Grit Clinic – Feet matters

Q: From Louise Hughes

I know I shouldn’t be so chuffed about it but after a year of running 5 or 6 days a week I now feel I can truly call myself a runner and not feel like a fraud because …….. I’ve got a black big toenail!
I went to the nurse and she said it’s caused by running downhill ~ c’mon I live in Snowdinia, we’re surrounded by ’em!
I was wondering if you could give me a bit of advice about foot care please?It’s not because I’ve got ill-fitting trainers. I had my gait/footfall digitally analysed in a running shop (it was free!) and I’m lucky to have a ‘neutral’ footfall. I think it’s probably because I run almost every day and there are a lot of hills/mountains where I live. I know that a daily run is probably overdoing it but I’m hooked! Have to report no other injuries though. I always warm up, cool down and stretch apres running and my runs during the week are only 3 or 4 miles with a 9 or 10 mile run at the weekends. Happy days!

A: Almost everyone who runs will at some stage get a black toenail. I currently have two and I consider them both to be badges of honour acquired during training for the Bristol half marathon.  Getting your first black toenail is a sign that you have arrived in the ‘running club’ and your training has gone into a new dimension. While most runners blame a shoe that is too small, this is often not the primary cause. Certainly toe pressure from the shoe can make the toe hurt, but pressure from underneath actually produces more black nails.

If a toe is under pressure from the shoe or a sock that is too tight or too thick, the sustained pressure from running produces a friction between the toenail and the tissue surrounding it. When the tissue gets damaged, fluid accumulates. TIP: check that your socks are not too tight or too thick.  Looser is better.   The black colour is the result of broken blood capillaries and the extra fluid accumulates beneath the nail.  When the pressure gets too great, the existing toenail will be separated from the fresh nail beneath. Even if it takes several months, (6 in my case and still counting), the blackened outer nail will drop off, revealing a fresh nail beneath. Sometimes the pressure of the fluid will warp the new nail, but it will get smoother as it grows out (with any luck).

No doubt the primary cause of your blackened nail is the action of the foot coming forward thousands of times during every run which is almost certainly aggravated by your running downhill. Each time your foot swings forward, a little extra blood is pushed into the toe region due to the force of the foot coming forward. TIP: Increase your distance regularly and VERY gradually, giving your toes the chance to adjust to each new maximum distance.  And go slow downhill.

Hot weather also increases your chances of getting a black nail. In the warmer weather your feet swell more. Because there is more pressure from the swollen foot, and more fluid, there are more black nails generated during the summer months which may explain the appearance of your’s now during our Indian Summer of sorts.

You’ll reduce your chances of another black nail if you ensure that you have enough room in your toe area when you fit your shoes. At least half an inch is needed.  If this black toenail is the first of many you may need more room for those toes. TIP: When you add more room at the end, ensure that the arch of the shoe matches up with your arch. Also, run in the shoe before you buy it to make sure that your foot doesn’t slide forward as you are running which will only exacerbate the problem.  Get advise from a specialist running shop here and try out all prospective new trainers under supervision.

However, the best thing to do when it comes to black toenails is NOTHING. About 80 percent of the black toe problems are best treated by ignoring them and painting over the offending nail in bright red nail polish so you can still wear summer sandals and flip flops without putting people off their food. The damaged part of the nail is gradually pushed out, and the foot slowly returns to normal. If at any point you see the redness associated with infection, see a proper doctor and indeed if it is causing you real pain.

The Grit Doctor says:

Black toenails are evidence of your commitment to running and a sign that your relationship with your inner bitch is scaling new heights *Mount Grit*


2 Responses to “Grit Clinic – Feet matters”

  1. Bonnie Sweet September 17, 2012 at 4:22 pm #

    Search runners world website useful shoe tying advice on how to tie shoes to help prevent and heal black toenails. Good luck.

  2. Sarah Clarke September 18, 2012 at 2:03 pm #

    or try barefoot running?

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