Marathon runners often complain of runner’s toe. Many people choose to get tattoos, sometimes with a sense of pride, as if it is a right of passage. One of the most common running injuries is out there.
What is runner’s toe?
This condition is also called runner’s toenail or runner’s toe. It occurs when the area under and around the toenail starts to turn black. This can happen from getting crushed, hit, or putting repeated stress on the area.
The change in color is caused by a small bleed under the toenail, which is also known as a subungual hematoma.
We spoke to experts on the causes of runner’s toe, as well as how to prevent and treat black toenail from running.
Ready?
Let’s jump in!
What Is Runner’s Toe?
Dr. Jordan Duncan, the owner of Silverdale Sport & Spine, sees runner’s toe often.
As the runner grips their toes into the sock liner of the shoe, the soft tissues of the toes are being pushed back under the toenail, which causes the small blood vessels under the nail to be disrupted.
This can happen to anyone, but runners are especially prone. If you run continuously, you will eventually smash your feet against the toe boxes in your running shoes. The toe boxes are the part at the end of the shoes that cover and protect your toes.
Even though the skin on your feet is thicker than other parts of your body, if you keep hitting them, they will eventually get damaged.
Dr. Duncan sees many patients who are runners with hammer toes. He explains that hammer toes usually occur in the 2nd through 4th toes, where the end of the toe is bent downward. A hammer toe generally means that the person has been clenching their toe for an extended time.
A black toenail from running may not be the most ideal situation, but it is manageable as long as you are aware of what to look for and how to treat it.
Symptoms Of Runner’s Toe
People with runner’s toe – or runner’s toenail – can expect to experience:
- Sharp, throbbing pain
- Red, maroon, or black-purple discoloration under some or all of the nail
- Swelling or tenderness at the tip of the toe
While mostly harmless, runner’s toe can look pretty gruesome.
An accumulation of blood under the nail bed can cause it to protrude. In other cases, the nail will lift off the nail bed and separate from it. Nails can fall off or separate from the nail bed gradually or suddenly.
It typically takes a few weeks to a few months for this to happen. This wait can be lengthy, but the pain should go away within a few days.
5 Effective Ways To Prevent Runner’s Toe
1. Wear the right shoes
Many runners experience issues due to not investing in the right equipment. Your shoes are essential for the entire activity.
You always want to prioritize comfort over price when it comes to your shoes. Shoes made with cheaper materials will not last as long as shoes made with more expensive materials. In the long run, you will probably spend the same amount of money on shoes regardless of the initial cost.
Choose running shoes that will last.
In order to prevent runner’s toe, choose a size where you have enough room at the end so that your toes aren’t pressed against it. Choose a size that is large enough so that your foot does not slide around.
That may make it even easier to cause injury. That is, aim for about one thumb width of space between the tip of your toe and the toe box of the shoe.
2. Trim your toenails.
Cutting your nails short will ensure that your toes hit the toe box of your shoe first, rather than your nails. Shorter socks are less likely to reach any part of your shoes.
Be careful not to cut your toenails too short, or you may have another problem – an ingrown toenail. Cut your nails so that the skin around them doesn’t try to grow over them.
3. Lace your shoes properly
Although you may have the perfect running shoes, it is still important to lace them correctly in order to get the most out of them.
You might say that you have known how to tie your shoes since you were five years old.
For basic walking, you’re right. Running, especially distance running, comes with its own unique set of challenges that you need to be prepared for.
The way you lace your shoes can have a big impact on the pressure in your feet, according to studies. Before hitting the track or road, your laces need to:
- Allow proper blood flow
- Have room for flexibility
- Have enough tightness to prevent rubbing
- Avoid putting pressure on delicate areas
- Keep your heels steady – to prevent ankle sprains
The way you lace your shoes can affect how comfortable they are.
How do you do this? Think about the shape of your foot and how it feels inside your shoe. To change the tightness of different areas, cross the laces diagonally in some places and horizontally in others.
To secure the holes at the top of the shoe, create an extra loop at each hole and thread the lace through the loop once again.
4. Wear moisture-wicking socks
Damp toes can make it easier to slip and your feet could slide into the toe box with more force. Prevent sweaty feet and blisters by wearing high-quality socks that wick away sweat and keep your feet firmly in place.
There are socks that are specially designed for runners that have extra grip on the inside of the sock and more cushioning in the toes. Some have an extra layer of fabric to absorb more moisture.
5. Use toe protectors
Running can cause a lot of friction and wear and tear on your toes, so silicone toe caps serve as a barrier to protect your toes and add cushioning to help reduce the impact. These socks are designed to fit any toe and cover it from all sides. Band-Aids are a great way to protect your skin from friction and prevent blisters. You can customize the size of some shoes to perfectly fit your foot.
How To Diagnose And Treat A Big Toe Injury In Runners
The first thing you need to do when you have pain in your big toe that prevents you from running is to get a diagnosis. Big toe pain can be more difficult to diagnose because it can be caused by a variety of things.
- Hallux rigidus is a term for a form of degenerative arthritis of the big toe joint. As you might guess from the name, one of the defining characteristics is a persistently “rigid” or stiff big toe joint. Your range of motion will be limited, and you’ll likely find walking barefoot to be more painful than walking with shoes on. You might have some swelling, too, but you won’t have any bruising. Fortunately, it’s easy for a doctor to definitively diagnose hallux rigidus and evaluate its severity with a plain x-ray. The downside is that, because it’s a degenerative condition, treatment is mostly focused on reducing stress on the joint through orthotics or shoe modifications, plus anti-inflammatories to reduce swelling. In more advanced cases, surgery is sometimes needed to cut out the bone spurs that develop in the joint as the cartilage wears away.
- Hallux valgus is the medical term for a bunion, which is probably the easiest big toe injury to diagnose. If you have pain on the side of your big toe joint, and your big toe is angled inwards, you can almost assuredly chalk it up to having a bunion. Initially, if the angle at which your big toe is pointing inwards is not too bad, you can get by with modifying your running shoes to take pressure off the outside of your foot. Some runners just take a razor blade to the shoe upper and cut a slit to reduce pressure on the side of the big toe, but buying a shoe with a roomier toe box can also work.
- Turf toe is one of the most common causes of big toe pain in athletes. Though it happens more commonly in football and soccer players, it does affect runners, too. You can think of it as the big toe equivalent of an ankle sprain: hyperextension of the joint causes damage to the ligaments that surround the big toe, and the result is substantial swelling, bruising, and severe pain when you try to walk. The ligaments need time to heal, so treatment for turf toe involves icing, rest, and using an air-cast or a similar device to immobilize the joint while it heals. It is a good idea to see a doctor for this one, because many medical professionals recommend placing the big toe joint in a specific position while it’s immobilized, to ensure that the ligaments don’t stay hyperextended when they heal.
If you have turf toe, you can use a turf toe taping to reduce stress on the area. The taping prevents the big toe from hyperextending, which is a good precaution to take when you are beginning to exercise again.
What Is Sesamoiditis
Sesamoiditis is an inflammation of the sesamoid bones. The condition is characterized by pain that is felt directly over the ball of your foot. Pain is more directly associated with pressure on the ball of the foot, rather than with the movement of the big toe.
The pain can usually be reproduced by pushing directly on the ball of your foot with your thumb. If you have sesamoiditis, it will hurt more when you walk barefoot, especially on hard surfaces.
To treat sesamoiditis, you need to reduce the amount of stress on your foot. This will hopefully stop the pain from running. . If you’re experiencing pain in your foot, addingpadding or getting a custom orthotic with a divot to fit underneath the ball of your foot can help alleviate some of the discomfort.
Use this method sparingly as it will put more pressure on the rest of your foot. The only way to treat sesamoiditis is by resting and icing the affected area.
Stress Fracture In The Sesamoid
Sesamoiditis is a condition that results in pain in the ball of the foot. However, in some cases, this pain may not be due to sesamoiditis, but rather to a stress fracture in the sesamoid. The pain from a stress fracture is worse, and you might not be able to walk at all if you’re not wearing shoes. The most accurate way to diagnose a stress fracture is with an MRI, but some doctors will also look at plain x-rays to look for evidence.
. The text is saying that a common cause of false positives when diagnosing fractures is that some people have bipartite sesamoids, which means they have one or more sesamoid bones that are naturally parted in two. This can be mistaken for a fractured sesamoid.
. Sesamoid stress fractures have a high risk of poor healing, so you should wear a boot, cast, or modified orthotic for at least several weeks to ensure that it heals properly.
Flexor Hallucis Tendonitis
FHL is a condition in which the tendon that helps flex your big toe downward and helps you push off the ground when you run becomes inflamed. The plantar fascia is a ligament that connects the heel bone to the toes and can cause pain in the foot.
In some cases, it might even be mistaken for a different condition called plantar fasciitis. The pain associated with FHL tendonitis extends into the arch of your foot and is most severe when initiating ground contact.
Although FHL tendonitis is not common, it is even less common in the area of the tendon that goes over the big toe joint. This means that the injury can be fixed through stretching and strengthening exercises.
Cross Training While Injured And During Recovery
Aqua jogging is a type of deep water swimming that involves moving your legs in a way that is similar to actual running. Your feet do not make contact with the floor of the pool, making it a low-impact and safe exercise for people with various injuries. Since aqua jogging mirrors natural running form, it gives a workout to the neuromuscular system in addition to the aerobic benefits. This helps keep the muscles used in running active. The same can’t be said for biking and swimming. Aqua jogging is only possible in pools that are deep enough to prevent runners from touching the bottom. If you have the good fortune of being able to use a large pool, you should start with aqua jogging as your cross training method.
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