Nail Damage in Runners and Other Athletes

Running and other sports bring great pleasure, enjoyment and fitness but many athletes suffer toe and foot problems. Good, specialised running shoes and the right socks are the first step in preventing the risk of some common running problems and avoiding the pain that many runners endure.

Common foot and toe issues include blisters, athlete’s foot, fungal nail infections, ingrown nails, calluses and subungual hematoma – sometimes called ‘jogger’s toe’ or black toe. It also occurs in soccer, tennis, basketball and football. Left untreated, complications can result in nail avulsion surgery. In simple terms, nail avulsion surgery is the surgical removal of ingrown toenails.

Shoes and socks are key pieces of equipment for runners and other athletes and are a good starting place for assessing the cause of foot trouble.

It’s commonly understood that the repetitive thrusting into the toe box of running shoes – in particular during downhill running – is a primary cause of trauma to the toes and nails. The process begins with erythema (irritation, causing dilatation of the blood capillaries) and edema (swelling, from injury). Left untreated, this can cause any number of complications, including the nails separating from the nail bed. Poorly cut nails, especially when encountering swollen skin, may lead to ingrown nails.

Specialised socks are important to relieve pressure on the sole of your foot and acrylic socks cushion better than cotton. The latter flattens quicker and therefore gives little support or relief from pressure. Synthetic fibres are usually better, with hydrophobic abilities (commonly referred as having ‘wicking’ qualities – i.e. moisture is drawn away), which is important. Extra moisture can swell the sock fibres and increase pressure on the toes and foot. Socks designed to fit multiple sizes will also put additional pressure on the toes.

Even if you put your foot perfectly into a sock, the friction increases the tension on the sock when the foot slides into the shoe. This potentially exhausts the sock’s elasticity.

In a correctly fitted shoe, the peak motion would occur at the heel and topline of the upper vamp of the shoe at the ankle level. This is an anchor to limit any forward motion of the sock. This rearward tension increases as the foot loads at heel strike and the momentum of the foot moves the foot forward into the toes of the sock.

Potentially, the sock is the main cause of nail trauma during running.

How to Prevent Foot Complication from Running

Simple actions required to avoid jogger’s toe include:

  • Well-fitted, running shoes – suited to your gait with a spacious toe box
  • Synthetic, supportive socks, ideally with ‘wicking’ qualities
  • Keeping nails suitably short to avoid hitting the end of the toe box

These are really simple steps any runner can take to limit the chance of developing painful complications and the risk of nail avulsion surgery.

Additionally, having a good understanding of your walking stride in general and how that translates to your running style, is important in selecting the right shoes. Another way Free Your Feet Podiatry can assist with that is via a Biomechanical Assessment.

And if the need for nail avulsion surgery does arise, our podiatrists are extremely experienced in undertaking the surgery and have helped many patients of all ages. Please contact us at Free Your Feet Podiatry on (02) 9680 3646 to discuss general and sports podiatry, biomechanical assessments and if required, nail avulsion surgery.

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