Background

Abrasions are injuries to the most superficial layers of the skin due to friction. This can happen from collisions between two players or an athlete contacting another object or surface, resulting in damage to the smallest blood vessels (capillaries) of the skin, creating an open wound where blood is lost. This can be painful because of the multiple small nerve endings that are exposed with abrasions. The most common areas of abrasions are the head, torso and then the lower limbs and are also known as road rash, turf burns and raspberries.

Symptoms

The most common symptoms are a sensation of pain, stinging and burning at the abrasion site. Active bleeding may be visible due to capillary injury. There may be swelling of the skin and slight warmth due to inflammation.

Sports Medicine Evaluation and Treatment

A sports medicine physician will review your symptoms and may ask about the type of sports activity performed, as well as the mechanism that caused the abrasion. He or she will also look at the area of the skin lesion.

Treatment of abrasion involves first cleaning the area with soap and water. If the abrasion is contaminated with foreign material, it may need to be irrigated under pressure to remove the particles. Cleansing is important to prevent infection. When the bleeding is under control, the wound is typically covered with a topical ointment that contains antibiotics and sometimes a local anesthetic. Covering the wound is important until healing is complete to prevent contamination. The ideal environment for wounds to heal is a moist healing environment. It is especially important that this type of environment is maintained as when abrasions dry out and scab, they are frequently re-injured by scab removal during sport participation. The normal healing time for abrasions is three weeks.

Return to Play

Abrasions seldom lead to absence from sport. If abrasions are actively bleeding, they should be covered prior to return to play. Once relief of pain and bleeding has stopped and the abrasion is covered, the athlete may return to participation. The affected areas should be monitored for infection. Abrasions in sports can be reduced by using protective measures, paddings, and appropriate clothing.

AMSSM Member Authors
Christina Giacomazzi, DO and Brian Liem, MD

References
1. Bannerman, Elana, and John Herbert Stevenson. 2017. “Dermatology Issues in Sports:” Current Sports Medicine Reports 16 (4): 219–20. https://doi.org/10.1249/JSR.0000000000000372.
2. Beam, Joel W., Bernadette Buckley, William R. Holcomb, and Mario Ciocca. 2016. “National Athletic Trainers’ Association Position Statement: Management of Acute Skin Trauma.” Journal of Athletic Training 51 (12): 1053–70. https://doi.org/10.4085/1062-6050-51.7.01.
3. Eijnde, Wilbert A.J. van den, Malou Peppelman, Edwin A.D. Lamers, Peter C.M. van de Kerkhof, and Piet E.J. van Erp. 2014. “Understanding the Acute Skin Injury Mechanism Caused by Player-Surface Contact During Soccer: A Survey and Systematic Review.” Orthopaedic Journal of Sports Medicine 2 (5): 232596711453348. https://doi.org/10.1177/2325967114533482.
4. Hoogenboom, Barbara J, and Danny Smith. n.d. “MANAGEMENT OF BLEEDING AND OPEN WOUNDS IN ATHLETES.”
5. Shrestha R, Krishan K, Kanchan T. Abrasion. [Updated 2020 Aug 8]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020 Jan-.Available from: https://www.ncbi.nlm.nih.gov/books/NBK554465/