Runners And The Issue Of Toenail Loss

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If you’re an avid runner, you’re probably familiar with the issue of losing toenails. It might sound concerning or gross but it is a very real possibility that if you run or play high impact sports, you might end up saying good-bye to a few nails here and there.

black toenail

Why does this happen?

When runners push off the ground with a high level of force, they are at risk or pushing the tips of their toes into the front of their running shoes. If this happens on occasion, it probably won’t cause too much damage. But if this happens often, the cumulative effect of these micro-traumas can result in the formation of a hematoma in the toenail bed. A hematoma is essentially a bruise or a pooling of blood under the skin. When this happens in the nail bed, it can cause the nail to separate and, next thing you know, you’ve lost a nail.

Is nail loss avoidable?

There are things you can do to minimize the risk of losing toenails. The first thing to understand is that if your toes are constantly hitting the front of your shoes, you might need to size up. It is common for runners to use a running shoe that is half a size larger than their usual street shoes. This is typically ⅛ inch difference. It may seem small but it can be enough to make a difference and save some toenails.

Another strategy is to make sure the heel is locked into the shoe as secure as possible to reduce forward slide. Many people don’t realize this but the small secondary hole next to the top lace hole on the shoe can be used to lace the shoes in a way that helps to keep the heel in place.

Step 1:

Pass the shoelace back through the extra hole next to the top lacing hole on your shoes to create a loop.

lacing step 1

Step 2:

Cross The laces and feed them through the loops.

lacing step 2

Step 3:

Pull downward on the ends of the laces to tighten them and then tie as normal. Pulling upward may create extra length on the loops but pulling downward will create the heel lock we are looking for.

lacing step 3

Other things you can do include trying another shoe brand, soaking your toes in epsom salts, and keeping your toenails cut short. Different shoe brands will use different toe box shapes and a wider toe box may help alleviate some of the small injuries to your toes. Epsom salts may help the nail beds stay healthy. Keeping your toenails short will minimize the risk of them hitting the front of the shoe.

If you do lose a toenail, it is not a medical emergency. Typically toenails will grow back in about six months. If the nail bed feels painful or under pressure, a quick trip to the doctor to release release the pressure may be in order. In the end, it is a common experience for athletes and it can resolve itself but some upfront knowledge about shoe fit can go a long way.

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