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Cross Training For Runners

Black Toenail From Running – How to Treat & Prevent Runners’ Toe

7 Mins read

Would you like to learn how to stop black toenails from running?

Then you have come to the right place.

Pursue running long enough, and you’ll come down with a runners toenail some point. No one is immune.

A few weeks ago, I did a 12-mile run and forgot to clip my toenails the night before.

Once I got home, I took my shoes and socks off and almost freaked out when I saw the blister on the big toe of my left foot. It was painful. And what made it more painful was that I could have avoided all the trouble by clipping my toenails the night before.

But I didn’t.

And I paid the price.

Luckily, you won’t have the pay the same price.

My painful experienced has forced me to gain more insight into the mechanics of black toenails. So, in today’s article, I will share with you a few things I learned over the past few weeks on how to prevent and manage black toenails from running.

More specifically, I’ll cover the following:

  • What is a black toenail?
  • What causes runners toe?
  • Why do I lose My Nail while running?
  • How common is the condition
  • The Symptoms of black toenails
  • How to treat black toenails from running
  • When to see a doctor
  • And so much more.

Sounds great?

Let’s get started.

Black Toenails From Running Explained

A black toenail is a bruise or blood blister under the toenail.

Also known as the runner’s toenail, the runner’s toe is a soft tissue injury where the area around and under the toenail begins to turn blue or black. This can occur due to getting stubbed, crushed, or placing a repeated load on the area (which is the case when you run).

A small bleed causes this change in color under the toenail, or what’s medically known as a subungual hematoma.

Running with a black toenail isn’t the most enjoyable experience, and if left untreated, the condition can become a real nightmare.

Unattended black toenails are ugly and painful and can also end up infected. This is because the warm and soggy environment inside the shoes is the ideal breeding ground for bacteria.

Black Toenails From Running – The Injury Process

Let’s start with identifying the injury process and what’s causing the runners toe.

This should help you better understand the condition and choose the right course of prevention and treatment.

Running-induced black toenails involve blistering, bruising, or bleeding beneath the nail from continuous trauma, either of the toe cramming into the shoe’s end or the top slamming against the nail.

Initially, your toes turn blue or black, and then then, over time, fall off.

What’s more?

In addition to trauma, a blood blister may appear under the toenail, which forces the tonsil upward. In some cases, the nail may fall off, a common running injury, especially among those running long-distance races.

Try to push through your pain and disregard the bruised toenail, then, the blood blister can turn into an infection, resulting in even more discomfort and pain. And you don’t want that.

The Main Culprit – Tight Running Shoes

Losing a toenail simply means that your shoes may be too narrow or the front of the shoes (the toe box) doesn’t match the shape of your foot. The top of the toenail slams against the shoe’s end—over and over again. This is because there’s no “breathing space” between the top of the shoes and your toes.

Black Toenails While Running –  The Symptoms

At the onset of the condition, the toenail appears to be of a dark, green, or back color that becomes visible under the nail. The black color of the nail is often the result of the presence of blood due to bruised or broken blood vessels. The toenail is also painful when pressure is applied.

The following were likely risk factors for runners

  • Ill-fitting or worn-out running shoes
  • High weekly mileage (over 40 miles)
  • Running on hard surfaces
  • Age
  • A history of running injury

What’s the outlook For Runners With Black Toenails?

Most runners don’t suffer from chronic complications from runners’ toenails.

In most cases, you can recover from a runner’s toenail if you:

  • Change your running shoes
  • Decrease your weekly mileage
  • Improve you form
  • Use the right socks

What’s more?

Remember that if your toenail falls off, it could take months to grow back. Also, the affected toe may remain tender, but you can resume training as soon as the pain fades.

runners toe

How to Treat Runners Toe

A black toenail may not require a doctor’s visit in mild cases since medical treatment depends on the initial cause.

In mild cases, a black toenail requires no doctor’s visit.  When it’s the case, it’s best to leave it alone as long as the pain is manageable. Rest the affected toe(s) for a few days and keep them clean and dry.

But if it’s too painful, you can visit your local podiatrist for a procedure known s nail trephination. During this procedure, the affected toenail is punctured to drain the extra fluid from the wound and relieve the pressure.

Also, get your nail checked by a healthcare professional if you notice any redness or infection or when the pain worsens.

Home Treatment for Black Toenails

If your toe hurts too much, especially 24 hours later, but you don’t want to visit a doctor, consider releasing the pressure yourself.

Remember that it’s always better to do this by a certified physician.

Additional resource – Running in the sun benefits

The Method

First, get your hand on a sterilized paper clip.

Begin by putting it over a flame of a match or light, then heating the top until it becomes red hot.

Once the needle is hot, slowly pierce the blister into the thin layer of skin at the edge of the toenail, where contact foot pressure will push out any additional fluid.

Next, clean the blister with an antiseptic and apply a sterile dressing to minimize infection risk.

How To Prevent Black Toenails While Running

The good news is, preventing black toenails while running is easy.

I mean, easy.

Here are the measures you should take.

Get the Right Shoes

Since improper footwear is the main cause of the condition, it pays well to invest in a proper pair of trainers.

This is especially true if you have a lousy history of black toenails while running.

As a rule, go for shoes that are a half size to full size bigger than your regular size. This way, you ensure plenty of room in the toe box.

There should be about a thumb’s length between your longest toe and the end of the shoe.

Just be careful. Too much space may cause your feet to glide and slide. That’s also a recipe for disaster.

What’s more?

Buy your shoes at the end of the day when the feet are most swollen.

The feet swell to almost a full shoe size over a day.

For more on how to pick proper running shoes, check the following posts:

Post 1

Post 2

Post 3

Avoid Foot Sliding

A useful measure to help stop—or at least limit—the toes from banging into the front of the shoe is by adequately lacing the shoes.

This helps keep the heel in the heel box instead of letting it glide forward on each foot strike, especially on the downhill.

Check out this helpful YouTube tutorial that shows you how to lace up your shoes to avoid black toenails.

Another measure to consider, especially if you notice that your feet slide around in your shoes, is to get a rubber or gel insole, which tends to help keep your trainers fit better and help your feet stay in place while running.

Keep Them Short

As previously stated, the problem behind a runners toe might stem from something as simple as your toenails being too long.

These can wreak havoc on your running feet, whether jogging for a few miles or running a marathon.

Long toenails can slam into the front of your shoe and cause bleeding beneath the nail and cut into the skin of adjacent toes. This can result in further pain and bleeding when running.

Make it a rule to ensure that your toenails are trimmed before you run.

This a no-brainer but something most runners scoff at—yours truly included.

To reduce infection risk, trim your nails with sanitized nail scissors or clippers, keeping them short and square—not curved—because it helps you equally distribute the impact on your toes.

Also, you can use a nail file to lightly file sharp edges.

The Right Socks

After finding the right shoes for the job, the next step in preventing black toenails is getting a good pair of running socks.

Moisture increases the risk of foot slippage, contributing to nail and toe injury.  Anything you can do to limit this forward slippage is undoubtedly helpful.

Additionally, activity, heat, and humidity make your feet swell. This, in turn, results in more contact with the shoes’ front and roof while pounding the pavement.

That’s why black toenails are more common during training in warm weather—when the feet swell.

To sidestep this, wear thin, lightweight, temperature-regulating socks, which absorb the moisture, instead of cotton or wool ones (that often retain moisture and become soggy).

Also, during the summertime, avoid wearing thick socks.

Instead, lighter and thinner material socks will wick moisture away.

Try Silicone Toe Pads

Designed for runners, silicone toe pads may help absorb some of the pressure from running by providing a cushion against the friction and constant motion of running.

What’s more?

Silicone pads may also prevent blisters and can stretch any toe, covering it on all sides.

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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