Runner’s toe, medically known as subungual hematoma, is a common foot condition affecting active individuals, particularly runners. It occurs when repetitive trauma leads to bleeding beneath the toenail, causing discoloration. While often not serious, it can be painful and is a frequent concern for those who engage in high-impact activities.
Recognizing Runner’s Toe and Its Causes
Identifying runner’s toe involves observing specific symptoms that develop over time due to repeated stress on the toenail. Common signs include pain or pressure under the nail, along with discoloration, which can appear as black, blue, dark red, or purple. In some instances, the toenail may also become loose, thicken, or even detach from the nail bed.
The primary mechanical cause of runner’s toe is repetitive impact or friction between the toenail and footwear. This often happens when toes repeatedly hit the front or sides of shoes, especially during activities like running, soccer, or tennis. Ill-fitting footwear is a significant contributor; shoes that are too short, too long, too narrow, or too wide can cause the foot to slide and the toes to jam against the shoe’s interior. Additionally, long downhill runs can exacerbate the problem by pushing the foot forward, increasing pressure on the toes.
Immediate Steps for Relief
Several at-home measures can provide immediate relief from runner’s toe and promote healing. Resting the affected foot by reducing high-impact activities allows the injured toenail time to recover. Applying ice to the toe can help reduce swelling and pain; it is advisable to wrap the ice pack in a cloth and apply for 15 to 20 minutes several times a day. Elevating the foot above heart level also assists in reducing swelling and pressure.
Over-the-counter pain relievers, such as ibuprofen, can manage pain or discomfort. Proper nail care is important; keeping toenails trimmed short and straight prevents them from hitting the shoe and minimizes pressure. If significant pressure or pain is caused by blood accumulation under the nail, a medical professional may need to drain the blood, a procedure called nail trephination. Avoid attempting to drain the blood yourself, as this can lead to infection or further injury.
Preventing Future Occurrences
Preventing runner’s toe involves proactive strategies focused on footwear, foot care, and running technique. Choosing properly fitting running shoes is important, ensuring there is about a thumb’s width of space between your longest toe and the end of the shoe. The shoe’s toe box should also be wide enough to allow toes to comfortably splay and wiggle without restriction. Shopping for shoes later in the day when feet are slightly swollen can help ensure a good fit.
Appropriate lacing techniques can secure the foot within the shoe, preventing it from sliding forward and impacting the toes. Wearing moisture-wicking socks can reduce friction by keeping feet dry and preventing them from shifting inside the shoe. Gradually increasing running mileage allows feet to adapt to increased stress and friction. For additional protection, silicone toe caps or protectors can cushion the toes and absorb impact.
When to Consult a Professional
While runner’s toe often resolves with home care, certain signs indicate professional medical attention is needed. Severe or persistent pain that does not improve with rest and home remedies warrants a visit to a podiatrist or sports medicine doctor. Signs of infection, such as increasing redness, warmth, swelling, or pus spreading from the toe, require immediate medical evaluation.
If the toenail appears severely damaged, is lifting significantly, or if you experience persistent numbness in the toe, professional assessment is advisable. A doctor can accurately diagnose the issue, rule out other conditions like fractures or fungal infections, and provide appropriate treatment such as safely draining accumulated blood. They can also offer guidance on proper nail care and footwear to prevent recurrence.