Treating Road Rash

The 2016 Olympic women’s and men’s road races were completed in Rio this past weekend.  It turned out to be a grueling race with several riders crashing on the descent of the final climb.

Assessing the Severity of Road Rash

Treating Road RashFalling onto the pavement at high speeds is obviously a traumatic experience for both professional and novice riders alike.  After ensuring there are no severe injuries or broken bones, the next thing to evaluate is the severity of skin damage or road rash.  The level of skin injury can be classified into three degrees.

  • First Degree – Only the outer layer of skin (epidermis) is affected.  The skin will appear red but typically will not require extensive treatment.
  • Second Degree – The outer and portions of the inner layer (dermis) are affected.  The skin will appear discolored and moist.  Medical attention is required if the bleeding won’t stop, if there is a deep cut that requires stitches, or if any debris remains deeply embedded within the skin.
  • Third Degree – This is the most severe and affects all layers of the skin.  The loss of skin reveals underlying fat and connective tissue.  This level of injury requires immediate medical attention and may require a skin graft to heal properly.

Cleaning Road Rash

Road rash should be cleaned as quickly and thoroughly as possible to prevent infection.  This can be accomplished with a large amount of water or with a saline wound wash under moderate pressure.  Mild antibacterial soap may be used, but avoid hydrogen peroxide or rubbing alcohol as they may harm the skin and delay the healing process.  Use a clean washcloth or gauze to gently remove any dirt or debris.  Do not scrub vigorously as this may further damage the skin.  Once the wound has been cleaned and dried, it needs to be properly dressed.  Many over the counter wound care products are available.

Dressing Road Rash with Ointment and Bandages

A traditional dressing is comprised of a thin layer of antibiotic ointment (Neosporin or Bacitracin) with a nonstick gauze pad (Telfa).  This may be applied and changed at least once a day for one week or until a scab forms.  To avoid scarring, avoid prematurely removing any scabs.

Dressings that promote a moist environment improve the rate of healing and avoid the formation of a scab.  A semipermeable dressing (Tegaderm or Opsite) or a hydrocolloid dressing (DuoDerm) may be placed directly onto the wound without any ointment necessary.  These dressings may be changed every couple days depending on how much the wound drains.

Monitor Healing

During the healing process, inspect the wound daily.  Once the skin heals, use sunscreen and keep the area covered for at least a month.  New skin is sensitive to the sun and may permanently darken.

When your skin meets the road, a thin layer of clothing offers little protection and some damage to your skin is unavoidable.  Proper treatment of road rash will prevent infections and repair the skin allowing you to get back on the bike faster.  If your skin does not appear to be healing properly or if you have any concerns, consult your doctor.

When to Replace Running Shoes

When to Replace Running Shoes

You’ve finally found the perfect pair of running shoes.  They have a wonderful fit, and you feel as if you can run in them forever.  Unfortunately after many miles, they are starting to show some wear.   Is it time toss your current pair and replace running shoes?

How much have the shoes been used?

There are several things to consider when deciding if your athletic shoes need to be replaced.  First, how much have the shoes been used?  For runners, a simple guideline is to replace running shoes every 300-500 miles, but there are many factors than can shorten or extend the life of shoes.  For example, a petite runner will generally have less wear than a heavy runner.  The type of running surface can also make a difference as a soft trail will result in less wear than a concrete sidewalk.  For activities such as basketball or tennis, it depends on the frequency and intensity of play as well as the type of court surface.

Check for signs of wear

Next, check for signs of wear on the bottom of the shoe.  Place your shoes on a flat surface and examine them from behind.  Excessive wear of the sole may cause the shoes to tilt to one side.  If the heels are not perpendicular to the ground, the shoes need to be replaced.  For most heel-striking runners, a normal wear pattern is on the outside corner of the heel.  If one typically runs on a road or track with a slope, an asymmetric wear pattern may develop.  A significant asymmetry should be evaluated by a podiatrist as it may be caused by an issue that may be improved through the use of custom orthotics.

Cushioning and support will wear down

Finally, it is important to know that the cushioning and support of shoes will eventually wear down, even if the exterior appears to be in good condition.  Athletic shoes typically have a layer of compressible foam material which loses its shock absorptive capabilities with prolonged use.  Other factors can speed the degradation of the foam such as high heat or UV light from the sun.  Loss of cushioning can lead to injuries such as stress fractures or shin splints.  Another part of the shoe that can wear out is the portion which wraps around the top of the foot.  This supportive portion of the shoe can become over-stretched with use.  When this occurs, the foot has more room to move inside the shoe which can lead to calluses and injuries.

Replace running shoes frequently to reduce the risk of injuries

Good shoes are important in all activities as they provide support, stability, and shock absorption.  With continued wear, the loss of these protective functions can potentially lead to overuse injuries of the foot, ankle, and legs such as plantar fasciitis, stress fractures, ankle sprains, and shin splints.  The decision to replace your athletic shoes depends on several factors, but if your shoes appear worn, it is time for new shoes.

Hubert Lee, DPM, FACFAOM is a podiatrist at CarePlus Foot and Ankle Specialists in Bellevue, Washington.  If you have any questions or would like to schedule an appointment, please call (425) 455-0936 or visit bellevuefootdoctor.com.