Toenail Loose - Racing?

author : AMSSM

comments : 0

Toenail problem results from running; Should it prevent racing?

Question from member dramaqueenjs

"I ran my first half marathon a couple months ago and was rewarded with a very bruised toenail (my own doing, didn't lace up enough). It's now falling off-- about 90% has let go and it's only attached on one side. I have managed to protect it pretty well through my previous tris this season but I don't think it's going to make it to the next one. What do I do? It seems pretty tender under and I'm worried if it comes off that I won't be able to race."

Answer from Vijay Jotwani, MD
Member AMSSM

Thank you for your question about running and “bruised toenails.” Unfortunately, this is a pretty common condition that comes up in endurance athletes on their feet.

Repetitive compression of the nail can lead to a subungual hematoma or blood collection under the nail due to bleeding from the highly vascularized nailbed. This blood collection ends up in a tight place not normally used to fluid build up, so it often causes a throbbing discomfort that can be relieved by seeing a physician who may place holes in the nail to allow the blood to drain.

If the blood is not removed, then the nail will not be able to adhere to the nailbed (the skin below) and will become loose. Some or all of a nail will fall off and should be clipped away if needed. Despite the loss of part or an entire toenail, you can continue to run and there should be minimal discomfort.

Nails will grow back from the base of the toe forward but may take up to 6 months to grow back completely. The new nail may grow back slightly different than the original nail and an ingrowing nail may be painful along either edge. If this occurs a physician or podiatrist can remove the edge of the nail to relieve the issue. If you have toenail fungus (often indicated by nails that are dark and thickened) you may consider placing antifungal cream over the toe nightly as the nail grows out to keep toenail fungus from infecting the new nail.

In the future, wearing shoes that are the correct size to allow your toes to comfortably wiggle or wearing shoes with a wider toebox may help prevent this from happening again.

I hope this information is helpful. Good luck in your upcoming race.

Vijay Jotwani, MD
Primary Care Sports Medicine
Houston Methodist Orthopedics & Sports Medicine
Houston, TX

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date: September 29, 2016