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Hikers and runners give their toenails a beating

toenail-care-for-athletesIf you have ever gone on a particularly long hike or run, or tried to run or hike in shoes that were too tight or too short, you may have experienced toenail trauma. Perhaps you developed pain around one or more toenails, bruising under the nail, or maybe even had a toenail (or two or three) fall off. Toenail injuries may occur to anyone, but they are particularly common among hikers and runners with the likelihood increasing as distance or intensity increase.

Toenail injuries among hikers and runners typically result from repetitive stress, sometimes called repetitive micro-traumas, to the toenails. Usually this occurs due to the toenail repeatedly hitting the end of the shoe. The longer your run or hike, the more often your toenails come in contact with the end of the shoe, especially if your shoes or socks don’t fit properly. Irregular or particularly steep terrain may also be contributing factors.

Toenail injuries may be small, but the resulting pain is often significant enough to prevent additional activity, making even simply walking around your home painful. Without treatment, toenail injuries may also lead to additional nail deformities or infections. The two most common types of toenail injuries among runners and hikers are subungual hematomas and ingrown toenails. A subungual hematoma is simply a collection of blood beneath the toenail, while an ingrown toenail occurs when the edge of the nail grows down into the surrounding skin. The pain may last for hours to several days, depending on the severity of the injury.

Treatment of toenail injuries will depend on the particular type of injury and the extent of the injury. A subungual hematoma, if it covers more than 25 percent of the nail area, may require a podiatrist’s intervention to alleviate the pressure. This may include trephination, making a small hole in the nail through which fluid may be expelled, alleviating the pressure, or avulsion, the surgical removal of the nail and treatment of underlying damage. For an ingrown toenail, your podiatrist may also perform an avulsion either of the entire nail or a portion. It is important to note that you should not attempt to remove the nail or cut into the skin around the nail yourself. Tools used at home may accidentally do more damage than good, in addition to increasing risk of bacterial infection. Your podiatrist is specifically trained to perform these and other treatments in a safe, clinical, and sterile environment. Your podiatrist will also be able to evaluate and treat your injury for any additional concerns.

In an effort to reduce your risk of suffering from toenail injuries, take time to make sure you purchase properly fitting socks and shoes. Ideally try on socks and shoes later in the day as the feet typically swell a bit over the course of the day. The feet also swell some during exercise so trying on shoes later in the day is more likely to result in proper fit. Look for a store that offers an incline board that you can walk up and down while trying on the shoes. In addition to walking up and down the incline board, spend a few minutes simply standing on the decline to see if your feet slide forward or push against the ends of the shoes. If you experience sliding of the foot or your toes hitting the ends of the shoes, try on a pair a half size larger and keeping going up in size until you find a pair that still fits snuggly in width from the forefoot through the heel, but without your toes hitting the ends.

In addition to ensuring proper shoe and sock fit, pay attention to the amount of weight you carry while hiking or running. The more weight you carry, the more likely you are to suffer from a toenail or other injury. Try to distribute the weight evenly across your back or waist and avoid excess amounts of weight. Take regular breaks during which you can remove the weight, whether it is a backpack, water pack, or otherwise. Take care that your shoes aren’t overly heavy either. While lightweight or ultralight shoes aren’t for everyone, take the time to find hiking and running shoes that aren’t overly heavy. Excess weight means having to do extra work to lift the feet and shoes and also means extra pressure on the toes simply due to the weight of the shoes. Just be sure that in giving up weight, you don’t sacrifice stability and quality.

If you are suffering from any type of toenail injury or have any concerns regarding your feet, ankles, and lower legs, please call Kansas City Foot Specialists today at (913) 338-4440 to schedule an appointment. We look forward to seeing you soon.