Black Toenails

It would have to be a very lucky long distance runner who has never encountered Subungal Hematoma, medical term for those horrid black toenails that seem to take forever to go away.

Over the years I’ve had plenty, after one Gold Coast marathon, I swear it took 12 months for one to finally grow out, and the one that grew in was pretty dodgy as well.

Why does it happen you ask? Its simply just trauma to the toes from bumping around in your shoes for hours at a time. The black is blood that pools in-between the nail bed and nail plate; it seeps in as the toenail lifts slightly from all the jiggling and wiggling.

The best and most important tip in most running injuries is prevention and black toenails are not an exception to this rule…keep your toenails trimmed.

The nails should not come out past the skin or your toe; keep your toenails trimmed really short. The best way to do this is use a nail clippers to cut them straight across, do not trim the corners as this can cause ingrown toenails (which is another painful toe condition), with the jagged corner edges, you should just use a nail file or emery board to take the edges off them. Now toenails grow quite quickly so you should really trim them weekly, especially if you are running long distances. Another good tip is to also file or sand down the whole nail, even on top, as the thinner the nail the more pliable it is and the less likely it is to be rigid and hard.

Treating Black Toes
If the nail has just become discoloured (blue or black) and is not painful and you are not feeling a tight pressure from the toenail, then leave it, it will be fine and will grow out or fall off eventually, this is where nail polish comes in handy girls (sorry guys)

However, if there is pain and pressure, this is caused by the build up of blood under the nail and it has nowhere to go as that is a very tight space between nail and nail bed. If the toenail isn’t totally black just use a sterilised needle to drill a hole in the nail in the centre of the black part, once you have a hole, put some pressure on the nail with your thumb and the blood should ooze out, make sure all the blood comes out, as it could block the small hole, if this happens use your needle again to unblock the hole…all the while wipe the blood away with a sterile swab.

Another way is to heat the end of a needle or paper clip, make a hole, in the nail as above and once again put pressure on the toe to get the blood out.

If the whole nail is black, instead of putting a hole in the nail, use your sterile needle and go in from the front under the nail, lift the nail, and this will relieve the pressure and the blood should ooze out the front, once again you will need to put pressure on the nail to get all the blood out

Now even though I am shuddering as I write this, I am told it is painless, it just sounds awful that’s all. If you can’t handle the thought of it, get a good friend to help ( I think mothers would be really good at this sort of thing as well)! But if there is pressure there make sure you do it, as I had a high pressured , throbbing black toe once and couldn't handle the needle bit and believe me, the pain and ordeal it took to get over it, was far worse.

The second problem you will have after your little surgical manoeuvre will be keeping infection at bay. You have exposed part of your nail bed and blood is involved, so make sure you clean the whole area with antiseptic or anti bacterial wipes and cover it with a good sterile band-aid or dressing

Ok what happens now you ask? You just sit back and wait. The nail will drop off eventually, don’t be tempted to pull it off before it is ready as it is usually joined at the nail bed or corner and can cause pain and more trouble if you rip it off before it is ready. If it is loose and driving you crazy, trim the loose bit back, or keep it covered so it doesn't keep snagging on things.

While all this is happening the new nail is growing and pushing out the old nail, and often it grow back strange, harder, and curvy…to try to prevent this happening, use Vaseline to soften it and try the filing method above, all over the nail, to try to keep it thinner and softer, and also keep the new nail trimmed.

If it is a real problem for you and painful, it’s best to see a podiatrist. They will treat the toes and show you how to trim and file them and look after them to try to prevent it happening. In severe cases you can have your toe nails removed surgically…and many professional runners opt for this treatment….ugghhhh…I’m shuddering again.