Bleeding under the toenail is a common runners’ complaint. The good news is that the blood under the nail will reabsorb, and so you have not been condemned to black toe nails for life.
Most runners do not experience pain on the toe. However, the leaked blood can place pressure between the nail and nail bed. In such a case a doctor or podiatrist may elect to drill a small hole into the nail to relieve the pressure.
There are times that the nail falls off. Do not be too alarmed, the nail will grow back.
- Make sure that you do not buy a running shoe that is too small. We try for a baby finger’s width between the longest toe and the rubber lip that curls up at the end of the shoe.
- Trim your toe nails regularly. A long nail can rub against the end of the shoe and cause bleeding.
Now for the bad news.
With all reasonable precautions taken, you might still get blackened toe nails as you go into higher mileage training. We have witnessed runners who in desperation have bought shoes a few sizes too big and yet have still got black toe nails. An overly large shoe can allow the foot to slip forward, causing more pressure to be placed on the nail.
The latest research suggests that the nail does not blacken from being scraped against the end the shoe, but rather as you push off you push off against the toes. As you push off from the toes there is an equal and opposite force pressing up through the toe into the toenail. This done often enough increases the chance of the toenail loosening, causing a haematoma to form under the nail.
Runners with diabetes are urged to exercise extra caution with anything that goes wrong with the foot, and to see their podiatrist or doctor if problems arise.
Remember, black toenails are a small price to pay for the privilege of being able to run long distances.