The Treatment of Rips on Gymnast’s Hands

RIPS

Despite every action and strategy that you attempt to use to prevent rips, chances are that sometime in your gymnastic career you are going to have to deal with and care for rips on your hands. For the beginner gymnast, rips usually happen because the hands are not yet accustomed and toughened to work for very long on bars. More advanced gymnasts usually rip because of exceptionally long bar practices or they did not tend to the calluses on their hands.

You Are Wounded

There are a number steps you need to take in the care of rips, ease the pain and to speed your return to having healthy hands. Rips, by definition, involve torn skin, which is a wound to the hand or wrist and must be taken seriously and taken care of. Once you get a rip, the healing and maintenance process should begin immediately.

Above All, Prevent Infection

Prevention of infection is the first thing that must be considered when treating a rip. Protect against and watch for signs of infection throughout the healing process. Look for redness around the rip, pus, yellowish discharge or fever. If any of these symptoms occur, see your doctor as soon as possible.

Clean Up Your Hand and the Wound

First, you will want to clean up any blood from the wound and your hands. Cleaning your hands is the first step in protecting against the possibility of an infection, which can be a very serious problem. Currently, the latest research shows that a mild anti-bacterial soap and warm water is best for cleaning wounds. Neither Betadine nor hydrogen peroxide are recommended as they are too strong and can delay healing.

Trim Off Excess Skin

There is most often a flap of skin left over from rips that needs to be trimmed off carefully so that it does not leave any raised edges that later will catch on the bars and rip even further. The usual tools for trimming the skin flap off are either a pair of very small sharp scissors or fingernail clippers.

You Can Rip the Rip, If You Have the Touch

I personally have a knack and understanding of rips and the remaining skin flaps so that I generally rip the skin off the rip. If you do it quickly, it happens so quick that any pain is very brief and often not noticed at all by the gymnast. You have to carefully pull the hanging skin off by pulling it directly away from that point at which the skin is still attached and where the tear line needs to be. When you do it right, there is no need to do any additional trimming of excess skin because there is none. If you do it wrong, you can make the rip bigger, further hurt the gymnast and still leave skin that needs to be trimmed off.

What are You Doing Next?

The next step depends on whether you are returning to bars to continue working, going to work on another event or are going home. You will be doing different things in each one of those cases.

Going Back to Bars?

If you are going back to bars, you must protect the wound from infection and you will want to take away as much of the pain as possible. You may also want to pad the rip so it does not hurt so much that you can continue to work and you will want to treat the wound with a product that kills the pain, starts the healing process and helps prevent infection. A small balloon taped over the rip can reduce the friction generated between the bars and the tape causes the balloon to rub against its inner surfaces and prevents motion between the balloon and the rip.

Padding the Rip Under Grips

Depending on what you have available, you will want to use a pad that keeps the rip from being exposed to bacteria and dirt to prevent infection. You may want to put a second layer of soft padding to help pad it from pain. If you have access to it, you may want to put an “O” shaped moleskin pad (surrounding but not touching the rip area) over the healing and infection blocking pad. You will have to anchor the pad(s) with athletic tape so it does not move around or come off. You may also want to apply some medication that will ease pain and begin to heal the wound. This set-up of pads and tape works equally well on other non-bar and ring events and without grips.

DuoDERM Dressings

DuoDERM Dressings provide a barrier to contamination with infection rates up to five times lower than with other bandages. It can be left on for as long as seven days in a row before needing to be changed, but to ensure chalk did not introduce in contamination, gymnasts may still want to change them every day they are on bars. The gymnast can wash their hands, shower and still keep the dressings in place. With the Extra Thin DuoDERM CGF Spot (from Convatec) dressing, gymnasts can even swing bars with the bandage held in place by athletic tape or Elastikon elastic tape beneath their grips.

Lower DuoDERM Costs

DuoDERM hydrocolloid dressings are used by many collegiate and professional sports medicine staffs for athletes in a variety of sports, including gymnastics because it has infection rates of up to five times lower than with regular bandages. These dressings are not inexpensive. Some have suggested that the best way to reduce the cost is to have a physician write a prescription for the DuoDERM dressings. Have your physician put several refills on the prescription, so more DuoDERM dressings can be purchased in the future without having to go back to the doctor. Most medical insurance companies cover the use of DuoDERM dressings, so now the cost to the gymnast would only be the cost of a prescription co-pay amount.

Mind Over Matter

You may have no choice but to go back and continue to work bars hard, either because you have an upcoming meet and need the work or because your coach demands it. Pain is definitely going to be a factor, but pain is a mental construct – it is not real, it is in your mind. Distracting your mind from concentrating on it can ease or eliminate the pain. Focus on the upcoming meet, focus on another part of your body, like straight legs or toe point or anything else but your hands and the thought of pain and the pain can disappear. One way or another, if you have important bar work to do or have an upcoming meet you have to practice for, you will just have to suck it up and deal with the pain and risk ripping the blister open.

Many Options for Working Rip-Free Bar Skills and Equipment

If it is possible and strategically wise, you will want to do bar skills and equipment that minimize the chances of ripping the blister open. Doing skills like cast handstands and pirouettes or using equipment like strap bars, tramp bars or floor bars can minimize the chances of further ripping open the blister. There also is the option of going to other events, especially if bars is your best event (or, at least, not your weakest event) and working effectively for a meet without further aggravating your ripped hand.

Healing Rips Quickly

Because rips are painful and can interfere with your normal gymnastics and bar workouts and competitions, you will want to heal them as soon as possible. To do this, you want to keep them clean and free from infection, use medications that will speed the healing process and keep them uncovered an open to the air. There are any number of healing salves, creams and oils that you can use. Putting them on a fresh rip may hurt, but the sooner you use them, the sooner you heal.

Give Yourself an Instant Second Skin

Depending on what you have to do, like go to school, you may want to protect your rip even further. You can purchase Spenco 2nd Skin® or New-Skin® that comes in patch or liquid form and may be placed directly over the rip. This provides a protective layer over the rip, helps avoid the possibility of infection and helps heal the rip. New-Skin® liquid bandages dry quickly and form a tough protective cover that is antiseptic, flexible, waterproof and lets your skin breathe. Brush on liquic New-Skin® and it protects the wound by keeping out dirt and germs and provides protection against infection with a built-in antiseptic. Continue to use tea tree oil products which can still penetrate the skin around the rip and help speed the healing process.

Don’t Crack Your Rip

Once a rip has begun to heal and a new layer of skin has covered the rip, you need to keep the rip moist. If the rip is allowed to dry up too much, the skin over the rip will crack and you will continue to rip again and again in the same spot. Rubbing Chapstick or a similar product over a rip that is drying up too much can also prevent cracking.

Ice Away the Pain

Just before a competition you can help deaden the pain of a rip by icing it. You can put it on an ice pack on your rip, hold a piece of ice on it until it melts or soak the hand in ice water. This will cool down the inflammation and ease the pain. You do not want your hands “frozen” when you have to compete, so make sure you have time to get your hands back to normal temperature before you actually have to compete.

BLISTERS

Blister vs. Rips
There are blisters and there are rips and they are not the same. Blisters have the same cause as rips but the damage is just not as great yet and the outer of layer of skin is not yet torn. If you get a blister, it is likely to turn into a rip if you continue to work on bars, before it heals.

Tea Tree Oil

To treat blisters, you have to have a medication that can penetrate the skin that still covers the blister to help speed the healing process. Tea tree oil products can penetrate skin and heal quickly.

Treating a Blister on your Hands

First you want to clean the area around the blister with warm water and soap. Currently, soap and warm water is considered best for cleaning wounds.

Heal By Itself or Drain It

You have to decide whether you want to let the blister heal by itself or whether you want to drain it. As a general rule, if you are not going to do any more bars for awhile, then you should let it heal by itself. If you are going to continue doing bars the same day or continue doing bars the next day, you will likely want to drain it, because it will heal faster. The trade-off is that opening the blister increases the chance of infection.

Hot Shot

A common blister treatment used by U.S. Army medics is to drain the fluid from a blister and to re-inject the same amount of compound tincture of benzoin. This helps seal the space created by the blister, serves as a local antiseptic and prevents further loss of skin. Among soldiers, this treatment is known as a “hot shot” because of the extremely painful burning sensation that is experienced for a moment when the tincture of benzoin is applied.

Sterilize

If you decide to drain the blister, you need to first sterilize a needle with alcohol and/or boiling water. Don’t try to sterilize the needle with a match or fire because that can oxidize any coatings on the metal, leave black soot and that can cause an infection.

Pierce

Carefully insert the needle at the side and base of the blister and drain all the liquid. Do not remove any of the loose skin that covers a blister since this opens the wound up to more chances of infection and that skin gives protection to the new skin that will begin to grow underneath.

Cover and Pad

Cover the blistered area with a pad like RipGuardian, http://ripguardian.com/ which may provide pain relief, protect the rip from infection and give some padding protection. Tape the pad into place so it won’t slip or fall off when you start working bars again. You may also use moleskin coated with an adhesive backing and cut into an “O” shape so the fabric does not adhere to the blister directly. The thickness of the moleskin helps protects the blister and keep tape off the blister itself. You may even use both a RipGuardian pad and a moleskin “O” pad as a second layer to keep tape and contact off the blister.

Modify Bar Training?

If possible, you will want to do skills that minimize the chances of ripping the blister open. Doing skills like cast handstands and pirouettes or using equipment like strap bars, tramp bars or floor bars can minimize the chances of ripping open the blister. If you have important bar work to do or have an upcoming meet you have to practice for, you will just have to suck it up and deal with the pain and risk ripping the blister open.

Working Out on Non-Bar Events with a Blister

For the best and fastest healing possible, you want to allow the blister to heal in the open air as much as possible. When you work out on any non-bar or ring events that don’t run the risk of ripping open the blister, you can continue to work out by applying a “O” shaped piece of mole skin to the skin around the blister. Leaving it uncovered will allow it to heal, while the moleskin will help pad it and prevent further injury. Continue to keep the blister clean.

Healing Blisters at Home

Tea tree oil product which penetrate can heal through the skin. If you have opened and drained the blister, it is going to sting when you get the tea tree oil product in the wound, but that will also heal it more quickly. There are a number of other products that can help the healing process as well. Keep putting on healing medications as often as necessary. Continue to keep the area clean by frequent washing with soap and warm water to avoid infection. Do not to remove the skin that covering the blister. It offers natural protection for the raw skin underneath and the new skin that will be forming and helps block bacteria from entering the wound and potentially causing an infection.

Constantly Check for Signs of Infection

If a blister has excessive amounts of pus draining from it, starts to smell or the area around the blister becomes red, the blister is probably infected. See a doctor immediately. Infections are a serious medical condition. If a foot blister contains blood, then most probably the injury is more serious and hit some capillaries. You must exercise caution in draining potentially infected or infected blisters to keep the infection from spreading.

PARTIAL RIPS

Sometimes you get rips that are only partially torn open and still have skin covering part of the rip. These kind of rips cannot be torn off in the way like I like to do and can be awkward to cut off as well. While it is a judgement call and also depends on the shape of skin and the percentage of the skin that is torn and the flap that is still on, you can super glue the skin back together and then continue to treat it just like a blister. When an untorn flap of skin still covers at least a third of the rip, it is definitely a candidate for Super Glue.

Super Glue on a Rip?

Super glue works great on callus rips and tears. What you want to do is super glue that flap of ripped skin right back down where it was before. I first heard about super glue being used medically in battlefield trauma units during the Vietnam war. Doctors still use a slightly modified type of medical super glue in emergency rooms today. But you can use the super glue that is sold in stores everywhere for gluing down rips.

Super Glue Surgery

Carefully pull the flap up and put a few drops (two or three) of super glue right in the middle of the rip. Duh, yes this hurts, but not for long. Use enough to cover the whole rip and flap of skin, but not so much that it will gush out the sides. Before you actually glue down the flap of skin, make sure you hold your hand completely open with your fingers spread wide apart. Otherwise, when you spread your hand apart and extend your fingers you won’t tear the flap back open the very first time you actually use it to do something.

Gluing Your Own Finger to the Rip is Funny But You Won’t Laugh

Don’t use your finger as you run the risk of gluing your finger to the ripped flap. If you do, invite friends over so they can laugh at you, with the finger of one hand super glued to the flap of skin of the rip on the other. You will be a comic hit, but will end up having to tear off the whole flap of skin and almost certainly tearing open the rip even more and making it bigger and more painful. Use the head of a pin or even the pin on the super glue top to make sure that the skin flap is completely glued down flat. Keep your palm open for a minute or two until the super glue dries.

You Now Have A Blister, Not a Rip

You have essentially converted a rip into a blister and you can treat it exactly the same as you would a blister from this point on. Just like with calluses, you will have to make sure to keep the edges smoothed out or filed down if need be. The edges of the glued rip may peel up a little over the next few days or so. Treat this just like you have a blister and a callus, keep the edges smooth and they won’t catch on the bars and re-rip. New skin will eventually grown under the super glued flap and the flap will just wear off just like with a blister.

Heal At Night While You are Sleeping

Whether you have a rip or a blister, you want to make use of all the down time you have at night to heal your wound as well as during the day. Medicate your rip or blister every night before you go to bed. Some gymnasts use a glove or a bag over their hand so they don’t do anything gross during the night, like get ointment in their mouth or rub it all over their face, and so they don’t have to smell some of the less appealing smelling treatment ointments. You want to get rid of rips quickly, so keep healing ointment(s) on them day and night. I have never heard of any problems mixing ointment creams so use one or many, as you choose. I have never seen anything personally that heals faster than tea tree oil products, which can completely heal rips in two or three days.