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Preventative blister taping - 4 potential mechanisms of action

Discussion in 'Biomechanics, Sports and Foot orthoses' started by Asher, May 25, 2014.

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  1. Asher

    Asher Well-Known Member


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    We had a thread last year about the mechanism of action of preventative blister taping. Since then, I’ve thought about it some more and as far as I can tell, we have not really established how this works. I think there are 4 potential mechanisms for how taping prevents blisters. It would be great to get your collective thoughts.

    1) Protection from rubbing - By the admission of athletes and sports medicine practitioners alike, the most common understanding of “How taping prevents blisters” is “by protecting the skin from rubbing.” But you don't need rubbing to cause a blister – shear peaks in a state of static friction rather than dynamic friction. Although there is no doubt protection from rubbing prevents the abrasion of the blister roof.

    2) Thermal insulation - The 2013 PA thread mentioned earlier centred on thermal insulation from the heat produced by rubbing. Firstly, we know blisters don’t require rubbing. Secondly, we know blisters are not thermal burns. But it is plausible that heat is indirectly causative. However, research to date does not support the theory that local surface heat generated by dynamic friction is a significant factor in blister formation. I outlined some of the research that establish this in this post. Significantly, if heat transfer from the skin surface to the stratum spinosum is a major factor in blister development, one would expect the thicker corneum of the soles and palms would afford a level of blister protection. In fact, a thick corneum is one of the requisites for blister formation (Naylor, 1955; Akers and Sulzberger, 1972).

    3) Reducing friction levels – I originally assumed tapes reduce shear by lowering the friction level (ie: the tape-sock friction level becomes lower than the skin-sock friction level). But we don't know whether it does or not. In fact none of the tapes used in blister prevention (Fixomul, Leukoplast, KinesioTex, RockTape etc) have had their friction properties tested in any research. Not even by their manufacturers – I’ve contacted the manufacturers of the tapes mentioned above! There is no coefficient of friction (COF) data for any sports tapes! Some in-shoe material COF data does exist for insole and orthotic covering materials. And Polliack and Scheinberg (2006) reported on the COF of some blister dressings. But no tapes. This fact seems surprising and represents an area for improving our understanding of this modality.

    4) Spreading shear load - Another possibility that J Marty Carlson spoke to me about last year is a spreading of shear load. Potentially, the application of a tape reduces shear at discrete locations due to the fact that they’re adhered to the skin. Just as cushioning spreads the vertical load over a larger area to reduce peak pressure, because tape is adhered to the skin, does tape spread the horizontal “pulling” load over a larger area to reduce peak shear distortion per unit area of skin?

    Any thoughts on this?

    Rebecca Rushton
    www.blisterprevention.com.au
     
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