Following the London Marathon this past weekend, thousands of runners are now dealing with the after-effects of long-distance running, including a lesser-discussed issue known as “runner’s toe”.
This condition often involves bruised, discoloured, or even lost toenails due to repeated impacts within the shoe. While usually harmless, a GP has warned that in some cases, it can lead to more serious complications, including fungal infections.
With this in mind, Dr Donald Grant, GP and Senior Clinical Advisor at The Independent Pharmacy, explains when runner’s toe is nothing to worry about, and when it may require treatment.
What is Runner’s Toe?
Dr Donald Grant, GP and Senior Clinical Advisor at The Independent Pharmacy, said:
“Runner’s toe is a common condition caused by repeated trauma to the toenails, particularly during long-distance running. The constant pressure inside the shoe can lead to bleeding under the nail, known as a subungual haematoma, which often appears as dark red, purple, or black discolouration.
“With the London Marathon taking place over the weekend, many people may now be noticing these symptoms for the first time. While it can look alarming, in most cases it’s relatively harmless and will resolve on its own, with the nail either recovering or eventually growing back if it’s lost.
Signs Your Runner’s Toe Might Be More Serious
“While runner’s toe is often harmless and may resolve on its own, there are certain symptoms that shouldn’t be ignored. If you notice intense or worsening pain, significant swelling, or a feeling of pressure under the nail, this could indicate a more severe subungual haematoma that may require medical attention.
“Additionally, any signs of infection, such as redness spreading beyond the toe, warmth, pus or discharge, or an unpleasant smell, should be assessed by a healthcare professional.
“If the nail becomes increasingly loose, or if you experience difficulty walking due to pain, it’s also important to seek advice, as this may suggest deeper tissue damage.
“Finally, if discolouration doesn’t grow out with the nail over time, or the nail becomes thickened and distorted, this could point to a developing fungal infection rather than simple bruising.”
The Link to Fungal Infections
“One of the main risks following nail trauma is the development of a fungal nail infection. When the nail becomes damaged or lifts away from the nail bed, it creates an entry point for fungi to thrive, particularly in warm, damp environments such as sweaty running shoes.
“Common signs of a fungal nail infection include thickened nails, yellow or white discolouration, brittleness, and changes in nail shape. Over-the-counter products such as Scholl Fungal Nail Treatment are effective at preventing the spread of infection.
How to Reduce the Risk After Running
“To avoid common issues such as runner’s toe, people should practice good foot hygiene after long and intense fitness events. This means keeping feet clean and dry while avoiding restrictive footwear. I also recommend removing damp socks immediately after the race, as this can reduce the risk of fungal infections developing.
“Overall, wearing properly fitted shoes is crucial, as it helps avoid repeated impact on the nails, giving the feet and toes time to properly heal.
When Should You Seek Treatment?
“If symptoms persist, worsen, or show signs of infection, it’s important to seek treatment as early as possible. Fungal nail infections can easily spread to other nails if they’re left unaddressed, highlighting the need for prompt intervention.
“Antifungal treatments, including prescription-only medication, can help prevent the condition from progressing and support a quicker recovery.”