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Running Injuries Part 5: Runners Toe

The final entry in our five part series address a problem that is less painful than the other entries, but certainly no less common. Runners toe is a condition that affects runners, especially long distance runners. The condition causes the toenail to turn black, most often the big toe, but this problem can also affect other toenails as well, especially if the are longer than the big toe.


Runners toenail, also known as subungual hematoma, is a condition caused by repetitive microtrauma to the nail. This trauma causes bleeding underneath the nail plate and often leads to a seperation of the nail from the nail bed. This is why many runners may experience a full loss of the nail.


The toenail can become sensitive to the touch and even painful before the nail falls out. It is also common for the damaged tissue of the nail to become thicker or more brittle. If you do lose the toenail do not fret, it will grow back, but toenails grow much slower than fingernails, so be patient.


Runner’s toe is often the result of shoes that are too tight, are improperly laced, or do not a a large enough toe box. The toe box needs to be large enough for the toes to move freely, but the shoe should not be large enough to allow movement at the heel. Often runners with this problem will try several different brands of shoes before finding the best one for their feet.


If you do experience runners toe and the nail does fall off take extra caution to keep the exposed nail bed clean. You may want to bandage the toe to help prevent infection. If the pain from the toe persists or the toe appears red or inflamed you should contact a podiatrist immediately, as these are signs of a potential infection.

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