As the running and race scene gets into full swing this summer, many of those runners may experience changes to their toenails. These changes can include loosening and discoloration, and can be cause for concern to those not used to nail issues when running. Many runners experience black toenails which are known as subungual hematomas. This change is caused by pressure from small amounts of trauma to the toe when in shoes. The discoloration can occur when a runners toes repetitively hit in the ends of their running shoes. Bleeding can occur under the nail which causes the nail to slightly elevate, with the discoloration being the direct result of the blood that accumulates under the nail. This condition can often be painful, although some runners have no pain at all.
The injury to the nails are often caused by shoes that are too tight, too long, or fit poorly overall. Athletes in other sports can experience this condition as well, and shoes are a big part of the reason this condition occurs in other activities. Prevention can involve simply purchasing properly sized and properly fitting shoes, and also being certain to select the correct shoes for the specific sport one is participating in.
Treatment options for a black toenail with blood underneath can include releasing the pressure under the nail by drilling or otherwise creating a hole through the nail to drain the fluid underneath, or by removing the entire nail. Removal of the nail is typically done when the nail itself is disrupted, so that the doctor can inspect the skin underneath to make sure it is unharmed and to remove the loose nail that would otherwise tear off. The nail will eventually grow back. However, if the injury damaged the nail root cells enough, the growth of the nail could be permanently changed and the result could be a thick, curved, or unsightly nail when it grows back.
If you have had changes to your nails due to running, please do not hesitate to see us at Indiana Podiatry Group. There may be ways we can maximize prevention to keep your nails healthy, and we can treat injured toenails to help them heal quickly.