What Is 'Black Toe' & How to Deal With It

No, we're not talking about painting your toes with black nail polish. Although we wish we were.

July 3, 2014
running sneakers

Picking up running as a hobby has many, many perks. All the cute running outfits and sneakers (multiple pairs, even) are totally justified. Toned legs and glutes are a by-product of all the miles you’ve logged. And perhaps the best benefit -- developing a bond with a community of like-minded striders to go to for support, company, and advice. Then there’s the not-so-glamourous running “badges." Chaffing, stomach issues, and the ever-popular black toe. Luckily for runners everywhere, a good dose of BodyGlide will thwart chaffing and you can experiment with different, easier digestible foods to cut down on emergency mid-run pit stops, but what is the real deal with black toenails?

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We recently chatted with Dr. Selene Parekh, MD, MBA, about all things black toe, including prevention and causes and treatment of these unsightly nails. It is open-toe shoe season, after all.


What is the cause of black toenails?
“This normally happens to runners from the impact of the nail hitting the inside of the toe box," says Parekh. "This is due to a low level of trauma on the nail which leads to bleeding under it.”
Sounds pretty gross, right? Basically, the repeated action of your foot coming forward, pushing against your sneaker, adds up to the “impact” Dr. Parekh is talking about. Because it happens so often, on every run, runners could end up damaging their toes.
How can runners avoid this from happening?
 “To avoid getting them, try getting your foot sized by an expert, so that you wear the correct sized foot wear,” offers Dr. Parekh. We highly recommend getting fitted if you're going to pick up running as a full-time hobby, logging multiple miles each week. Google running stores in your area to find one that will analyze your gait and fit you for the appropriate kicks.
Think your sneakers now are doing the job just fine? Make sure you're giving your toes enough room to breathe and extra room for swelling that may occur from longer runs. Running legend Jeff Galloway recommends “At least half an inch, when you’re standing in your perspective shoes -- the sitting position doesn’t allow for the toes to be all the way forward,” on his website.

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Once your toes have the room they need, the bashing force rate can be cut considerably, leaving them less traumatized after your long (or short) run.
Treating black toe
For those of you who may have already been doing damage to your tootsies, we can't blame you for contemplating an all-black polish pedicure. The food news? There are ways to manage your pain and, better yet, get rid of the nail safely.
According to Galloway, you should be able to tell if the pain is tolerable or not within 24 hours. “About 80 percent of the black toe problems are best treated by ignoring them. The damaged part of the nail is gradually pushed out, and the foot slowly returns to normal.” That’s the good news. However, if you see any redness or if the pain is not manageable, you should see your doctor immediately.
“[The doctor can] release the pressure underneath and apply antibiotic cream, which can speed up the healing time considerably.”  
Shedding black toenails can take up to several months, but the best thing you can do is allow the process to happen as naturally as possible. Although the new nail may be warped if you opt to see a doctor to remove excess pressure, it will indeed smooth out as it grows in.

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Tags: running