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Hi everyone.

I've got some questions about the Women's World Cup being played on synthetic pitches in Canada and the concerns about the effect of heat transfer to their feet. I must admit, I know very little about synthetic surfaces. But I'm assuming not much will change in the near future. Locally, almost all of my lawn bowlers have complained about hot feet on the new synthetic green.

Question 1: Does anyone know what has been used in the past to minimise heat transfer - for any sport? Have different insole materials been used? Perhaps a reflective layer under the traditional insole? Specialised outersole materials? Socks? Tapes? Topical creams?

And getting back to the Women's World Cup, the following quotes make me think the skin problem our Aussie Matildas were suffering was more maceration than blisters (my thoughts on this blog post):

1. “You can’t really get a grip so your feet are sliding around in your boots because they’re that hot and kind of sweaty."
2. “You wouldn’t want to see the bottom of our feet after a game. They just turn white. The skin is all ripped off. It’s pretty disgusting."
3. "It’s like walking on hot coals with your skin ripping and slowly cracking, constantly.”​

As far as I know, options for treating severe maceration in a sports medicine point of view include:
a) Time and a warm dry environment - the default management plan, but can we accelerate it?
b) Talc powder - it absorbs moisture but is known to increase friction.
c) Water-repelling lubricants (eg: Hydropel and similar) - This won't work because lubricants degrade traction, which is the very reason soccer players like the sticky socks.
d) Applying benzoin - definitely has a drying effect but significantly increases friction when applied to skin (it's used as an adhesive-enhancer under tapes and dressings).
e) Taping or dressings over the macerated skin to try and hold it together - will reduce the shear load on the weakened skin but prevent evaporation, possibly worsening the maceration. And could tear the skin off when removing the tape.

Question 2: Are there any other ways to treat severe maceration? I'm thinking particularly in the big ultramarathons. Races where runners stop for a while (to sleep or until the next stage the following day). What's the best way to get the skin integrity back to normal and able to deal with the rigours of running? Could absorbent ulcer dressings help?

Thanks
Rebecca Rushton
www.blisterprevention.com.au