Running - Knowledge

Running Injuries: Black Toenail and How to Deal with it

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Issues with toenails and toenail problems, major or minor, are not only painful but can be also extremely frustrating to have, especially issues such as blackened toenails, toenail fungus, or even ingrown toenails are involved. Toenails are naturally white and slightly translucent, and normal discolourations could occur due to nutritional deficiencies, trauma, injury, infection, or even repetitive use of a dark nail polish. After a good run, have you noticed a black spot under your toenail? If yes, then you might suffer from black toenail. 

While the causes could be many, occasionally these take of their own and clear up, however, should they be accompanied by pain, or take an unnecessary time in healing, you should probably visit a doctor. As the skin beneath toenail heals it is not uncommon for the toenail to become separated from the nail bed causing your toenail to fall off. If your black toenail falls off, it usually takes about four or five months for the toenail to fully grow back. 

Table of Content

  • Evaluating Black and Blue Toenails 
  • Causes of Black Toenail
  • Symptoms of Black Toenail
  • Why Do Runners Lose Toenails
  • Prevention of Black Toenail
  • Toe the Line!

Evaluating Black and Blue Toenails 

Black and blue toenails are generally, caused by an injury to the skin beneath the toenail.

As the blood and fluid collect beneath the nail plate, the nail in itself, which is somewhat translucent, begins to appear black. While athletes are quite attuned to the occasional black nail making an appearance, or even taking up permanent residence, ill-fitting running shoes are just one among the various reasons for black toenails. 

But there are various reasons, and preventative measures and treatments available to combat these foot conditions to restore your nails back to health. In order to determine the cause of your blackened nail, your podiatrist will speak with you regarding your physical activities and other indicators. The doctor will then palpate or press the area at the end of the toe to determine the extent of pain. Your toe and foot are examined for any signs of infection. If a fracture or bone spur is suspected, x-rays may be needed. If small black spots are present under the nail, other problems may need to be ruled out. Let's find them out!

Causes of Black Toenail

                                        The Badge of a Runner, The Pain of a Warrior

First of all, let’s identify and determine the different causes of the blackened toenail fungus, to understand and identify the symptoms. 

1. Repetitive Trauma from your Shoes

Yes, your shoes can give a trauma to your foot! Surprised?

This is the most common reason for causing black nails is the repetitive trauma from running and is usually the result of wearing athletic shoes that do not have adequate space in the toe-box causing the toes to repeatedly bang against the top, front, and sides of the shoe during physical exertion. This repetitive stress to the toe causes a blood blister to form beneath the toenail.

This condition is a familiar occurrence among runners and soccer players because their toes are subjected to the roughest impact. The effect of the toe-box impact can be more pronounced in athletes who do not trim their toenails frequently also. Repetitive trauma could range from mild which is small, painless, black-and-blue discolourations beneath the nail and severe which are large, bloody blisters between your nail and nail plate.

In the mild cases, usually, all that is required is time for the nail to simply grow out. In severe cases, the nail blisters beneath the can result in the nail to either partially or wholly detached. Should the nail detach only partially, the process can be rather painful.

While a complete detachment of the nail would be the preferred non-painful process, what can be a trying time, is the time taken for a new nail to replace it, like a year for the big toenail and about three to six months for the smaller toes. 

2. Fungal Infections  

Considering they spend most of their time in your shoe in a warm, moist environment, your toenails are very susceptible to fungal infections which thrive in such conditions.

Fungal infections, of the nature of athlete’s foot, can very easily spread to your toenails, turning your toenails into varying shades of yellow, blue, green, brown, purple and black. The range in colour is dependent on the kind of the fungal infection.

Sometimes, these fungal infections cause a debris build-up - a chalky white substance with a funky odour – lining the nail bed and causing the blackening of the toenail. 

Should you notice any of these symptoms, head on down to your doc, as you might have a fungal infection. The doctor will clip a small portion and confirm the diagnosis via a biopsy. Depending on the severity of the options, treatment could vary, with milder cases easily treatable with topical medications and severe cases with oral medication or laser treatment. 

black toenail
black toenail

Home remedies for Toenail Fungus 

A nail fungal infection which will usually start as a white or yellow spot on the tip of the nail develops while making the nail thick, brittle/crumbly/ragged, change shape, become darker in colour, or get dull. Without treatment, toenail fungus can go on indefinitely. Even with treatment, it can occur on and off.

1. Tea Tree/Orange Oil Rub

Tea tree oil is a natural disinfectant, possessing fungicidal and antibacterial properties that make it popular in treating toenail fungus. Orange oil has also shown promising results when it comes to getting rid of fungus and can be added to the mixture as well.

Always remember to dilute the essential oil before applying to the nail. As soon as you notice the tell-tale signs of nail fungus, mix together 1 part of tea tree oil, ½ teaspoon of orange oil, and ½ teaspoon of grapeseed or olive oil. Soak a cotton ball in the mixture and apply to affected nail pressing it on gently but firmly so the liquid comes out. Let this dry naturally.

Alternatively, you can place 4-5 drops of tea tree oil in enough water to soak your feet in, and do that for 15-20 minutes. Both treatments should be done faithfully morning and evening.

2. Baking Soda and Vinegar - Soak your Feet 

While baking soda is not fungicidal, which means it doesn’t kill the fungus, it is, however, a fungistatic, which means it can prevent the fungus from growing and spreading.

Why does baking soda help?

The reason it acts as such is that it is alkaline - the opposite of acidic - and fungus is unable to flourish in an alkaline environment. 

Moving to vinegar, it belongs to the acidic medium, is very mild and will help to kill off the fungus without altering the PH of the environment in a harmful way. 

Mix a cup of chosen vinegar with enough water to soak your feet in. Soak for 15 minutes, and then pat dry with paper towels. 

Follow this by adding several tablespoons of baking soda to enough water to soak your feet in, and soak for 15 minutes. Pat feet completely dry with paper towels. Do this twice a day. The idea is that the vinegar will kill off the fungus, while the baking soda will then inhibit the growth of more.

black toenail
Foot Soak(Source)

3. Coconut Oil

Traditional coconut oil can be a help too!

The fatty acids that are found abundantly in coconut oil naturally insert themselves in the lipid (fat) layer of the fungal membrane and disturb it, leading eventually to cell disintegration and the ultimate destruction to the fungus.

Remember to wear gloves or wash your hands between applications, if you have more than one affected nail. Rub coconut oil onto the area and let it absorb and dry naturally. Repeat 2-3 times daily.

3. Black Toenail Melanoma 

You might be surprised that even a black toenail can lead to skin cancer!

Melanoma is the most serious kind of skin cancer. It can grow underneath your nail bed on the nail plate and cause hyperpigmentation of the skin. 

How to identify it?

It often appears as a dark brown misshapen spot on your nail plate. It’s mostly a slow and a painless growth, which is why it tends to go unnoticed for quite a while. But to ID melanoma, keep an eye out for the discolouration that extends beyond the nail and onto the cuticle. 

In case you haven’t gone through a recent injury or incidence of trauma, to have been the cause of the discolouration, you should have it shown and checked out by your doctor. While the disease is known to be deadly, it is a rare occurrence, and if detected early enough, it is treatable. 

4. Subungual Hematoma

While you might cringe at the very description, a subungual hematoma occurs when you drop a heavy object onto your foot! 

What happens then? 

Well, you might notice instant blackness on your nail bed. This is because the blood vessels burst open and there is a rush of blood under your nail.

This type of a blackened nail is easy to spot since it occurs almost immediately after the accident. The build-up of the blood will cause a painful throbbing sensation. 

Want a quick solution?

This can be relieved by pricking a tiny needle through the nail to drain out all the blood. By this procedure one can alleviate the pressure as well as the dark colour under the nail, however, please do not attempt it by yourself at home. The procedure is required to be carried out by a doctor, otherwise unsanitary and ineffective amateur attempts could only complicate the situation and cause more hurt and pain.

black toenail
Subungual Hematoma

5. Skin Tone 

Sometimes, a darkened nail has nothing to do with any of the above causes – no injury, no melanoma, just a matter of having a darker skin tone.

The nail being slightly translucent easily shows the skin colour of the nail bed, which like the skin on other parts of the body, could also be hit by pigmentation from time to time. 

Many times, this pigmentation could be contained to just one toe, but often, similar pigmentation is noticeable on multiple toenails. You could also double check for similar pigmentation under your fingernails. However, if you still feel you cannot determine pigmentation changes, it’s advisable to have it looked at by a doc, to play it safe. 

Symptoms of Black Toenail

Now let’s find out why does toenail turn black and what are the symptoms?

At first, the toenail appears to be discoloured and is painful. The big toenail is the most commonly affected. Bruised, broken blood vessels cause the black, blue, and deep purple colours under the nail. 

The relative lengths of your individual toes depend on the kind of foot you have. The ‘Egyptian Foot’ is where your big toe is the longest and ‘Greek Foot’ is where either your second or third toes is the longest. Depending on your foot type, the longest toes and consequently their toenails are more likely to get injured. 

The black colour of the nail is usually because of the presence of blood, from a blister, drying up. If the black toenail is the result of a blood blister the painful symptoms should decrease within 24 hours. Once a new nail grows in, the damaged nail will usually fall off. 

black toenail
Downhill Runners suffer from Black toenail

Who is more prone to black toenails?

Well, runners, training for a marathon or who do a lot of downhill running are the most likely candidates for black toenails because their toes are constantly rubbing up against the front of their shoes. 

Did you know?
You're also more likely to get black toenails if you run long distances in warmer weather because your feet swell more when it's hot.

Why Do Runners Lose Toenails

Runners have tough feet for a reason since when you run longer distances, your feet take a real beating. Whilst you run on trails, the track or the pavement, your feet are facing wear and tear, and your toenails are one of the main victims, too. 

The black colour is the brunt your toenail is taking of all the activity. This happens mostly in marathon-distance runners and runners who do a lot of downhill training. These bruisers are also more likely to happen in warmer weather. They hurt a little, but go away soon enough. Prep yourself with the ultimate marathon running guide from start to finish, and protect your toes from any kind of injury. 

Sometimes when toenails take repeated beatings, they can fall off as a result of all the impact from running. If you notice the signs early, you can easily take care of your toenail and avoid infection. 

Do Listen:

You don’t need to stop running, but make sure moisture stays away from the nail, as moisture can cause infection. 

The pain shouldn’t be stronger than your average bruise because that is essentially what is happening. If you don’t have too much pain, you can still run with your toenail in this condition. If you do not see improvements, then you should see your doctor for additional treatment.

Toenail problems can also come from how you run. Should you be newly incorporating running into your lifestyle, it is worth your while to learn a proper running technique. This will cut back on injuries and even help improve your pace and endurance. 

Prevention of Black Toenail

Many nail problems can be prevented by wearing healthy shoes and trimming your nails properly.

To help avoid infection, keep your feet clean and dry. If you have diabetes, see a podiatrist at the first sign of foot injury since diabetic feet are subject to an elevated risk of infection and complications from foot conditions.

1. Healthy Shoes Keep Nails Healthy 

The impact of the shoes you wear on the health of your nails is higher than most people can begin to imagine.

Livingit Tip:
The most basic step to take is to always wear shoes that fit.

If you have had nail problems previously, get your foot measured before buying a new pair, even if you think you know your size! As you age, your shoe size can change. Take keen note on how the shoe feels when you try it on.

black toenail
Proper Fit Running Shoes

A break-in period is a popular new trend myth. Remember that - a shoe needs to feel comfortable from the moment you try it on, if it doesn’t, give it back and try on another. 

Your shoes need to be supportive and roomy enough for you to be able to wriggle your toes. While this will make sure that there is sufficient circulation in your shoes to keep them fresh and dry, it will also prevent you from getting black toenails that occur when your toes are uncomfortable and squeezed up and against the roof and the sides of your shoes. Know how to buy different types of shoes based on your feet!

Remember that moist and cramped shoes are the healthiest breeding grounds for bacteria, which increases your likelihood of contracting toenail fungus. What will also help is if you lookout for shoes made up of natural materials such as leather as these are also breathable, allowing your feet to do some ‘breathing’. 

2. Use Foot Powder

Before putting on your shoes, apply some foot powder to your foot, in your socks and in your shoes, which will help absorb most of the moisture and reduce friction. 

Livingit Tip
An alternate idea is to use a skin lubricant on your toes. 

3. The Right Socks 

During warmer months, avoid wearing thick socks, instead opt for thinner and lighter material socks that will wick away the sweat. If you are running downhill, lace-up your shoes tighter.

4. Proper Trimming 

Poor cleaning habits can be a cause of black toenail too!

Overly long, ragged and misshapen toenails not only get caught on things but also attract fungi and other bacteria, risking damages to the entire toenail matrix, if you need to stop suddenly while running or walking. Trim your nails regularly. If you trim them straight across without cutting down into the corners decreases the likelihood of ingrown toenails. 

black toenail
Proper Trimming is essential

Toe the Line!

It seems simple enough, but sometimes you just forget or put it off, or just don't pay attention to your toenails entirely. If you're an avid runner, some toenail issues are probably unavoidable. Run for long enough, and sooner or later, you’ll find yourself with a black toenail, a.k.a. runner’s toe. If you can help prevent it, do it since no one wants to end up with blisters or infection under your toenails. Find out about the causes, symptoms and treatment for blisters on feet.

By paying a little bit of attention to your running shoes and your feet, you should be able to avoid the majority of these painful nuisances. And, sadly there's no way to make it go away; just chalk your black toenails up to a running badge of honour!

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