What is Runner’s Toenail? | Causes & How to Treat

What is Runner’s Toenail?

black and blue toenail with runner's toeWe’re all familiar with “no pain, no gain,” a phrase which, along with ballet-style leg warmers and VHS exercise tapes, gained popularity during the aerobics craze of the ‘80s. While many attribute “no pain, no gain” to Jane Fonda (who was fond of also shouting, “Feel the burn!”), the proverb dates to Benjamin Franklin. He no doubt meant that we must work hard to reap rewards. In the years since, however, it has come to be interpreted as follows: Suffering is necessary to achieve results.

Well, no, it is not. This attitude toward training is particularly pervasive in the running community, where injuries abound, whether we are talking marathon runners or weekend warriors out pounding the pavement. Among the most prevalent problem is known as Runner’s Toenail, or subungual hematoma, and it is just as unsexy as it sounds.

Runner’s toenail results from microtraumas to the big toes (and in some cases the second toes). A microtrauma occurs every time your foot hits the ground, and the tips of your toes hit the front of your sneaker. If that does not sound all that serious, think of it as walking around the house barefoot, accidentally tripping and banging your big toe on the coffee table leg…over and over and over again. Ouch, right?

While sneakers are obviously a lot softer than coffee table legs, just like the black and blue that might result from bumping into a table, the repetitive stress of repeatedly hitting your toe against the front of a running shoe can damage the blood vessels that feed the toenails. The result? The toenails turn black.

As unsightly as a black toenail may be, it is often painless, so those who feel they are born to run often just keep on keeping on. Yet, this is where it is important to note that the damage to blood vessels is cumulative. While a discolored toenail might not seem like a big deal at first, ignore the problem, and painful complications often ensue. These can include infection, blood blisters, and even the loss of a toenail altogether. All of which will certainly slow you down.

Of course, a discolored toenail can also be the result of a fungal infection, or a side-effect of diseases like diabetes, issues with the heart and/or kidneys, anemia or even melanoma. But if you are otherwise healthy, a black toenail signals it is time to take a breath and examine the fit of your running shoes and your training regimen.

When it comes to proper fit, keeping your running shoes tightly tied will stabilize your feet and keep them from sliding forward while you stride. And it should go without saying: Keep your toenails short so the end of your toenail does not constantly hit the front of your shoe, and wear socks designed to cushion impact. Also, in this age of online shopping, it is a good idea to shop for running shoes the old-fashioned way: High-step it to a brick-and-mortar store that caters to athletes for a professional fitting.

Finally, to decrease the risk of injury, if your toenails hurt, you may need to review your overall running technique, from distance to mechanics. Local running groups abound, and other runners can help check out your stride. If your pain is mild, Ibuprofen may be the answer, but any swelling, redness, fever, pus or foul smells (we’re not talking sweaty feet here) means the best course of action is to stay a step ahead and consult a doctor about treatment options.

To be evaluated by one of our podiatrists, call 336-375-6990 or visit triadfoot.com to request an appointment. 

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