Running can be hard on the feet, particularly the toenails. But just because you love to run, it doesn’t mean you have to ruin your toenails.
Most runners know wearing running shoes that are too tight can bash the toes leading to discolored black and blue toenails. Many also know that wearing upsizing the running shoe can also cause problems because the foot can slide around inside the loose shoe, whack the toes in the toe box and still cause damage. Making sure you get the proper running shoe fit is important, but here are Doc On The Run’s Top 5 Tricks for maintaining healthy toenails in runners.
One common culprit for damaged toenails is the repeated scraping of the toenail as its catches on a seam at the end of the running shoe, just above the toe. As your leg swings forward, the toes bend upward. The nail edge can lightly scrape one of the seams or stitching areas inside the toe box. If it happens over and over, the toenail can become bruised (black and blue color) or it can get toenail fungus under the nail (yellow or white color).
Reach your hand inside the shoe and feel for any seems or edges in the toe box. If you feel any, you might want to try a different shoe with a smoother toe box.
This one is straight forward. The longer the toenail, the more likely the toenails are to rub on the inside of the shoe. The more rubbing, the more damage. Simply trimming the toenails short is one of the simplest defenses against toenail damage.
If I do marathon or Ironman triathlon without filing the leading edges of my second toenails smooth, I get sore, bruised toenails. But if I file them down smooth…no problems at all!
Feel as you rub your finger over the toenail. Slide your finger from the tip of the toe across the edge of the toenail as your hand moves toward the top of your foot. If you feel any friction at all the toenail is at risk of repeated rubbing and scraping inside the shoe.
File the edge at a 45 degree angle. Smooth the nail with an emory board or nail file. After filing, check the nail again. If you feel less friction, you will have a lower chance of repeatedly scraping the edge of the toenail in a way that can cause damage to the toenail. Do this the day before every long run or race.
Skin lubricants are often used by distance runners to prevent friction blisters. But skin lubricants like Body Glide can help the toes as well. Damaged runners toenails basically result from too much friction. That cumulative friction adds up to trauma that shows itself as bruising, loose toenails, or fungal infections.
I personally keep Body Glide in my transition bag during Ironman triathlon races. As soon as I get off the bike, I put Body Glide on my toenails, right before I slip on my running shoes and head out for the marathon.
If you put a tiny dab of Body Glide on your toenails, you will have less friction when you run. This one trick may actually be enough to decrease the ongoing damage to your toenails when you run.
Most of the runners I see in my practice have a tight Achilles tendon. If the Achilles tendon is tight, then the muscles on the front or the legs have to pull harder to keep you from tripping over your toes as your leg swings forward when you run.
The extensor tendons that pull the toes upward away from the ground can pull so hard that the toes end up bumping the inside of the shoe above the toes. Believe it or not, there is even a medical term for this. Doctors call this “extensor substitution.”
If you do calf stretches and make the Achilles tendon more pliable, it will take less force from the extensor tendons to dorsiflex your foot. This may help reduce the damage to your toenails on long runs.
It isn’t simply one factor that leads to damage in a runner’s toenails. The more of the possible causes you address, the more likely it will be that the problem resolves completely. And it is important to fix it.
Repeated trauma to the toenails can eventually lead to disfiguring the toenail “matrix,” often referred to as the “root of the toenail.” If the root of the nail gets damage, the toenail can become permanently thickened. The toenail gets thick, rough, and yellow. It then looks a lot like a fungal toenail, but it can’t be cured. “Runner’s Toenail” is a permanent condition.
Even if you don’t get irreversible damage to the root of the toenail, you could get a toenail fungus infection. Running shoes are the perfect incubators for toenail fungus. It is the same fungus that causes athlete’s foot. If you get the fungus in your running shoes and then repeatedly bump the toenails inside the shoe, the fungus can get under the toenail.
Toenail fungus causes the toenail to become yellow, thick, crumbly and ugly! And, it is extremely common. Toenail fungus is treatable, but you have to distinguish it from “Runner’s Toenail” caused by repeated trauma to the nails inside the shoes.
If you think you might have an early case of toenail fungus, time is of the essence! It is a lot easier to treat toenail fungus when the problem first starts. The longer the fungus grows, the more the fungus damages the toenails. The longer you wait, the harder is it to treat on your own.
Whether you have brushed nails or thick yellow toenails, the first step to healthier toenails is to make sure you decide whether you are bashing the toes or may have taken on a case of toenail fungus.
If you have thick yellow nails that may have fungus in them, start treating the fungus right away. If instead you seem to get bruising on the nail, try all of the tricks we just talked about and see if the toes don’t feel better, and look better, after your next long run.
Dr. Christopher Segler is a podiatrist and ankle surgeon who has won an award for his research on diagnosing subtle fractures involving the ankle that are often intially thought to be only ankle sprains. He believes that it is important to see the very best ankle sprain doctor in San Francisco that you can find. Fortunately, San Francisco has many of the best ankle sprain specialists in the United States practicing right here in the Bay Area. He offers house calls for those with ankle injuries who have a tough time getting to a podiatry office. You can reach him directly at (415) 308-0833.
But if you are still confused and think you need the help of an expert, a “Virtual Doctor Visit” is the solution. He has been “meeting” with runners all over the world and providing just that sort of clarity through online consultations for years. He can discuss your injury, get the answers you need and explain what you REALLY need to do to keep running and heal as fast as possible.
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