Runner’s Toes

Runner’s feet often look like they have been at war; they are battered and bruised. I lost my big toenail in my debut marathon. What causes this and how can it be avoided?

Answer

You are not alone when it comes to this. It is a very common problem experienced by runners and I see it a lot in my practice. There are many different reasons for damaged toenails and all runners and running styles are different and need to be treated individually.

Some of the common causes include:

1. 
   
   incorrect running shoes or fitting of running shoes;
   
   
2. 
   
   incorrect socks;
   
   
3. 
   
   incorrect toenail cutting;
   
   
4. 
   
   structural abnormalities (e.g. clawing or hammer toes);
   
   
5. 
   
   incorrect fitting of orthotics;
   
   
6. 
   
   incorrect lacing.

The way to prevent losing a toenail is to see a podiatrist as soon as the nail turns black. A fine burr is used to drill a hole in the nail and release the pressure. This assists in decreasing pain and may prevent you from losing the toenail. Another good way of protecting the nail is to use silicone toecaps. They fit over the top of the toe and cushion the nail from any pressure caused by the shoe during running.

 Running socks should be seamless and provide the foot with enough cushioning. Make sure your socks are not too tight or too loose. Try wearing socks that are specifically designed for the right and left foot respectively. When buying running shoes, try them on later in the day or after running, as your feet will have swelled. This will allow you to size your shoes correctly and will ensure you have enough space in the front of the shoes. If you are sliding too much in your shoes while running, pressure will be placed on the nails. Adjust your lacing pattern and always remember that your shoes should be snug, not tight and never loose. 

 Also, ensure you cut your nails correctly before running a race. Professional help may be necessary if your nails have thickened and are too hard for you to cut yourself. Orthotics, innersole modifications and even the correct category of running shoe can provide your feet with all the support they need. It is important to have your feet and running style assessed by a podiatrist.