How To Take Care Of Calluses - Courtesy of CrossFit LA

Taping Your Hands For Pull-ups - Courtesy of CrossFit LA

Wednesday, November 19, 2008

Hand Maintenance


Hand Rips
Causes, Treatments, and Prevention
CrossFit Journal Issue 68 April 2008 by Phil Savage

Rips of the skin and calluses on the hands are an annoying and painful part of any physical exercise that uses the hands intensively. Anyone can get them, and there’s no getting around that fact. You can get them from shoveling snow, playing baseball, throwing the javelin, climbing ropes, or swinging on bars. You can get them from doing just about anything involving the hands. Gymnasts have to deal with them all the time, as do weightlifters and, of course, people who do a high volume of kipping pull-ups.


Hand guards (grips)
There are several ways to prevent or at least minimize rips or tears on your hands. As a gymnastics coach, I encourage my athletes to wear hand guards or grips when they are training on the rings and high bar so they can train longer and harder without worrying whether their hands are going to tear. Gymnasts typically wear these leather hand grips (guards) when training and competing on the rings and the horizontal bar (high bar) or uneven bars. Grips for the rings have two finger holes and those for high bar have three; all types have a strip of leather that protects the working side of the hands, and some have dowels in them to extend the fingers’ reach and help the gymnast lock onto the bar or rings. You can order these grips online from most any gymnastics equipment and supply company. I personally use american-gymnast.com (http://www.american-gymnast.com/home/index.cfm)

Rip causes and treatment
There are basically two qualities that make your hands susceptible to ripping. Your chances increase a lot if you’ve got either a) soft hands with little or no callus build-up or b) too much callus buildup that makes bumps or ridges on the surface of your hands. You need the happy medium—deep but smooth and supple calluses that protect the hands but remain intact when working. Once you get a rip, the healing and maintenance process must begin immediately. If you happen to have fairly thin calluses and thus the ripped skin is fairly thin as well, I suggest that you carefully pull the hanging skin off by pulling on it directly away from the point at which the skin is still attached. If the skin is stubborn and not easily detaching, get some small nail clippers or small scissors and carefully cut as much of the skin as you can away from its point of contact. If the ripped skin is very thick (heavy callus), wait until you can use nail clippers or scissors to remove the loose skin.

When my gymnasts get a rip, I usually remove their dead skin myself almost right away (I’ve had 35 years of experience with this tricky situation). Then I have the athlete wash their hands with soap and water (yes, this stings) to remove any blood and other impurities and cleanse the area of possible bacteria. After washing, we apply an antibacterial ointment (Neosporin), which also acts like a lubricant to replace the lost natural skin oils that were washed away in the cleansing process.


As I always tell my athletes when they get ready to go home, remember to do three things before you go to bed that night:
1. Wash your hands with soap and water one more time.
2. Apply a generous amount of Neosporin to the fresh wound.
3. Cover the wound with a small bandage or tape. This will allow the Neosporin to do its job overnight to keep the area moist and prevent infection.

Oftentimes, if the hands are exceedingly well-callused and the rip is deep, I have my athletes also wear a glove on the hand (over the bandage and all).

When you wake up the next morning, go ahead and wash your hands. Next, again apply a generous amount of Neosporin. If you have vitamin E oil handy, use it instead of the Neosporin. I’ve found that vitamin E oil does a wonderful job in healing the wound quite fast. You can purchase vitamin E from any drugstore that sells vitamins. It comes in the form of gel capsules or just plain old oil. I prefer the gel capsules. Just break one capsule open, squeeze the oil out, and apply it to the ripped area. Do not cover the rip from this point forward. I have found that the sooner you expose the new skin to the open air, the more quickly it’ll heal and more quickly you can return to normal training.



Personally, I do not have my gymnasts use Superglue to keep the torn skin on the hand, though this is popular in some circles. If at all possible, I take the loose skin from the hand as soon as possible (preferably right after the blister formed) and follow the steps above for caring for a rip. I’ve had many of my athletes return the very next day and train hard with the tape on their hands even after a deep and bloody rip.

Prevention
There are several ways to keep the hands from developing blisters and tears. First, if your hands are soft, thin-skinned, or generally unconditioned, you must slowly and gradually build up your calluses to meet the demands of your exercise. Don’t overdo your hand-intensive exercise while you’re building up the thickness and toughness of the skin, or you’ll just keep ripping your hands and not have a chance to develop good healthy protective calluses.

Once you’ve developed a tough and thick skin on your hands, it’s important to maintain the quality of the skin by keeping the surface well groomed. This means simply that the overall thickness of the skin on the hand surface is consistent throughout and the surface is smooth. Otherwise, over time, the calluses will have a tendency to get thicker in certain areas of the hand and not in others. You will develop “ridges” of thick skin that will eventually lead to a tearing of the skin.

What I like my athletes to do to try to prevent the hands from ripping in the future is to actually shave the calluses down to a level that maintains a relatively thick yet consistent depth of skin throughout the hand. Ideally, your entire palm surface should be one thick callus with no bumps or ridges in any one
particular area. In order to do this, groom your hands always after a hot shower or bath (this allows the calluses to swell up).

While the calluses are still “swollen,” I take a double-edged razor and very carefully shave the dead callus bumps down a little at a time until the bumps are about even with the thickness of the rest of the hand. With my younger students, I simply ask them to get a callus stone (you can buy one at any drug store), and gently sand the callus down even with the rest of the skin. Remember, whenever you groom or shave your calluses, don’t overdo it, since you don’t want to go too deep into your skin. Always leave enough thick skin so to facilitate your workout the following day. The goal is to maintain an even and consistent thickness of hard skin throughout the entire palm.

Training with a rip
The accompanying photos show how I have my gymnasts tape their hands the day after they rip so they can keep training.
1. Tear off a 14-inch length of 1½-inch athletic tape.
2. Split the strip of tape lengthwise from one end to about the midpoint.
3. Place the tape on the hand with the solid half directly over the rip on the palm and with the start of the split right at the base of the finger. Press the tape down against the skin, starting from the inside of the wrist all the way to the split tape on the back of the hand and the top of the wrist. You can add a second layer of this tape grip on top of the first one for additional protection.
4. Use some more tape around the wrist to wrap the loose ends of the tape grip. This will “lock in” the tape grip covering the rip, and keep it from moving and coming off the hand. You only need to wrap around the wrist twice. The first time around is to hold the tape grip down, and the second time around, you can tuck in the loose extra ends of the tape grip back over the taped wrist and then tape over those extra ends. When the grip is complete, the hand should be able to open completely.



Resources
Additional online information on hand care, callus maintenance, and rip prevention:
http://board.crossfit.com/showthread.php?t=13254&page=1
http://drsquat.com/articles/rips.html
http://rifsblog.blogspot.com/2007/05/how-to-tape-your-hands.html
http://www.crossfiteastside.com/2006/02/hand-maintenance.html


Hand Maintenance
This portion is from CrossFit Virtuosity:
http://www.crossfitvirtuosity.com/

Calluses are areas of thickened skin caused by repeated friction and pressure. They form to protect the skin and the structures beneath it from injury or damage. While calluses are a layer of protection and a testament to hard work, excessive calluses can be troublesome and lead to injury. For example, when doing high repetitions of pull-ups the excess skin can grind between the bar and the hand and eventually tear away. So it is in our best interest to keep our calluses smooth and shaved down to avoid further complications. There are a few essentials you should have in your gym bag or in your medicine cabinet.

First is a
pumice stone. These moon rocks are great for keeping the calluses to a minimum. A few minutes with one of these every few days should keep things under control.

The second thing you want to get is a
callus shaver. This tool is a little more heavy duty and is good for especially tough skin. If you have some serious calluses or are the type that only takes care of your hands when things get really bad, then you'll want to invest in one of these.

The next thing you will want to invest in is some good
lotion. Personally, I hate the feel of lotion on my hands, so I put it on right before bed. You want to keep your hands moist because the frequent washing and use of chalk will dry them out and when dry skin cracks it is painful.

Here are some other recommendations for callus maintenance tools. The first is the
Ped Egg and the second is the Dremel Multipro. Obviously the Ped Egg is a good choice if you don't care what people think of you when they see a pink egg in your gym bag. The Dremel is awesome if you have money to burn or are a hobbyist of sorts and already need one for fine detail work.

This article examines first aid and care for ripped hands and torn calluses. If you train hard doing pullups, deadlifts, cleans and snatches, you will eventually tear open the calluses on your palm. These tips also can be used if you get tears from muscle ups on your wrists or if you open blisters on your feet from running or dancing. The trick is to know how to care for the rips before they put you out of commission so you can get back to training hard as soon as possible.The best defense is a good offense.
Wearing gloves is not the answer: learning how to hold a bar is. People tend to overgrip the bar: gripping so that the bar is firmly in the palm. However once there is weight on the bar, the bar will move more into the fingers. If you are holding tightly the bar will move and take the skin with it. Your best bet is to put the bar where it is going to go not where you think it should be.

When lifting or doing pullups, you are going to want to chalk up.
Chalk is essential to training. Chalk improves your grip on the bar. Gyms that do not let you use chalk are not places you want to frequent. However, if you are tied into your contract at your globo gym, then I highly recommend buying liquid chalk because it does not leave a dust trail. It goes on wet and dries in 30 seconds and keeps your hands dry for a long time. Also worth trying are products like Tite-Grip. It is more tacky than chalk and if you like that feel then it is a great investment.

Your treatment has several phases. Phase 1 is when you immediately rip your callus. Some people will be able to finish their workout with ripped hands and some will need to stop and address the problem immediately. That depends on what workout you are doing, the severity of the injury and your level of pain-tolerance. Let's say you've stopped temporarily to address the injury. Immediately pack the wound with chalk to stop the bleeding and prevent dirt from getting into the wound. You may want to quickly wrap your hand with tape to keep the tear from opening further.

Once the training is over, please clean off your equipment with some bleach. Most Crossfitters are not squeamish but nobody wants to use bloody equipment. Be considerate. If you are a coach, then you should be following up and cleaning off the equipment again after the athlete takes a first pass. Running a gym requires that you maintain and clean the equipment and wiping off blood and other bodily fluids is a first priority.
Back to the problem at hand (pun intended), Phase 2, cut off the flap of skin with a sterile blade or nail clippers. Clean the wound with soap and water. Now is when you want to get all of that chalk and dirt out. It will sting; close the door so nobody sees you crying.


If you are at your gym, see what is in the first aid kit. You will want to put some disinfectant on the wound. Apply some
liquid bandage to the wound to keep it covered on the way home. Holding on to a cold can of beer will help numb the pain.
Phase 3, once you are home you can remove the liquid bandage by applying a fresh coat and quickly wiping it off while it is still wet. Soak your hand in warm water saturated with salt for about 15 minutes. This is extremely painful but great for healing the wound. If you are really hardcore then just pour a fistful of salt into your hand and hold it for a while. Let the wound air dry for a couple of hours until it stops oozing and seeping.

Another great tip I received from my friend Marieka J. is to make a slurry out of ibuprofen and water. "Take Advil tablets and crush them into a powder. Use a drop or two of water and mix in some of the powder to form a paste. Apply to open wound. It's a cheap, but highly effective topical anesthetic. The powder can be kept in a small vial, so you always have it prepared and in your bag."

The Final Phase is the healing phase. When your wound is dry you might consider putting some more liquid bandage on it especially if you are going to use the hand for anything or you can also apply a light guaze wrap. In the evening, put some antibiotic ointment on the wound and cover your hand with a glove or a sock to keep the ointment from getting everywhere. Apply lotion, vaseline, chapstick or antibiotic ointment a couple of times a day to keep the area from drying out and cracking. You should be back to normal in about a week.

It is important to remember that torn calluses are an injury. Whenever you have an injury, you must give it time to heal. Altering your training to focus on lower body exercises is the preferred course of action. However, sometimes competition and personal factors makes it necessary for athletes to train or compete with an injured hand. What are you going to do to protect your hands and keep from aggravating the injury? Wear gloves? No way!

Tape grips. That's the answer. I learned how to make these from the guys at
CrossFit Marin and I think they are the cheapest and most effective way to train with torn calluses. We have all tried to simply wrap tape around our hands and had it bunch up and make a mess. This technique will keep your hands safe and allow you to train even with the gnarliest of torn calluses. You might even decide to use these when your hands are not injured just to protect them.
Making these tape grips is sort of like
origami so you will want to practice making them until you get it right. But once you do, you will be able to make them in a jiffy and also be able to keep a stockpile of tape grips in your gym bag in case of emergencies.

All you need is a roll of
1.5" Athletic Tape and a pair of scissors.

1. Take a long strip of tape about 15 or 16 inches long. It depends on the size of
your hands. Experiment until you find the correct length. Do not be stingy with the tape because if you make them too short, they will not work. Start long and eventually you will be able to eyeball the exact length.



2. Fold this tape strip length-wise leaving about an eighth of an inch of the sticky
side exposed. Having some of the sticky side exposed is necessary for the next step



3. Take your tape strip and fold it over on itself leaving a little pointed end. The
exposed sticky sides should hold it together.



4. Take another long strip of tape about 13 or 14 inches long. This should be
about 2 inches shorter than the first strip.

5. Fold this new strip over the previous strip. This extra strip acts as
reinforcement and keeps the original strip from splitting in half. Try to cover as much of the first strip as you can right up to the little pointy bit.



6. This is your tape grip. You will want to practice making several of these. Keep
the good ones in a zip-lock baggy in your gym bag. They will come in handy.


7. Using your scissors cut just enough of a hole in the top to put your finger
snuggly through the little pointy bit. Put the appropriate finger through the hole so that grip covers your torn callus. Usually placing the grip over your middle or ring finger works best. Depending on how bad your hand is, you might need to use two or more on the same hand.



8. The end of the grip should come down over the palm to your wrist. Take a
third strip of tape and secure the end of the grip to your wrist with a few wraps around the wrist. Do not wrap it so tight that it cuts off your circulation.


There you have it. Pretty simple really. I hope you find this helpful. Now go do some pull-ups!

6 comments:

Devan said...

The fact that no one commented on this great post yet is a shame.

Ripped a callus on each ring finger of each hand, for the first time a few months back. This post has helped me a lot.

Thank you!

Lauren C said...

This is very informational. I havnt had this problem since I bought one of those home gyms though.

climbonproducts said...

What an in-depth and well thought out article!

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malacca2u said...

my hands

Alieen Stewart said...

Informative Post on Hand Maintenance.You can tell a lot about a person by the look and feel of their hands.But if not taken care of properly they can make you look Bad.
Skin Care Clinic in Chandigarh

saranya magesh said...

My cousin recommended this blog and she was totally right keep up the fantastic work!








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