.

Note that this cream is, as yet, untried and unproven by RRBC members.

Treatment

Paul Wilkin’s advice on blister care and repair:
– if you are going to row with them again soon, blisters need draining. A needle is best (either hypodermic syringe or sewing needle but make sure it’s sterile by pouring under boiling water
– if blisters split while rowing, they need cleaning and preferably disinfecting – torn blisters are nothing like as painful as infected blisters
– personally, I like to harden the drained/torn blisters with surgical spirit. If there’s raw flesh/new skin exposed this is very painful!! If, however, the blister has cracked open and is bleeding, the skin might need to become more supple to recover and repair itself. In this case, Savlon and then protection is key

Adding to Wilkin’s advice, Chris Covey suggests:

‘The trick to allowing blisters to heal is to make sure antiseptic is applied to avoid infection; then the blisters need to be kept dry and open to air. I prefer not to use plaster tape, but if absolutely necessary, the flexible stuff is best, with some Vaseline applied to the blister itself.’

Rowperfect UK’s David Hudson, with over 40 years experience, began rowing in skiffs. Hudson recommends cutting back thick callouses with a scalpel blade. ‘It’s important to shave down hardened skin,’ he explains. ‘Blood blisters can form under and around big padded areas of hard skin and these are extremely painful.’

Training with Blisters

‘You should be able to recover from blisters (allowing callouses to form) in 1-2 weeks while continuing to train if you look after yourself properly,’ says Wilkins.

His tips for training with blisters:
– most blisters can be protected while you scull/row
– put a plaster on and then wrap in electrical tape to keep the plaster in place. A plaster on its own will soon rub off while you scull
– if you can get hold of some, animal bandages wrap round and stick to themselves and will last an outing
– you shouldn’t put either the plaster or tape on so tightly that you feel it’s compressing your finger/thumb or your digit will swell either side of the plaster and you’ll be almost guaranteed to get new blisters above and below the plaster

Claire Allen (Robs Women’s Masters Squad) recommends the Swedish product Mefix self adhesive fabric tape to protect existing blisters during outings. ‘Mefix must be put on while hands are completely dry before outings,’ says Allen. Boots (Petty Cury) will order Mefix with a two-working-day turn around. Mefix is available in various widths ranging from 25mm to 200 mm in 5 or 10 metre rolls.

Nicholas Cutler (Robs Senior Men’s Squad) suggests the use of a Compeed plaster for outings where  a blister is present from the onset. Although this product has been designed to be used on feet (and can be found in the footcare section of local pharmacies), Compeed (www.compeed.co.uk)  makes the following general recommendations:

‘Applying a COMPEED® Blister Patch can help prevent further progression of the blister as the cushioning layer forms a barrier against friction. The patch contains hydrocolloid technology which creates an optimum environment for wound healing while instantly reducing pain. Its also waterproof & helps protect the wound from harmful bacteria & dirt. The patch should not be removed too soon, wait until it starts to lift at the edges and then it can gently and easily be peeled off in the bath. Do not deliberately burst the blister but if it does open clean it with mild soapy water, soak it in a salt water footbath for 10 minutes and cover with a protective pad such as COMPEED®.’

Robs J15 athlete Hamish McLuskie recalls racing Leg One of the 2012 Winter League Head Race with blood covered oar grips from burst blisters. His bank party, Juniors coach Pete Shiels, casually reassured him mid-race that he should stick with it. McLuskie quotes Shiels as telling him:

‘Pain is weakness leaving the body.’

And what advice was the junior sculler given by Shiels for treating his handful of blisters after the race?

‘Apply neat TCP. It may hurt but helps harden the skin.’

The most extreme blisters experience amongst Rob Roy Boat Club members has to be that of Chris Covey during his record-breaking  31-day non-stop Atlantic crossing last year as one of Team Hallin’s six person sculling crew. Says Covey:

‘We all developed blisters on our hands. Ocean rowing sculls are rigged wide so that the handles don’t cross over. This is essential to avoid blade handles clashing together and damaging the scullers’ hands during frequent high waves and occasional extreme turbulence of open ocean. In those conditions, blistering is inevitable.’

‘But the worst affected region was from contact with seat padding. We each had our own way of coping but we knew from the onset that bare skin on the seat pad was going to be the best arrangement. Sea water drying on cloth would leave a deposit of salt- quite painful on open sores! My preference was for a sheepskin seat cover, which I found most comfortable turned upside- down. The tricky moment was standing up and realising that, during the two hour sculling stint, the seat grip had firmly attached itself to skin. Seat blisters never had time to heal during the ocean crossing. I used Diclofenac (Voltarol) gel to reduce pain, but would never recommend that to freshwater rowers, as blisters should not be allowed to get that bad.’

On returning to England, Covey gave an interesting talk to club members about his ocean row challenge. Summing up, he said:

‘It was quite an experience.  I would recommend it to none of you.’

What happens when, despite due care and attention, a blister becomes infected? David Hosking MBE, Former Royal Naval Commander and skipper of the 2011 Team Hallin Atlantic crossing, suggested to his crew (in a talk preparing them for their voyage) an appropriate course of action. He first recommended the use of TCP, an antiseptic containing Phenol and concentrated phosphoric acid. If that didn’t work, he suggested Corsodyl, a chlorhexidine digluconate gel. For more persistent infections, he then advised injecting hydrogen peroxide deep into the wound using a clean needle. This could offer relief and some perverse satisfaction while visibly bubbling the infection and accompanying stench to the surface of the wound.  All of these chemicals are available without prescription but Hosking’s procedures represent the sort of drastic action that it is hoped would only be required during a challenge in hostile environments. As Hosking told his crew, ‘There is no A and E on the ocean.’

For the rest of us, with easy access to a general practioner’s surgery, I guess the preferred treatment for a badly infected blister would be a prescribed course of antibiotics.

Comments and feedback to:

Donna McLuskie                                                                                                                          Communications Officer                                                                                                                                       Rob Roy Boat Club                                                                                                    communications@robroyboatclub.org.uk

Donna McLuskie has asserted her rights under the Copyright, Designs and Patents Act, 1998, to be identified as the author of this work. Contributions from Rob Roy Boat Club members and other sources as cited. No part of this publication may be reproduced or transmitted or utilised in any form or by any means, electronic, mechanical, photocopying or otherwise, without  prior permission.