If you ask a non-runner to name the most common running-related problems and injuries, they’ll probably say knee, ankle, or heel pain or possibly an overuse injury like plantar fasciitis.
Ask a seasoned runner the same question, however, and you’ll probably hear “black toenails.”
The podiatrists at Premier Foot and Ankle Center in Worcester and Webster, Massachusetts, know how quickly any foot problem—including black, loose, or missing toenails—can stop you in your tracks.
They offer a full scope of podiatry services, including preventive strategies for overcoming and avoiding common problems like activity-induced black toenails. Here’s what the experts at Premier Foot and Ankle Center want you to know.
If you’re an avid runner, toenail problems can be as much a part of your life as local 5K or marathon invitations and post-run stretching. Fellow runners may even view your first black toenail as an initiation into an exclusive club or a bona fide badge of respect.
It may feel great to know you’re putting in the miles, but a black toenail can be irritating or problematic, especially if it loosens or falls off. So, what causes this common runner’s issue?
Simply put, a black or dark toenail is just a sign of bruising or blood on the nail bed beneath the nail itself. Also known as runner’s toe, this damage occurs when your toenail repeatedly comes into forceful contact with the front or side of your shoe.
While black toenails alone aren’t usually painful, continued trauma and pressure can lead to ongoing irritation and discomfort. It can also lead to the development of a blood blister that lifts and loosens the toenail, possibly causing it to fall off.
Black toenail injuries are especially common among distance runners, those who train at a high intensity, or those who increase their mileage rapidly.
But runners aren’t the only active people vulnerable — other sports associated with repetitive toenail stress include soccer, rock climbing, tennis, squash, and racquetball.
A bruised or bleeding toenail heals when no longer subjected to repetitive trauma. You may ease up on your training, change your running mechanics, take steps to protect your toes, or all the above.
Try these strategies to reduce your chances of developing a recurring problem:
Like most common foot problems, black toenails can often be prevented with the right shoe. When choosing running shoes, visit a reputable running store to get a professional fitting that considers your foot structure and running gait.
Your toes should have ample room inside the toe box, but not so much that your foot slides around inside the shoe.
When you keep your toenails short and trimmed, they’re far less likely to come in contact with any part of your shoe. Just be sure to trim your toenails straight across — avoid tapering the corners — so you don’t develop another common foot complaint: ingrown toenails.
Even if you’ve found the perfect running shoe, proper lacing is still an essential element of fit and functionality. Research shows different lacing techniques can significantly influence the pressure on your foot (and toes) as you run.
Proper lacing helps you maximize shoe comfort by allowing proper blood flow, supporting foot stability and flexibility, and preventing rubbing, tightness, and pressure.
Damp, sweaty feet are slippery, and that ease of motion can cause them to slide into the toe boxes of your running shoes with greater force than normal. To prevent this, opt for high-quality, moisture-wicking socks that absorb your sweat to help keep your feet firmly in place.
Made just for runners, silicone toe pads provide a cushion against the friction and repetitive motion of running. They stretch to fit any toe, covering it on all sides. In addition to preventing black toenails, silicone toe pads also help prevent blisters.
If your black toenail isn’t getting better or is even getting worse, book an appointment. A blood blister that lifts the nail plate can become painful and leave you prone to infection, two things that can derail your training sessions in no time.
Don’t attempt to pull off a lifted toenail yourself — doing so can cause the nail bed to tear and scar, leaving you with a deformed nail when the new one grows in. Your podiatrist can drain the blood, relieve your pain, and help preserve your nail.
If you have questions about runner’s toe, schedule an appointment at the Premier Foot and Ankle Center location near you.
