5 Tips for Runners to Prevent Black Toenails

Runner’s toe is a very real diagnosis. When your toe repeatedly slams into the box of your shoe, your nail experiences stress that can cause bleeding under the nail. Your toenail turns black as a result. 

Black toenails aren’t dangerous to your health, but they can be painful and ugly. 

At Foot and Ankle Care of Passaic in Lodi, New Jersey, our skilled podiatrist, Dr. Sean Rosenblum, offers a full scope of podiatry services, including preventive strategies for overcoming and avoiding common problems like black toenails from running.

Here’s what you can do to avoid developing black toenails and how to treat them if they do occur.

Why black toenails develop

Runners who put in long miles are more prone to developing a black toenail. These toenails can even loosen or fall off altogether. 

The blackness comes from 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 runners commonly develop black toenails, other active people who participate in sports like soccer, rock climbing, squash, tennis, and racquetball are also at risk. 

Should I worry about a black toenail?

Black toenails may or may not be painful. Ongoing trauma and pressure from your weekend-long run 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.

If your toenail is painful, it could cause you to adjust your gait slightly, which may affect performance and cause compensatory pain elsewhere in your body. 

Prevent toenail damage

Your black toenail heals when it no longer experiences trauma. If you have a bothersome toenail, it’s a good idea to ease up on your training, change your running mechanics, evaluate your shoe choice, and cross train with activities that cause less impact like cycling or swimming. 

Take these actions to minimize black toenails:

1. Choose the right shoe

If you’re a distance runner, you know how important the right shoes are to support your gait. You should make sure that your shoes are also the right size. If they’re slightly too tight, you’re more likely to develop a black toenail. 

Get fitted for shoes later in the day after your foot has had a chance to swell slightly to get a good fit. Your toes should have ample room inside the toe box, but not so much that your foot slides around inside the shoe.

2. Maintain trimmed toenails

Trim your toenails straight across and short so they are less likely to come in contact with any part of your shoe. Avoid tapering the corners so you don’t develop another common foot complaint: ingrown toenails.

3. Lace your shoes properly

Proper lacing is still an essential element of fit and functionality. It can prevent unwanted movement within your shoe that causes your toe to bang against the toe box. Lacing correctly can also enhance blood flow and help you maintain foot stability. 

Research shows different lacing techniques can significantly influence the pressure on your foot (and toes) as you run. 

4. Choose moisture-wicking socks 

Moisture-wicking socks prevent your foot from slipping and sliding within the shoe. Moist feet are more likely to slide forward 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. 

5. Consider silicone toe pads

Silicone toe pads provide a cushion against the friction and repetitive motion of running. They’re made just for runners and stretch to fit any toe, covering it on all sides. In addition to preventing black toenails, silicone toe pads also help prevent blisters.

Should I worry about a black toenail?

If your black toenail gets worse, causes more pain, or shows signs of infection, make an appointment at our office right away. 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. If you do have a blood blister, Dr. Rosenblum drains it safely to relieve your pain and help preserve your nail. 

If you’re a runner who has questions about your feet, gait, toenails, or ankles, contact us today to book an appointment. 

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