Running Rx: What to do when your workout wrecks your toenails

Runner stretching toes

(Photo: weheartit.com)


Except for changing the color of your polish, you probably take your toenails for granted. Unless you’ve wounded or lost some nails running or in some other fitness mishap with, say, a free-weight. Then you become extremely aware of your toenails.

But many serious runners assume that black, loose, or missing toenails are just part of the deal.

“I see people for this all the time,” says Suzanne Levine, M.D., a Park Avenue podiatrist who offers “foot facials” at Institute Beaute and author of My Feet Are Killing Me. “Long-distance running is the number one culprit, but I see it in skiers, tennis players, and ballroom dancers who wear high heels.” (She tended to the two I knocked off descending Kilimanjaro.)

What happens is that inflexible shoes rub off the toenail, making it separate from the nail bed. “It’s like a hammer repeatedly hitting the nail,” says Dr. Levine. Trauma is occurring to the nail matrix (the place the nail grows from). Eventually the nail plate pops off. (Sorry, TMI?)

Lost toenails grow back, of course, but it takes six months. (And if the injury has damaged the nail matrix, the new nail will be thicker.) Since injured nails often don’t come off immediately, walking around with bruised, loose nails that you know are going to fall off (hopefully not in yoga class) is not much fun. Neither is getting in infection, which you’re at risk of as well.

Here’s what Dr. Levine says to do about it.

1. Start with your shoes.
Make sure your shoes fit properly—you want a thumb’s width between the tip of the toe and the front of the shoe. Dr. Levine suggests wearing two pairs of socks when running.

2. Moisturize your toenails.
It’s for health, not vanity! Before you put your running shoes on, slather nails with a urea lotion. “It really moisturizes and penetrates more than anything else out there,” she says. Thought it’s not natural. She also recommends coconut oil to moisturize the nail, and a dilution of tea tree oil to fight fungus. And make sure you’re eating right, as nutritional deficiencies can weaken nails.


Some healthy treatments for injured toenails: swabbing with a dilution of tea tree oil in water and soaking in peppermint tea.

3. Consider your pedicures.
Another way to keep your toes in top form is to maintain a square-shaped toenail. “People and pedicurists tend to penetrate too much into the edges when trying to achieve a round nail,” she says.

4. Treat injured nails immediately.
When you take off your socks and see black and blue, “it’s important to do something about your injured toes immediately.” Clean the injured little piggies and start using an antibiotic cream regularly. Then soak your feet in peppermint tea to reduce the hematoma (black deoxygenated blood) under the nail.

5. Don’t pull the nail off.
Don’t yank it off before it’s ready. Don’t cut it or dig underneath it with an orange stick. Definitely don’t take a Tanzanian mountain guide’s offer to drill a hole in it with his Swiss Army knife to drain the blood. Poking around induces bacteria and is likely to cause a painful infection. (The hole isn’t the worst idea, but should be made by a doctor in a sterile environment.) If it’s really flapping around, you can carefully snip it off, but Dr. Levine prefers to err on the side of caution, keeping it taped and antibiotic-ed up until it’s really ready to come off. Soaking with Epsom salts is also a good idea.

6. Act when it’s off.
Switch from the antibiotic to a topical antifungal. As the new nail grows in, try to thin it out by using a buffer and a urea cream or the coconut oil. A podiatrist can also use a laser to thin the new nail. Skip the nail polish, and wear sandals if you can.

7. See a doctor.
If you’re in a lot of pain, the black-and-blue doesn’t go away, the nail oozes, the new nail looks funky, or you’re tempted to self-treat with pedicure tools, do your feet a favor, and go to a professional. —Ann Abel

For more information, visit www.institutebeaute.com


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4 Comments | ADD YOURS

  1. April 21st, 2014 at 11:20 am

    The third point about keeping a square toenail is extremely important.
    Great advice, thanks for sharing

  2. Jasmine
    May 12th, 2014 at 4:59 pm

    Hi there, I currently have this problem with my toenail and it was doing okay and looking like it’ll grow out just fine until I managed to jam it when opening the door. It’s now in pain and looks as if the nail pulled away just a bit from the nail bed.I want to do something about it immediately and I luckily have the antibiotic cream. I saw you wrote to soak in peppermint tea, I was wondering if there was a reason for that specfic? would green tea help as well? I currently have that in my possession. Thank you for your time and great article!

  3. August 2nd, 2014 at 12:54 am

    My black toenail went away after I started tying my laces as shown in this video. It locks the shoe around your ankle so your toes don’t jam against the front of the shoe when you run.

  4. September 5th, 2014 at 2:36 pm

    The best advice I ever got was to wear a shoe a half size larger than your dress shoe.

    I’ve been running competitively for 14 years now and have never lost a nail – and that’s after several Ironmans, marathons and dozens of shorter races.

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