Runner’s toe, medically known as a subungual hematoma, arises from repeated impact or pressure on the toenail. This common issue affects many runners and individuals engaged in high-impact activities. This article outlines effective strategies for healing runner’s toe and implementing measures to prevent its recurrence.
Understanding Runner’s Toe
Runner’s toe occurs when small blood vessels under the toenail rupture, leading to bleeding and discoloration (black, purple, or red). This pooling of blood creates pressure, causing significant discomfort.
Symptoms include a throbbing sensation, tenderness, and pain. Intense pressure can cause the toenail to lift from its bed or even detach completely over time.
Primary causes include repetitive microtrauma from toes striking athletic shoes. Shoes that are too small or large allow the foot to slide forward, increasing impact. Running long distances, especially downhill, and improper toenail trimming also contribute.
Immediate Relief Strategies
Upon recognizing runner’s toe, initial steps focus on managing pain and reducing swelling. Applying the principles of Rest, Ice, Compression, and Elevation (RICE) can provide immediate comfort. Rest the affected foot by avoiding activities that worsen pain.
Apply ice to the injured toe for 15-20 minutes to reduce swelling and throbbing. A light, non-restrictive bandage can minimize further swelling. Elevating the foot above heart level assists in draining fluid from the injured area.
Over-the-counter pain relievers, such as ibuprofen, can alleviate pain and inflammation. Protect the toe from further irritation by wearing open-toed shoes or shoes with a spacious toe box to prevent additional pressure.
Ongoing Healing and Recovery
As the initial pain subsides, ongoing care focuses on the natural healing process of the toenail. Keeping the affected area clean and dry helps prevent secondary infections. The discolored nail will gradually grow out, pushing the trapped blood forward as new, healthy nail forms underneath.
The old, discolored nail may eventually separate and detach as new nail grows. Carefully trim the old nail as it separates to prevent snagging. Monitor the toe for signs of infection:
Increased redness
Swelling
Warmth
Pus discharge
Severe pain
Gradually return to physical activity as the toe heals and pain diminishes. Rushing back into high-impact activities can delay recovery. During this period, continue wearing properly fitting shoes with ample toe space to avoid undue pressure on the healing nail.
Preventing Recurrence
Preventing runner’s toe involves addressing underlying causes through footwear and training habits. Select running shoes with a proper fit and adequate toe box space. Try on shoes later in the day when feet are slightly swollen to ensure enough room.
Employing specific lacing techniques can also help secure the foot within the shoe, preventing it from sliding forward and impacting the toe box. Trimming toenails straight across, rather than curving the edges, helps prevent ingrown nails and reduces the likelihood of the nail pressing against the shoe.
Adjust training routines by gradually increasing mileage and intensity, especially on downhill segments, to reduce cumulative stress. Choose moisture-wicking socks to reduce friction and prevent excessive moisture buildup.
When to Consult a Professional
While many cases resolve with self-care, seek professional medical evaluation for certain signs. Consult a doctor if experiencing severe or increasing pain. Signs of infection warrant immediate consultation:
Spreading redness
Warmth
Pus
Fever
Other reasons to see a doctor include persistent numbness, suspected fracture, or inability to bear weight comfortably. If the nail does not improve or falls off without new growth, a professional can assess it. Podiatrists or sports medicine doctors can diagnose and treat these conditions.