Let’s start with this, black toenails from running are not required to be in the club and not a 100% certainty for all runners.
We often treat our injuries like war stories. Each runner has the toenail they’ve lost, the race they pushed through when they shouldn’t have and all of it makes it seem like running is really taking a toll on the body.
But of course we know that it doesn’t have to! The same goes for your toes.
Why do runners toenails turn black?
Running is a repetitive sport, which is exactly what leads to this toenail situation.
The foot is moving in your shoe with every single stride you take and the foot is producing tremendous force in to the ground.
- A too tight toebox means that with each step the shoe is compressing the top of the foot, which often leads not just to toe issues, but top of foot issues
- A too big shoe means with each step your foot moves forward and hits the front of the shoe
- Downhill running also presses the foot forward in the shoe (consider toecaps or padding)
Why do runners lose toenails?
Usually after this damage has occurred, the body starts to grow a new toenail.
Eventually it pushes off the dead toenail…or sometimes the dead toenail comes off before you have that new on. Again why the toe caps can become a good tool (see more below).
Tips to Prevent Losing a Toenail from Running
The best treatment is always prevention first.
How do you treat runner’s knee, you add in a lot more glute and hip strength. When it comes to your toes step 1 is to prevent the bruising or loss of the toenail.
- Shop for shoes at the end of the day when feet are at their largest
- Keep toenails cut short
- Stop wearing super thick socks that are creating too much pressure inside the shoe
- Increasing mileage too quickly can also cause an issue because of the pounding in your feet and the pressure required for push off
- Summer running may increase your toenail issues because of increased foot swelling
How do you treat a black toenail from running?
Once you have a black toenail from running, here’s what you need to do:
- Nothing. That’s right, step one is not to try to fix it, but leave the toe alone.
- Get shoes with more room in the toebox.
- Get thinner socks.
However, if you are experiencing pain and the result is that you can’t run we all know you’re going to do something.
So let’s make it a smart something.
Should you cut a black toenail?
NO. You will end pulling off live skin, creating an additional problem and an area now prone to infection from being constantly damp with sweat.
If the bruised toenail is painful and creating a lot of pressure, you can attempt to alleviate it much like a blister.
- Sterilize a needle
- Try to get the needle just under the toenail where you see a volume of fluid and create a small puncture allowing fluid to release
- Apply Neosporin or another anti-bacterial cream
- You can try to cover the nail with a Compeed for your toe, they tend to stay on better than a band-aid
- Once you are done running and in a clean place, try giving the area time to air out by not using any covering
If the area of pressure is right in the middle of the toenail and not near the edge, the treatment starts to feel a bit more intense. One of the most common recommendations is:
- heat a paperclip
- place the hot end on the nail and let it melt through the nail
- this creates a hole for the fluid to escape
- follow the above tips to prevent infection
If you are doing ANY of these during a race please, please follow a few rules:
- You have to keep cleaning the area and putting on anti-bacterial so it doesn’t become a bigger issue
- Don’t take pain relievers and run – they cause liver damage and have been shown in ultra runners to actually create leg fatigue. Try something like Turmeric pills instead to fight the pain and inflammation.
What about toe caps for runners?
Whether you have lost the toenail or are trying to prevent issues from a big downhill race, toe caps can be an option.
The big thing is to ensure you don’t create new problems by adding bulk to your shoe or rubbing on other toes creating pain or blisters.
- Pro-Tec is one of the most commonly recommended silicone gel toe caps, likely because it’s thin.
- You don’t want to wear them on all toes, so pick the ones you most often have issues with (usually a big toe for downhills or if you have a longer toe)
- Some folks like to wear these with the Injini toe socks for a little added comfort that they will stay firmly in place
- Definitely look at sizing – I haven’t tested these but I know sizing is one thing to consider when getting a good fit (i.e. do they have Big toe vs other toe options like Zen Toes).
Looking for more to treat your feet right?
- How to prevent running blisters (and what to do if they happen)
- Should you use running insoles?
- When to replace your running shoes?
Other ways to connect with Coach Amanda
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