Spring gives many of us the desire to throw open the door, breathe in the fresh air, lace up and run! Each time those sneakers slam down on the pavement with the force of about 3 times your body weight, it creates impact to your body. Which is of course why protecting yourself with uniquely custom fitted footwear, will minimize injury. If your running habit becomes intense, biomechanics alone won’t solve all running foot health concerns.
As your holistic foot health team, we’re here to protect your feet further.
As part of our signature medical Footcare Spa treatment, we treat many implications of the feet, from minor ones to major ones.
RUNNER’S OR BLACK-TOE – WHAT IS IT AND WHY DOES IT HAPPEN?
Align Clinical Chiropodist Braveenan Nirmalan, (D. Ch.) explains that one of the most common running injuries of the feet is ‘runner’s toe’, or ‘black toe’ (subungual hematoma), where typically the big toe appears dark red or black because of blood build-up underneath the nail. Once blood gets underneath the nail plate, it lifts and separates the nail plate from the nail bed beneath. This is primarily caused by repeated trauma of the toe against the tip of the shoes. This motion in the shoe is exacerbated and more harmful when the feet swell and expand when running.
“The root cause of black-toe in runners may also be a combination of things” explains Darius Dinshaw, Align Clinical Athletic Therapist, Strength & Conditioning Specialist and Pedorthist. Having poor foot stability can also cause black-toe. This can occur when leg muscles and connective tissue are unable to control the movement generated on landing, primarily the internal rotation at the hip and pronation in the foot. This leads to changes in the way the foot attempts to stabilize itself, such as the long toe flexors bending the toes down in an attempt to make the arch rigid. It can add additional stability for a period of time, but it may also place the toenails in a vertical position in which they sustain force. This repeated force eventually causes damage under the toenail, also leading to black toe. Where the black toenail/s only occur on one foot, it’s possible that the stabilizing muscles are fatiguing earlier on that side. Most commonly, we'll find black toe is caused by improperly fitted footwear and often simply, if the running shoes are too big or too small!
HOW WILL THE ALIGN CHIROPODIST TREAT IT?
Braveenan explains that the Align Chiropodist may need to rule out a stress fracture using a vibration test. They will determine the next steps. If the blood can be drained, or if the nail is lifting, they will provide treatment so that the new nail may safely and hygienically grow from the base. There is also a procedure called a total nail avulsion. The runner can choose to make this permanent (leave the nail off for good) or allow the new toenail to grow back.
Toe nails normally grow at the rate of approximately 1mm per month, so if you damage or lose your big toenail, which can be from 12-15mm long, it can potentially be over a year before a new nail has fully grown back in.
You might see information online on how to drain pooled blood under a black-toe yourself. But the toenail is a thick, complex area, where bacteria can easily get trapped. It could get infected, and you could also cause permanent damage to the nail bed. We do not recommend trying to do this yourself at home.
Not only will your running downtime be increased, the risks are far worse than losing your toenail. So please don’t risk it!
Using moisture-wicking compression socks are a top choice, to reduce shearing and friction and protect the feet’s skin and nails. They also provide extra grip inside your shoe and more cushion in the toes, as well as support for the achilles and calf muscles and can help with build up of lactic acid in the legs during and after a run.
Getting a medical pedicure by a Chiropodist will also help to clean the bacteria and fungus on the skin that can cause problems, such as Athlete’s Foot. This is another common runner’s concern due to the skin’s open pores’ prolonged sweat inside a moist shoe. It’s best to be seen early and prevent the spread to other nails, skin and different areas of the body – as it’s very difficult to get out of under the nail. Blisters, itchiness and fighting the infection for a very long time is imminent. Simple medications and treatments will help to clear athlete’s foot. And using antifungal Align Orthotics certainly helps with maintaining a balanced flora on the skin, helping to avoid various forms of foot fungus.
Joint mobilizations are another way to relieve the pressures on your feet. Specific manipulations of the joints, ligaments and muscles help so much to soothe aching feet after runs that clients can feel the difference as soon as they stand up.
TIPS TO AVOID BLACK-TOE
At Align, proactive health, and determining root cause is our focus, in addition to treatment. Other preventative tips to consider are if runners have longer toe nails, they are at increased risk of trauma. So, always keep your toenails cut short, and smooth. Beware not to cut them too short, though, or you may deal with another problem, the ingrown toenail. Cut straight across so the skin around your nail doesn’t try to grow over it.
Always make sure your footwear is the correct size and width for your feet. While some may feel they can save money by buying shoes online, sizes can vary between different manufacturers and even among different styles from the same brands, and even still, style variation from season to season! We always recommend trying footwear on before buying, especially with guidance about your unique biomechanics from a medical foot health specialist. Never wear new footwear straight out of the box for a long walk or run. Always wear them in gradually. See our recent vlog on how to properly try on your new shoes.
HAVE BOTH THE BODY ALIGN AND THE FOOTCARE SPA CHECK-UP
If you are noticing something different about your toenails or skin after running, it might be an indication to come in. If you’re concerned about foot health or have history of ingrown prior to your first marathon, that would be a good indication to come have a visit with the Align Chiropodist, also. And as always, in the true spirit of preventative health, we encourage a foot health check-up regularly.