Treatment Tips For Common Triathlon Injuries

By Mark A. Caselli, DPM

Ever since the first modern triathlon competition was conducted in San Diego in 1974, interest in the sport has grown steadily over the years. Currently, millions of amateur athletes participate in thousands of events annually worldwide. Since triathlon competitors perform three events with little or no rest between them, it can be a challenge for podiatrists to treat injuries that athletes sustain in these events.
Race distances vary and finish times range from approximately 30 minutes to several days as athletes compete in swimming, bicycling and running. Although the Ironman distance race is probably the most well known, races of Olympic distance or shorter are the most popular, representing 97 percent of racing opportunities. To support New York City’s bid to host the 2012 Summer Olympic Games, the first New York City Triathlon was conducted last year and the second was held on August 18. Podiatrists served on the medical team at both of these events, rendering care to the injured athletes.

In terms of common injuries, 79 percent of these athletes report an injury of the lower extremity below the knee. Common acute traumatic injuries among triathletes include contusions, abrasions, lacerations, blisters, sprains, strains and fractures.

Treating Acute Injuries In Triathletes
Contusions. Contusions are usually caused by collisions or falls. These injuries can result in hemorrhage and may be marked by ecchymosis. Subsurface damage may extend for varying depths beneath the skin. Blood vessels in the tissues usually tear and varying amounts of blood and plasma leak into the wound, and produce swelling and pain.
Small contusions require no special emergency care. Rest, ice, compression and elevation, along with stretching and range of motion (ROM) exercises, are often all that is needed. When you’re dealing with severe closed soft tissue injuries, be aware that extensive swelling and bleeding beneath the skin may occur. Applying local padding and a soft roller bandage for counter pressure can partially control this bleeding in the extremities. Elevating the extremity and applying ice locally to the area are also helpful in decreasing bleeding of injured tissue and preventing initial tissue swelling. If the athlete has suffered extensive soft tissue damage, you might suspect an underlying fracture.
Blisters. Foot blisters are among the most common injuries for athletes. Blisters result from frictional forces that mechanically separate epidermal cells. Hydrostatic pressure then causes the area of the separation to fill with lymph-like fluid. Small, intact blisters that don’t cause discomfort usually don’t need treatment. The best protection against infection is a blister’s own skin roof. To protect the roof, you can cover this type of blister with a small adhesive bandage or blister guard. You should drain larger or painful blisters without removing the roof.
Follow this by applying an antibiotic ointment and covering it with a bandage. Materials such as a Coban elastic bandage are excellent to use “in the field” since they are capable of securing a gauze dressing to the athlete’s sweaty foot. Blisters that have large tears should be unroofed, cleansed with soap and water or an antibacterial cleanser, and dressed with an antibiotic ointment. Remind the athlete to change the dressing daily.

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