Bruised Toenail

Bruised Toenail – This is also known as bleeding under the toenail. It is usually caused by blunt force trauma and exercising with bad shoes!

What Is A Bruised Toenail?

A bruised toenail occurs after your toes experience some serious overuse or injury! This can happen if your drop something on your toes or bang them very hard.

This type of injury can also occur during some extreme exercise, such as marathon running or training. It is especially more common after running hills, hiking and starting a new exercise class.

The problem with bruised toenails are not only how unsightly they are! They can continue causing severe pain and can even fall off over time. If these nails are not properly treated, this can lead to fungal infection and deformed regrowth of the nail in the future.

Are Bruised Toenails Common?

• It is very common to experience toenail pain after a race.
• It is common knowledge that after a long race such as a marathon, a good deal of people will experience toe pain.
• This is especially more common if  this is one of your first marathons, or you are just getting your body used to this type of punishment!
• Your feet and toes will usually be swollen.
• If your feet and toes are swollen, this means your toenail will have a decrease in blood and will also undergo inflammation.
• If this swelling and pain is severe enough, your toenail may loosen and fill with blood.
• The under-surface of the nail plate is rich with blood vessels and if ruptured they will bleed!

What Toenails Are Most Commonly Bruised?

• The most commonly bruised toenails are those from the longest toes.
• It is usually the longest toe that is most commonly effected.
• In most people this is the big toenail, but it is perfectly normal for the 2nd toe to be the longest in some people.
• It is also common for the 3rd toenail to experience bruising as well!
• The 5th toe is likely to go numb and experience tingling, experience a corn or callus, but rarely a bruised 5th toenail!

Bruised Toenails in Ultra-marathoners:

• I previously worked a couple ultra marathons at an aid station as a student.
• It is amazing how many injuries develop at the end of these massive races. Some of these runners have never ran anything like this, but push themselves to the limit.
• Bruised toenails, loose toenails, stress fractures and chronic muscle inflammation in places you have never seen before!
• At these distances, bruised toenails are very common! So you have nothing to worry about, there is nothing wrong with you!

Who else gets Bruised Toenails?

• “Weekend Warriors”- Those who go all out with a body not prepared for it.
• People starting new exercise classes.
• People starting a weight loss routine and pushing themselves very hard at the beginning.
• People breaking in new shoes.
• People who drop something heavy on their toenails.
• People who stub their toenail very hard!

Bruised Toenail Causes:

The basic formula for developing a bruised toenail is the amount of force with the repetition of that force. So two scenarios are possible for acquiring a large bruised toenails.

1) One Large Very Forceful Impact.

A massive amount of force in just one hit. Examples of this include dropping a heavy object onto your toe, or smashing your toe against a stair while running.

Symptoms:

• Obvious pain.
• Swelling and bleeding within 30 minutes.
• Numbness and tingling are possible.
• Black or red toenail.

2) Many Small Repetitive Impacts.

This is the type of pain runners usually experience.

This is most common in runners. This is experienced as shear stress. As you are running forward, with each step as it plants into the group, the toes slide into the shoe.

So with each step, the skin under the toenail is pulling away from the toenail. The more steps you take, the heavier you are, and the tighter your shoe is: the more damage is being caused.

Symptoms:

• Obvious pain.
• Swelling and bleeding within 30 minutes.
• Numbness and tingling are possible.
• Black or red toenail.

What makes runners more susceptible to this type of injury?

1)Poorly fitted shoes:

As mentioned above, your foot does need room to slide forward into the front of your shoe with each step. If you are only running for 20 minutes or less per day and are in shape, this won’t make much of a different. But the tighter the shoe, the more you weight and the farther your run- the more you are at risk!

2)Running hills:

The more you down hills and up hills, the more your feet will slide. The more the slide in your shoe absorbing impact, the more your toenails are at risk!

 3)Increased weight:

The more you weigh, the more at risk you are for friction forces through the front of your toes.

4)Extremely long races:

The further your run, especially marathons and ultra-marathons, the more you are at risk! In my experience, losing a toenail is very common in ultra- marathoners!