Toenail and forefoot injuries in sport
Black toenails, subungual bleeding and forefoot blisters usually trace back to fit and downhill running.
Repeated impact of the toe against the front of the shoe causes bleeding under the nail. It is common in runners and hikers and is usually a footwear problem rather than an injury problem.
Immediate care
- Cool the toe and elevate the foot.
- Leave the nail alone. Do not attempt to release the blood yourself.
- If pressure is severe and throbbing, that is worth having drained properly.
If the nail lifts or comes off
Do not pull it. Trim only clearly detached parts, keep the nail bed clean, and cover with a non-adherent dressing changed daily until the surface hardens.
Fixing the cause
- Shoes half to a full size larger for distance — feet swell.
- Heel lock lacing to stop the foot sliding forward on descents.
- Toenails cut short and straight across.
See someone if
There is severe pain, the toe looks deformed, or you cannot bear weight — that may be a fracture rather than a nail injury.
See a pharmacist, GP or urgent care if a wound will not stop bleeding after ten minutes of firm pressure, is deep or gaping, was caused by something dirty or rusty, contains anything you cannot flush out, or shows spreading redness, heat, swelling, pus or a fever. Get help urgently for animal or human bites, wounds over a joint, and any wound in someone with diabetes or poor circulation.
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FitMedix products are CE-marked medical devices intended for the care of minor wounds. This site does not provide medical advice — seek professional help for deep, dirty or non-healing wounds, or if signs of infection appear. Always read the instructions on the pack.