Say Goodbye to Black Toenails: The Runner’s Guide to Prevention and Care

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Cross Training For Runners
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David Dack

Ever had that dreaded moment when you peel off your socks after a run and discover a black toenail lurking beneath? Yeah, we’ve all been there.

I recently had a 12-mile run that left me with a painful blister on my big toe because I forgot to clip my toenails the night before. Ouch! But hey, you can learn from my mistake.

In today’s article, I’m here to spill the beans on black toenails from running—what they are, why they happen, and how to deal with them. I’ll cover everything from prevention to treatment and when it’s time to call in the experts.

So, if you’re tired of those pesky black toenails, lace up your shoes, and let’s dive in!

Black Toenails From Running Explained

A black toenail, often referred to as a runner’s toenail, is essentially a bruise or blood blister that forms beneath the toenail. This condition occurs when the soft tissues surrounding and beneath the toenail become discolored, typically turning blue or black. This discoloration is the result of various factors, including trauma, repetitive stress, or injury to the toe, which commonly happens during running.

The root cause of this discoloration is a small bleed underneath the toenail, medically termed a subungual hematoma. While running with a black toenail can be uncomfortable and unsightly, it can also lead to more serious issues if left untreated.

Neglected black toenails have the potential to become infected. This risk arises from the warm, moist environment inside running shoes, which creates an ideal breeding ground for bacteria. Consequently, it’s crucial to address black toenails promptly to prevent pain, infection, and complications.

The Injury Process

The occurrence of black toenails in runners is linked to continuous trauma, which can lead to blistering, bruising, or bleeding beneath the toenail. This trauma typically arises from either the toe being cramped inside the shoe’s front end or the top of the toe repeatedly striking the nail.

Initially, you may notice your toes turning blue or black due to this trauma. Over time, if the condition worsens or is left unattended, the affected toenail may eventually fall off. It’s important to address this issue early to prevent further complications.

In addition to trauma, runners may develop blood blisters beneath the toenail, causing it to lift. In some cases, the nail may even detach, which is a common running injury, especially among long-distance runners. Neglecting the pain and ignoring a bruised toenail can result in the blood blister becoming infected, leading to increased discomfort and pain.

This is a situation you’ll want to avoid.

The Main Culprit – Tight Running Shoes

If you’ve experienced the distress of losing a toenail due to running, the culprit might very well be your running shoes. Specifically, tight or ill-fitting shoes are often to blame for this issue.

When your shoes are too narrow, or the toe box (the front part of the shoe) doesn’t align with the shape of your foot, problems arise. In this scenario, the top of your toenail repeatedly collides with the end of the shoe, creating a constant impact. The absence of sufficient space between the shoe’s top and your toes is a key factor in this repetitive trauma.

The Symptoms of Black Toenails While Running

When dealing with black toenails from running, you might notice several symptoms:

  • Discoloration: Initially, your toenail may take on a dark green or black hue. This discoloration is typically caused by the presence of blood due to bruised or broken blood vessels beneath the nail.
  • Pain: Applying pressure to the affected toenail can be painful. The sensitivity is often a result of the trauma and blood accumulation beneath the nail.

Likely Risk Factors for Runners:

Several factors can increase a runner’s risk of developing black toenails:

  • Ill-fitting or Worn-out Running Shoes: Shoes that are too tight or no longer provide adequate support can contribute to toenail issues.
  • High Weekly Mileage: Running long distances, particularly over 40 miles per week, can increase the risk of toenail problems.
  • Running on Hard Surfaces: Frequent running on unforgiving surfaces can lead to more foot and toenail stress.
  • Age: Older runners may be more susceptible to toenail issues.
  • A History of Running Injury: If you’ve previously experienced running-related injuries, you may be at a higher risk of developing black toenails.

What’s the outlook For Runners With Black Toenails?

For runners dealing with black toenails, the outlook is generally positive, and most individuals don’t experience chronic complications. Recovery is possible if you take appropriate measures.

Here’s what you can do:

  • Change Your Running Shoes: Ensure your running shoes fit properly and provide enough space in the toe box to prevent further trauma to your toenails.
  • Decrease Weekly Mileage: Reducing your weekly running mileage can help alleviate stress on your toenails, allowing them to heal.
  • Improve Your Running Form: Focusing on your running form can reduce the likelihood of toenail trauma. Ensuring your feet strike the ground correctly and that your shoes fit well is crucial.
  • Use the Right Socks: Proper running socks can help reduce friction and moisture, which can contribute to toenail issues.

How to Treat Runners Toe

In mild cases of a black toenail, medical treatment is usually not necessary, as it depends on the underlying cause.

Here’s how to approach it:

  • Mild Cases: If you have a mild case of a black toenail, there’s often no need to visit a doctor. You can manage it at home. Rest the affected toe(s) for a few days and keep them clean and dry.
  • Pain Management: If the pain becomes too uncomfortable, consider visiting a podiatrist. They can perform a procedure called nail trephination, which involves puncturing the affected toenail to drain excess fluid and relieve pressure.
  • Watch for Infection: Keep a close eye on your toenail. If you notice any signs of infection, such as redness or increased pain, it’s essential to seek medical attention promptly.

Home Treatment for Black Toenails

If you’re experiencing significant pain from a black toenail and are unable to see a doctor immediately, you can consider releasing the pressure yourself, although it’s essential to exercise caution. Please note that it’s always safer to have a certified physician perform this procedure.

Here’s how it can be done:

  • Gather Supplies: Get a sterilized paper clip or needle. You can sterilize it by holding it over a flame from a match or a lighter until it becomes red hot. Make sure it cools down slightly before proceeding.
  • Pierce the Blister: Carefully and gently pierce the blister on the black toenail with the sterilized paper clip or needle. Aim to puncture it at the edge of the toenail, where the contact foot pressure can push out any additional fluid.
  • Clean and Dress the Wound: After puncturing the blister, clean the area with an antiseptic solution to minimize the risk of infection. Apply a sterile dressing or bandage to protect the area.


Black Toenails From Running – The Conclusion

There you have it.

See, preventing runners toe is no rocket science.

All you have to do is pay a little attention to your feet and running shoes.

Do that, and you should be able to easily steer clear of most of these painful nuisances.

Now it’s your turn.

Do you have any time-tested black toenail prevention tips?

I’d love to hear from you in the comments section below.

In the meantime, thank you for reading my post.

Keep Running Strong

David D.

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