Sports Medicine

, Volume 41, Issue 9, pp 709–719 | Cite as

Skin Conditions in Figure Skaters, Ice-Hockey Players and Speed Skaters

Part I — Mechanical Dermatoses
  • Brook E. TlouganEmail author
  • Anthony J. Mancini
  • Jenny A. Mandell
  • David E. Cohen
  • Miguel R. Sanchez
Review Article


Figure skaters, ice-hockey players and speed skaters experience a range of dermatologic conditions and tissue-related injuries on account of mechanical trauma, infectious pathogens, inflammatory processes and environmental factors related to these competitive pursuits. Sports medicine practitioners, family physicians, dermatologists and coaches should be familiar with these skin conditions to ensure timely and accurate diagnosis and management of affected athletes. This review is Part I of a subsequent companion review and provides a comprehensive review of mechanical dermatoses experienced by ice-skating athletes, including skater’s nodules and its variants, pump bumps, piezogenic pedal papules, talon noir, skate/lace bite, friction bullae, corns and calluses, onychocryptosis, skater’s toe and skate blade-induced lacerations. These injuries result from friction, shear forces, chronic pressure and collisions with surfaces that occur when athletes endure repetitive jump landings, accelerated starts and stops and other manoeuvres during rigorous training and competition. Ill-fitting skates, improper lacing techniques and insufficient lubrication or protective padding of the foot and ankle often contribute to the development of skin conditions that result from these physical and mechanical stresses.

As we will explain, simple measures can frequently prevent the development of these conditions. The treatment of skater’s nodules involves reduction in chronic stimulation of the malleoli, and the use of keratolytics and intralesional steroid injections; if malleolar bursitis develops, bursa aspirations may be required. Pump bumps, which result from repetitive friction posteriorly, can be prevented by wearing skates that fit correctly at the heel. Piezogenic pedal papules may be treated conservatively by using heel cups, compressive stockings and by reducing prolonged standing. Talon noir usually resolves without intervention within several weeks. The treatment of skate bite is centred on reducing compression by the skate tongue of the extensor tendons of the anterior ankle, which can be accomplished by use of proper lacing techniques, increasing pliability of the skate tongue and using protective padding, such as Bunga Pads™. Anti-inflammatory medications and cold compresses can also help reduce inflammation. Friction bullae are best managed by careful lancing of painful blisters and application of petrolatum or protective dressings to accelerate healing; preventative measures include the use of well fitting skates, proper lacing techniques and moisture-wicking socks. Corns and calluses are similarly best prevented by the use of well fitted skates and orthotic devices. Symptomatic, debridement reduces the irritant effect of the thick epidermis, and can be accomplished by soaking the area in warm water followed by paring. Application of creams with high concentrations of urea or salicylic acid can also soften callosities. Cases of onychocryptosis benefit from warm soaks, antibiotic ointments and topical steroids to reduce inflammation, but sometimes chemical or surgical matricectomies are required. Preventative measures of both onychocryptosis and skater’s toe include cutting toenails straight across to allow for a more equal distribution of forces within the toe box. Finally, the prevention and treatment of lacerations, which constitute a potentially fatal type of mechanical injury, require special protective gear and acute surgical intervention with appropriate suturing. The subsequent companion review of skin conditions in ice skaters will discuss infectious, inflammatory and cold-induced dermatoses, with continued emphasis on clinical presentation, diagnosis, treatment and prevention.


Nail Plate Figure Skater Speed Skater Anterior Ankle Protective Padding 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.



The authors have received no funding and have no conflicts of interest.


  1. 1.
    Jaworski CA, Ballantine-Talmadge S. On thin ice: preparing and caring for the ice skater during competition. Curr Sports Med Rep 2008; 7 (3): 133–7PubMedGoogle Scholar
  2. 2.
    Bradley MA. Prevention and treatment of foot and ankle injuries in figure skaters. Curr Sports Med Rep 2006; 5: 258–61PubMedGoogle Scholar
  3. 3.
    Brown TD, Varney TE, Micheli LJ. Malleolar bursitis in figure skaters. Indications for operative and non operative treatment. Am J Sports Med 2000; 28 (1): 109–11PubMedGoogle Scholar
  4. 4.
    Lipetz J, Kruse R. Injuries and special concerns of female figure skaters. Clin Sports Med 2000; 19: 369–80PubMedCrossRefGoogle Scholar
  5. 5.
    Davis MW. Figure skater’s foot. Minn Med 1979; 62: 647–8PubMedGoogle Scholar
  6. 6.
    Porter EB, Young CC, Niedfeldt MW, et al. Sport-specific injuries and medical problems of figure skaters. Wis Med J 2007; 106 (6): 330–4Google Scholar
  7. 7.
    Fortin JD. Competitive figure skating injuries. Pain Phys 2003; 6: 313–8Google Scholar
  8. 8.
    Smith AD, Ludington R. Injuries in elite pair skaters and ice dancers. Am J Sports Med 1989; 17: 482–8PubMedCrossRefGoogle Scholar
  9. 9.
    Uchiyama M, Tsuboi R, Mitsuhashi Y. Athlete’s nodule. J Dermatol 2009; 36 (11): 608–11PubMedCrossRefGoogle Scholar
  10. 10.
    Omey ML, Micheli LJ. Foot and ankle problems in the young athlete. Med Sci Sports Exerc 1999; 31 (7): S470–86Google Scholar
  11. 11.
    Redbord KP, Adams BB. Piezogenic pedal papules in a marathon runner. Clin J Sport Med 2006; 16 (1): 81–3PubMedCrossRefGoogle Scholar
  12. 12.
    Doukas DJ, Holmes J, Leonard JA. A nonsurgical approach to painful piezogenic pedal papules. Cutis 2004; 73 (5): 339–40, 346PubMedGoogle Scholar
  13. 13.
    Mailler-Savage EA, Adams BB. Skin manifestations of running. J Am Acad Dermatol 2006; 55 (2): 290–301PubMedCrossRefGoogle Scholar
  14. 14.
    Urbina F, Leon L, Sudy E. Black heel, talon noir or calcaneal petechiae? Australas J Dermatol 2008; 49 (3): 148–51PubMedCrossRefGoogle Scholar
  15. 15.
    Zalaudek I, Argenziano G, Soyer HP, et al. Dermoscopy of subcorneal hematoma. Dermatol Surg 2004; 30 (9): 1229–32PubMedCrossRefGoogle Scholar
  16. 16.
    Janowicz RA. How to evaluate figure skating injuries. Podiatry Today 2006; 19 (4): 64–74Google Scholar
  17. 17.
    Bruening DA, Richards JG. The effects of articulated figure skates on jump landing forces. J Appl Biomech 2006; 22: 285–95PubMedGoogle Scholar
  18. 18.
    Bruening DA, Richards JG. Optimal ankle position for articulated boots. Sports Biomech 2005; 4 (2): 215–25PubMedCrossRefGoogle Scholar
  19. 19.
    Freeman DB. Corns and calluses resulting from mechanical hyperkeratosis. Am Fam Physician 2002; 65 (11): 2277–80PubMedGoogle Scholar
  20. 20.
    Yates B. Management of the sports patient. In: Turner W, Merriman L, editors. Clinical skills in treating the foot. Philadelphia (PA): Elsevier/Churchill Livingstone, 2005: 393–430CrossRefGoogle Scholar
  21. 21.
    Martinez-Nova A, Sanchez-Rodriguez R, Alonso-Pena D. A new onychocryptosis classification and treatment plan. J Am Podiatr Med Assoc 2007; 97 (5): 389–93PubMedGoogle Scholar
  22. 22.
    Heidelbaugh JJ, Lee H. Management of the ingrown toenail. Am Fam Physician 2009; 79 (4): 303–8PubMedGoogle Scholar
  23. 23.
    Mailler EA, Adams BB. The wear and tear of 26.2: dermatological injuries reported on marathon day. Br J Sports Med 2004; 38 (4): 498–501PubMedCrossRefGoogle Scholar
  24. 24.
    Dubravcic-Simunjak S, Pecina M, Kuipers H, et al. The incidence of injuries in elite junior figure skaters. Am J Sports Med 2003; 31 (4): 511–7PubMedGoogle Scholar
  25. 25.
    Dubravcic-Simunjak S, Kuipers H, Moran J, et al. Injuries in synchronized skating. Int J Sports Med 2006; 27 (6): 493–9PubMedCrossRefGoogle Scholar
  26. 26.
    Stuart MJ, Link AA, Smith AM, et al. Skate blade neck lacerations: a survey and case follow-up. Clin J Sport Med 2009; 19 (6): 494–7PubMedCrossRefGoogle Scholar
  27. 27.
    Quinn A, Lun V, McCall J, et al. Injuries in short track speed skating. Am J Sports Med 2003; 31 (4): 507–10PubMedGoogle Scholar
  28. 28.
    Eaglstein WH, Sullivan T. Cyanoacrylates for skin closure. Dermatol Clin 2005; 23 (2): 193–8PubMedGoogle Scholar

Copyright information

© Adis Data Information BV 2011

Authors and Affiliations

  • Brook E. Tlougan
    • 1
    Email author
  • Anthony J. Mancini
    • 2
    • 3
    • 4
  • Jenny A. Mandell
    • 5
  • David E. Cohen
    • 5
  • Miguel R. Sanchez
    • 5
    • 6
  1. 1.Department of DermatologyColumbia University Medical CenterNew YorkUSA
  2. 2.Department of Pediatrics, Feinberg School of MedicineNorthwestern UniversityChicagoUSA
  3. 3.Department of Dermatology, Feinberg School of MedicineNorthwestern UniversityChicagoUSA
  4. 4.Division of DermatologyChildren’s Memorial HospitalChicagoUSA
  5. 5.Ronald O. Perelman Department of Dermatology, School of MedicineNew York UniversityNew YorkUSA
  6. 6.Department of DermatologyBellevue Hospital CenterNew YorkUSA

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