What should you know about bruised toe nail running?

During a run, a toe may repeatedly strike the front of a shoe or slide forward on descents. A shoe that is too short, a thick sock, a long toenail, or a sudden increase in distance can add pressure. Blood then collects under the nail, producing a tender red, purple, or black patch. Repeated trauma can loosen the nail and make it shed later. Other causes of a dark nail exist, so a mark that appears without running, changes in an irregular way, or extends onto surrounding skin should be reviewed; Discoloured Nails provides related information.

Pause runs that make the pain worse and use footwear with adequate toe room. Keep toenails trimmed straight across without cutting into the corners, and check that socks do not bunch at the front. Rest, elevation, and a wrapped cold pack can ease early soreness. Do not puncture the nail yourself. If pressure is severe, a clinician can examine the toe and decide whether drainage or another treatment is suitable. Nail Surgery may be discussed for selected nail conditions, but most running-related bruises are managed according to the injury’s severity.

Seek prompt assessment for severe throbbing, inability to walk, a split or lifted nail, suspected fracture, numbness, or a toe that looks crooked. Get medical care for increasing warmth, redness, swelling, pus, or fever. If bruising keeps returning despite footwear changes, ask a clinician to check the nail and the way your foot is loading during activity.

Ask whether the injury is limited to the nail bed, whether you can safely resume running, and how to prevent another impact bruise. Ask when a dark nail should be photographed or rechecked if it does not grow out normally.