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Paddling Articles In the Same Boat

Where's the Rub?

It's Only Skin Deep —
Coping With Chafe and Blisters

By Tamia Nelson
tamia@paddling.net

January 3, 2006

We've all suffered from them. I'm talking about chafe and blisters. While they're only close cousins and not fraternal twins, they still have a lot in common. Both originate "where the rubber meets the road." Both are painful, sometimes exquisitely so. And both can lead to something worse if not cared for promptly — and properly. As it is, either one can turn a pleasant paddling excursion into agony. Yet they're both preventable. How? To answer this question, it helps to begin by…

Looking Beneath the Surface

The human skin is a remarkable organ, flexible, elastic, and self-renewing. But it's also vulnerable. Tough yet tender, in other words. And — with a nod to Rodney Dangerfield — it don't get no respect. Like cyclists and climbers, we paddlers soon learn that our muscles won't perform if we don't keep them in condition between outings. So we sweat to stay in shape through the winter months, and we train for long trips. But though our muscles may be hard when we get to the put-in, our skin is often soft. In short, we take our skin for granted. Until it begins to hurt, that is. That's when we notice it.

We should pay more attention, much sooner — before the pain starts. Structured, composite materials get a lot of buzz in paddling circles, after all, and our skin beats the best of the bunch. From the horn-like scales of the stratum corneum (the outermost layer of the epidermis and our body's first line of defense) to the highly vascularized corium, or dermis, whose projecting papillae lock epidermis and dermis together, our skin is a study in organized complexity, constantly reengineering itself to meet new environmental challenges. Given enough time, it will even harden to withstand the demands of accelerated wear and tear. Unfortunately, paddlers are often in a hurry to get stroking, and…

There's the Rub

Pressure and friction. Damp and heat. That's the recipe for chafe. And chafe is the bane of runners, cyclists, and paddlers, particularly sea kayakers. A tight wetsuit. A hot day. A hard seat. A long crossing. Sweat and sand and salt water. Before you know it, your bum's red and raw. Keep going for a little while longer, and it'll be covered with small sores. And by that time you'll be mighty sore, too. Of course, chafe is happy to attack anywhere there's a target of opportunity. Maybe your paddling jacket has a stiff, high collar. No? OK. Then perhaps it's a little tight under the arms. You'll soon find out. Or maybe you just crossed a three-mile portage in snug-fitting, wet jeans. Now you know why cowboys walk the way they do in the movies. Chafe doesn't need to be invited twice. It makes itself right at home as soon as you open the door. Amphibious paddlers face double trouble. Bicycle seats rub all the places that kayak seats spare, and hauling a trailer full of paddling gear behind a bike is hard, sweaty work. With a little (bad) luck, you can experience 360 degrees of misery below the waist in no time at all. It's no fun.

Is there any good news? Yes. You can't stop the rain from falling or make the blackflies go away, but…

Chafe Can Be Prevented

A little painful experience will tell you where your most vulnerable bits are. Now go on the attack. Pressure and friction. Damp and heat. These are your enemies. Take the pressure off with seat pads and properly sized clothes. The amphibious brigade of paddling cyclists — it's more like a corporal's guard, really, but our numbers are growing — have a not-so-secret weapon: bicycle shorts. These tight-fitting Lycra numbers boast synthetic "chamois" pads that make a hundred-mile day on a rock-hard bike seat almost painless. They also take the sting out of some whitewater saddles, and they're not bad on a touring kayak seat, either. (I'm partial to the LiquiCell® chamois myself. It holds less water than foam.) Next, fight friction with something slick. Experiment. Some paddlers go for dry lubes like talcum powder. Others prefer slippery goo. Petroleum jelly and coconut oil are popular choices, and Bag Balm®, long a favorite with cyclists, works for paddlers, too. Whatever you use, apply it as often as necessary to keep things sliding smoothly.

Damp and heat are harder to combat. One expert kayaker simply advises you to "avoid sweating." That's a good trick. I wish I could manage it. No, I don't. Heat stroke is worse than chafe any day. So what is the best course? Slow down. Ventilate when you can. Stop often and air-dry your sweaty bits. Keep both your body and your clothes as clean as possible. Wash in fresh water daily, but don't scrub! You don't want to damage intact skin. Use a mild soap or detergent, never a harsh soap, and pat yourself dry. Your clothing choices matter, too. Wool is wonderful stuff, yet many paddlers start to chafe just looking at it. They're better off with wicking polyester.

But what happens when you miscalculate, or when an approaching storm (or a can't-miss rendezvous with a floatplane) forces you to ignore the early warnings? It's too late for prevention now. You're already red and raw.

What Next?

Stop as soon as you can. Wash the affected area gently with mild soap or detergent. (NO scrubbing. Remember? And no rubbing alcohol, either.) Air dry. If the skin is broken, cover with a sterile, nonadherent dressing. Then keep the area dry and clean until it heals. Be patient. Healing takes time.

I told you that prevention was better than cure, didn't I? And that's true of another commonplace evil, as well:

Blisters

Friction blisters, that is. (Don't confuse these with the blisters caused by plant poisons and burns.) But while blisters and chafe share a common cause — friction — they're not the same thing at all. Chafe favors the neck, trunk, inner thighs, and bum, while blisters pop up in places where taut skin lies close over bone. Feet and hands are the usual victims. Here's where the wonderfully intricate structure of our skin becomes its…er…Achilles' heel. Friction tugs at the skin, but the bone anchors it firmly in place. Guess what happens next. The skin starts to delaminate, that's what. The layers pull apart. Then fluid fills the gap, and a blister is born. Chafe and blisters have a few more things in common than friction, however. Both thrive on damp, heat, and pressure. Once again, it's active folks who suffer most: outdoor workers, paddlers, runners, hikers, and cyclists. Still, like I said earlier, it's easier to prevent blisters than it is to treat them. So let's begin by looking at ways of…

Stopping Blisters Cold

The stratum corneum of hard-working skin thickens into a protective callus. Though a callus that's grown too thick can cause trouble on its own, tender feet and soft hands invite blisters. (Not for nothing were novice cowboys called "tenderfeet.") The lesson for canoeists and kayakers is obvious. Build your paddling time gradually. The same goes for other sports. Walk (or run or cycle) a little further each day than the day before. Your calluses will grow apace, and when you reach the put-in for the start of your Big Trip your skin will be as hard as your muscles. Some paddlers (and many cyclists) try to hurry the process along by rubbing their feet and palms with alcohol or immersing them repeatedly in cold water. Unfortunately, it doesn't work. At least it doesn't work for me. Hikers — and all paddlers are hikers, at least some of the time — who dread blistered toes and heels sometimes soak new leather boots in water and then walk them dry, believing this will break them in. But such drastic treatment is usually neither necessary nor helpful. It's a relic of the days when military contractors skimped on material, cutting the uppers of marching shoes too small. Soaking the tight footwear gave the hapless infantryman a fighting chance of stretching his boots to size. Durability suffered, but that wasn't a primary consideration. Modern fabric and leather boots don't need this sort of kill-or-cure approach, however. If they're going to fit, they'll fit right out of the box. (If they don't, exchange them for a pair that does.) And what about the increasingly rare all-leather boot? As cyclists wedded to leather Brooks saddles have long known, there's just no substitute for a gradual break-in. You get a bonus, too: your feet get tougher at the same time. It's a win-win scenario.

A few things make the process less trying. Taping blister-prone areas can help — some old woodsmen sing the praises of adhesive-backed felts like moleskin — and liberal dustings of talcum powder can reduce friction. It also helps if your socks are free from lumps and seams. Keep them clean, too, and change out of wet socks as soon as possible. Gloves provide comparable protection for the hands. And if a hot spot develops, act immediately. Find the cause and correct it. If you haven't taped the area, now is the time to do so, before a blister forms.

But what if all your efforts come too late? It happens. Then it's…

Off to the Surgery

Before venturing further, however, please read and heed this timely WARNING: I'm not a doctor, and while I've drained blisters many times without untoward incident, you may be less lucky. Diabetics, in particular, must exercise extreme caution in caring for any injury to their feet. They should consult a doctor before attempting self-treatment. In fact, that's very good advice for everyone!

Always try to preserve the blister's "roof," the dome of skin across the top. If this roof tears away, healing will be delayed and the risk of infection increased. Happily, if you catch a blister early, before much fluid has collected, it may be enough to compress the dome, forcing the roof back into contact with the living skin beneath. A tight, nonadherent bandage should do the trick. On the other hand, if a blister is already swollen and painful, elementary field surgery may be the only way to preserve the roof more or less intact. Opening the blister and draining the accumulated fluid won't just lessen the pain, it will also permit the roof to collapse. With a little luck, and a well-placed pressure dressing, the roof may even reattach, greatly speeding the healing process.

This operation — and it is an operation, however minor it may seem — requires great care. The resulting opening can easily allow infectious organisms to gain a foothold in a favorable environment. To make sure the odds are in your favor, do your best to keep things clean. I scrub the blister and surrounding skin with an alcohol prep pad, and use the tip of a prepackaged sterile surgical blade from my medical kit to do the cutting. (On several occasions, I've even used a needle from my ditty bag or a sharp penknife, but since alcohol can't be relied upon to sterilize a blade, and flame sterilization may destroy the temper of good steel, I do not recommend this.) When the alcohol has dried, I carefully pierce the roof of the blister near its base, allowing the fluid to drain away. Once the drainage is complete — gentle pressure with a sterile gauze pad may be necessary here — I bandage with a snug, nonadherent dressing. I then take great pains to keep the area clean and dry.

And what if you've left it too late? What if the roof of the blister is torn away? All you can do then is clean the wound, protect it with a sterile, nonadherent dressing — Spenco Second Skin® is a favorite — and hope for the best. So far, I've been fortunate. I've never had an infected blister. If, however, despite all your care, any of the classic signs of infection appear (redness, swelling, pain, or fever), seek competent medical assistance immediately. In a remote area, of course, you may be on your own. That's when you'll be glad you sought your physician's advice before you left for the put-in. You'll also be thankful that you have a good medical handbook in your pack.

Where's the rub? Where the action is, of course. Chafe and blisters may only be skin deep, but they bedevil outdoor workers and recreational paddlers alike. And they can ruin a trip in a hurry. Don't let this happen. There's truth in the old saw. Prevention really is better than cure — and it's a lot simpler, as well!

Copyright 2006 by Verloren Hoop Productions. All rights reserved.









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