Downhill Running, Tight Shoes Can Injure Toenails

by Stephanie Oakes

Question:
I'm a longtime runner and have suffered few injuries. However, I repeatedly get black toenails from my shoes. Is it the brand or my feet?

-Kathleen Fitzpatrick, Provo, Utah

Answer:
Many runners get black toenails by wearing shoes that are too small. I had the same problem two years ago; in fact, I spent the entire summer painting my toenails bright red to cover them up. But it can also be caused by spending a lot of time training on downhill courses.

When your shoes are too small or you run downhill, your nails (particularly on your big toes) are constantly being pried upward. This causes the nail to bleed at its base as it separates from the underlying tissue. The blood forms a clot, which eventually turns black. Besides looking unattractive, black toenails are often painful.

If your nail doesn't hurt, leave it alone and it will eventually fall off. (That's a whole other pedicure experience.) But, if the pressure and pain affect your running or walking, ask your doctor or podiatrist to bore through the nail. The blood will then escape through the hole, which should stop
the discomfort.

You can prevent black toenails by:

* Wearing the right shoe size. Your running shoes should never be the same size as your street shoe; you need room to allow your feet to expand as you run. Running shoes should usually be a full size larger than your regular street or dress shoes. When standing in your running shoes, there should be a full thumbnail's length between the end of your big toe (your second toe if it's the longer of the two) and the front of the shoe. Don't try this size test sitting down; your feet will be pushed forward in the shoe and you won't get an accurate measurement.

* Avoiding too much downhill running. If you know you're going to be training in an area with many hills, wear padding over the toenails most susceptible. Also, on days that you're doing specific hill workouts, try walking back down the hill rather than running.