Runner’s Toe: 5 Ways to Prevent and Treat It So You Can Get Back to Running

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Runner’s Toe, also known as subungual hematoma, is a common injury among runners that occurs when the toenail becomes bruised or bloodied due to repetitive trauma or pressure. This condition can be quite painful and may hinder a runner’s ability to continue their training. In this article, we will explore the causes of Runner’s Toe, effective prevention measures, home treatments, professional treatments, recovery tips for runners, and how to get back on track.

What is Runner’s Toe?

Runner’s Toe is a condition characterized by bleeding or bruising beneath the toenail. It is most commonly seen in long-distance runners and can cause significant discomfort and pain. The repetitive trauma and pressure on the toes during running can lead to blood vessels breaking, resulting in bleeding beneath the nail. This can cause the nail to turn black or purple and may even result in the nail detaching from the nail bed.

Causes of Runner’s Toe

Several factors contribute to the development of Runner’s Toe. These include:

  1. Poorly fitted footwear: Wearing shoes that are too tight or too loose can increase pressure on the toes, leading to trauma and subsequent bleeding.
  2. Long-distance running: Engaging in activities that involve prolonged repetitive impact on the toes, such as long-distance running, increases the risk of developing Runner’s Toe.
  3. Running downhill: Descending steep hills while running can increase the pressure on the toes, making them more susceptible to injury.
  4. Toe deformities: Conditions such as hammertoes or bunions can increase the pressure on specific areas of the toes, making them more prone to trauma.
  5. Improper toenail trimming: Cutting the toenails too short or at an angle can cause irritation and trauma to the nail bed, leading to Runner’s Toe.

5 Effective Prevention Measures

Preventing Runner’s Toe involves adopting certain measures to minimize trauma and pressure on the toes. Here are five effective prevention measures:

  1. Choose proper footwear: Invest in well-fitting running shoes that provide adequate support and toe room. Ensure there is a thumb’s width of space between your longest toe and the shoe’s end.
  2. Trim toenails correctly: Trim your toenails straight across, avoiding rounded edges. This prevents the nails from digging into the surrounding skin and causing trauma.
  3. Protect your toes: Consider using toe caps or gel toe protectors to provide an additional layer of cushioning and protection to your toes.
  4. Gradually increase mileage: Avoid sudden increases in mileage or intense training. Gradually increase the distance and intensity of your runs to allow your toes and feet to adjust.
  5. Strengthen your toes: Perform toe-strengthening exercises, such as picking up marbles with your toes or using resistance bands, to improve the strength and stability of the muscles surrounding your toes.

By implementing these prevention measures, you can significantly reduce the risk of developing Runner’s Toe and continue running without interruption.

Treating Runner’s Toe at Home

When Runner’s Toe occurs, prompt treatment at home can help alleviate pain and promote healing. Here are some effective home treatments for Runner’s Toe:

  1. RICE method: Rest the injured toe, apply ice to reduce swelling, compress the area with an elastic bandage, and elevate the foot to minimize blood flow to the injured toe.
  2. Pain relief medications: Over-the-counter pain medications such as ibuprofen or acetaminophen can help manage pain and reduce inflammation.
  3. Soaking in Epsom salt: Soaking the affected foot in warm water with Epsom salt for 15-20 minutes several times a day can help relieve discomfort and promote healing.
  4. Protective padding: Apply a soft padding or adhesive cushioning to the affected toe to provide additional protection and cushioning.
  5. Avoid pressure and impact: Temporarily reduce or modify your running routine to avoid further trauma to the injured toe. Consider cross-training or engaging in low-impact activities until the toe has healed.

It’s important to note that if the pain persists or worsens, or if there are signs of infection, it is advisable to consult a healthcare professional for further evaluation and treatment.

Professional Treatments for Runner’s Toe

In some cases, Runner’s Toe may require professional intervention to alleviate pain and aid in the healing process. Here are some commonly recommended professional treatments for Runner’s Toe:

  1. Drainage of blood: If a large hematoma is present beneath the toenail, a healthcare professional may perform a procedure to drain the accumulated blood, relieving pressure and discomfort.
  2. Nail removal: In severe cases where the nail is detached from the nail bed or causing significant pain, the healthcare professional may remove the nail to promote healing.
  3. Corticosteroid injections: Injections of corticosteroids may be recommended to reduce inflammation and pain associated with Runner’s Toe.
  4. Orthotic devices: Custom orthotic devices, such as toe separators or orthopedic inserts, can help redistribute pressure and relieve pain during running.
  5. Physical therapy: A physical therapist may provide exercises and techniques to improve strength, flexibility, and alignment of the toes and feet, reducing the risk of future Runner’s Toe episodes.

These professional treatments should be pursued under the guidance of a healthcare professional experienced in sports medicine or podiatry.

Recovery Tips for Runners

Once the initial treatment for Runner’s Toe has been implemented, it is important to take certain steps to aid in the recovery process. Here are some recovery tips for runners:

  1. Follow a gradual return-to-running plan: Gradually reintroduce running into your routine, starting with shorter distances and lower intensity. Listen to your body and increase the duration and intensity of your runs gradually.
  2. Modify running technique: Evaluate your running technique and make necessary adjustments. Seek advice from a running coach or physical therapist to ensure proper form and reduce the risk of further toe injuries.
  3. Cross-train and strengthen: Incorporate cross-training activities, such as swimming or cycling, to maintain cardiovascular fitness while reducing impact on the toes. Additionally, continue performing toe-strengthening exercises to improve overall toe stability.
  4. Monitor and rest: Pay close attention to any discomfort or pain during or after running. If pain persists or worsens, take a break from running and consult a healthcare professional for further evaluation.
  5. Maintain proper foot hygiene: Keep your feet clean and dry to prevent fungal or bacterial infections that can delay the healing process. Wear moisture-wicking socks and change them regularly.

By following these recovery tips, you can gradually return to running while minimizing the risk of recurrent Runner’s Toe.

Getting Back on Track

Runner’s Toe can be a frustrating setback for runners, but with proper prevention, treatment, and recovery, you can get back on track. Take the necessary steps to prevent Runner’s Toe, and if it does occur, seek appropriate home treatments or professional interventions. Give yourself time to recover and gradually reintroduce running into your routine while focusing on proper form, cross-training, and foot hygiene. With patience and perseverance, you’ll be able to resume your running journey and achieve your goals.


Q1: How long does it take for Runner’s Toe to heal?

A1: The healing time for Runner’s Toe can vary depending on the severity of the injury. In most cases, it takes around 2-4 weeks for the bruised toenail to grow out and for the pain to subside.

Q2: Can I continue running with Runner’s Toe?

A2: It is advisable to take a break from running or modify your routine to avoid further trauma to the injured toe. Engaging in low-impact activities or cross-training can help maintain fitness while allowing the toe to heal.

Q3: Can I drain the blood under my toenail myself?

A3: It is not recommended to drain the blood under the toenail at home. Improper drainage techniques can lead to infection or further damage. It is best to consult a healthcare professional for proper drainage if necessary.

Q4: Will Runner’s Toe happen again once it has healed?

A4: With proper prevention measures and adequate recovery, the risk of recurrent Runner’s Toe can be significantly reduced. Taking necessary precautions, such as wearing proper footwear and gradually increasing mileage, can help prevent future episodes.

Q5: When should I seek professional treatment for Runner’s Toe?

A5: If the pain is severe, the toenail is detached, or there are signs of infection, it is advisable to consult a healthcare professional for further evaluation and treatment.

Q6: Are there any exercises that can help prevent Runner’s Toe?

A6: Yes, performing toe-strengthening exercises, such as picking up marbles with your toes or using resistance bands, can help improve the strength and stability of the muscles surrounding your toes, reducing the risk of Runner’s Toe.

Q7: Can Runner’s Toe lead to long-term complications?

A7: In most cases, Runner’s Toe does not lead to long-term complications. However, if left untreated or if the injury is severe, it can potentially lead to complications such as infection or permanent nail deformities. Seeking prompt treatment and following appropriate recovery measures can minimize these risks.

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