If you are a serious runner, or participate in any number of sports where you are either running, or constantly in a “stop-start” motion with your feet, then you may already be familiar with this condition.

Runner’s toe is a condition which causes destruction to one or more nails on your feet, and is the result of repetitive trauma to the toes. The constant jamming of your toes into the end of your athletic shoes is the culprit. Most people will blame running shoes that are too short as the problem, and although that is true, in many individuals it can be caused by other issues.

Symptoms

It can present itself in various ways. Most common of course, is a darkening of the nail, which represents bleeding underneath the nail. This is the result of the nail being lifted away from the nail bed as you run, and so the skin is torn, with the end result being some bleeding. In many of these cases, the nail may not be loose at all; and other than the bleeding underneath, the nail may otherwise appear normal.

As with any discolouration of a nail, it is important to be aware of some conditions that may present as bleeding underneath the nail, but may actually be some kind of growth instead. If the discolouration grows out over time, then more than likely it’s just dry blood. Alternatively, if the nail continues to grow, but the localised discolouration stays, then the nail bed needs to be examined by a doctor or podiatrist.

In more serious situations, the offending nail may actually become loose; so much in fact,  that the nail falls off, by simply pulling off your socks. Additionally, if the nail loosens up just a bit, you are a candidate for developing a fungal infection, which  untreated, may cause permanent disfiguration.  It may also spread to other healthy nails that are not affected by running. Probably the most serious potential problem in runner’s toe, is a bacterial infection. Let’s face it; the nail is loose, there is bleeding, feet get dirty, and before you know it, an infection develops.

Treatment

There are things that can be done both in treating the problem. If the nail has started to come loose, try to cut the nail as short as possible, to lessen the chance of it coming off accidently. If you must keep running before you can seek medical attention, taping down the nail with tape or a band aid, is also a good idea. Applying an antiseptic to the nail is a good precautionary treatment too.

Now, should the nail be slightly loose, with drainage coming from the area, while the toe appears more red around the nail than the nearby toes, it’s probably a sign of bacterial infection. Since every case is different, I will just take the position that if you suspect a bacterial infection, seek medical care. If you are diabetic, or if it is known that your circulation is compromised, then seeking medical attention is your only option.

It is worth noting that once a nail becomes loose to any extent, chances are you will eventually lose that nail. What happens, is that the new nail actually starts to grow under the existing nail, and at some point will loosen up the nail so much, it will just come off. In other words, you cannot salvage a nail once it starts loosening up.

Once a nail comes off either immediately, or over time, it is important to examine the nail bed, which is the skin underneath the nail. In most cases that I see, there is evidence of fungus on the nail bed. Left untreated, as the new nail grows out, there is a good chance it will become infected, becoming thick and discoloured, whether you’re running or not.

Prevention

The obvious advice given all over the internet, is to buy athletic shoes one half to one size longer than you normally wear, in a bid to reduce the jamming of the toes. I am not against a slightly longer shoe, but there is more to it than just that. Firstly, purchase your shoes at the end of the day, when your feet are most swollen.

The other consideration is the architecture of your toes. By that I mean the shape of your toes, and their relationship to each other. The nail(s) most affected in runner’s toe, are those on the longest toes. For some people, that will be the big toenail; for others, it may be the second, or third nails. If you have hammertoes, which change the angle at which your nails hit the end of the shoes, that too will impact the damage to the nails.

So the key in athletic shoe selection, is to ensure your longest toe is not hitting the end of it. Styles are different, and for some, it may require choosing a different brand. This speaks to a toe box that is either wider, or perhaps higher, to better accommodate the forefoot’s architecture.

Lastly, if you are prone to this problem, I would recommend you keep your nails cut short. Remember, too long nails, only increase the chances of nail  damage, by hitting the end of the athletic shoe.

Finally, if you are suffering from this problem, and are concerned, or there’s pain or possibility of infection, my best advice is to check your doctor or a podiatrist, who can evaluate your particular situation, and offer advice on ways to prevent a worsening of runner’s toe.

                                             Your feet mirror your general health . . . cherish them!