Toenail Pain and Athletes

When people think of injuries that can sideline athletes, toenail problems do not often come to mind.  Unfortunately, that is exactly what occurs to many athletes from school-age to professionals.  Toenail pain can limit individual performance, and distract an athlete from concentrating on their position in team sports.  In some cases, athletes even have to be benched due to the pain.

Toenail pain can be caused by multiple different conditions.   The most common cause is from the good old fashioned ingrown toenail.  Ingrown toenails are very common, and most of you readers probably have one at this very minute.  All an ingrown toenail has to do with its shape- if it curls into the skin at a steeper angle than usual it is technically ingrown.  One is born with a nail this shape, or one develops it after damage occurs to the nail root cells growing the nail out.  The damage can be something as simple as getting the toe stepped on, or even subtle long term pressure damage from a tight shoe.  Most of the time, an ingrown toenail does not hurt.  However, once something irritates the skin next to the toenail, such as when one stubs the toe or is stepped on, or when one cuts back on the nail too far and nicks some skin, the resulting skin inflammation leads to pain with pressure on the nail as well as an infection.  The more one tries to 'dig this out' on their own, the worse the nail and skin get.

Another common cause of toenail pain includes pressure damage to the toenail that results in bleeding under the nail.  The so-called bruised toenail is in actuality a result of a direct smashing injury to the nail, either through stubbing the toe or having someone or something crush the toenail.  In its lightest form, this is simply a small amount of partial bruising due to the pressure of the toe in the shoe when running.  In more serious forms due to a crushing injury, the bruise forms underneath the entire nail and are severely painful due to the pressure of the liquid blood pushing up on the nail above.  Until the fluid is properly drained, this pressure can be very painful, and can even force the nail to lift off of the skin bed it sits over.  Sometimes immediate proper treatment is necessary in these cases as the bleeding could be caused by a cut in the skin bed surface under the nail from a spike of bone broken during the injury.  Since this bone is exposed through the skin (even if it is still technically under the nail), it is considered an open fracture and needs to be treated differently to prevent bone infection.

Another injury that can lead to toenail pain is from a direct force coming in from the front tip of the nail that lifts, or shears, the nail off of the skin bed surface.  This kind of injury often occurs when one is barefoot and kicks the edge of something flat and hard.  The nail either lifts off partially, or it completely rips off.  This can look terrible and bleed an awful mess, but it usually heals just fine.  If the nail is still partially attached, the periodic lifting of the loose portion of the nail and the strain on the attached portion can cause some pain to continue until either the nail adheres back on the skin bed or it falls/tears off.

One final common cause of toenail pain has to do with the shape of the toenail.   Toenails, particularly the big toenail, can be painful if the toenail is simply thickened.  Thick toenails can be the result of chronic pressure on the nail root cells, which causes damage and a permanent change in the nail growth pattern, leading to abnormally thick nail tissue.  Nail fungus infections can also deform the nail, making them thick and painful, as well as crumbly and loose.

The good news for athletes is that just about all causes of toenail pain can be easily addressed and quickly treated.  If you are an athlete (or anyone else for that matter) and find yourself experiencing toenail pain, don't wait until it benches you from your sport (or job).  Come see us today and we will do our best to make sure you walkout without pain.

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