The Black Toenail: Runners, keep your feet primed with shoes that fit

During the Boston Marathon last April, I passed a sign, held by a group of cheering spectators: “Don’t worry, Jim, we found your toenail!” I laughed then, sympathizing with Jim. That was somewhere about 25 km along the 42.2 km course, my first crack at it, and my own toes by then were fairly numb. I was certain, however, that all my toenails were accounted for.

That evening, as I limped on my cramping legs toward a diner, I felt a strange pain in my big toe. A detailed examination in the bathroom revealed that it was swollen and the nail had turned an angry shade of purple. There was some bruising visible under the toenail, too, but I dismissed it as just another case of “black toenail” — an ugly blood blister that develops under the nail, common to long distance runners.

Fast-forward three weeks: it was a gorgeous day, hot and sunny — perfect for a barbecue. I put on the slippers I usually wear for the yard work and noticed something strange. The toenail was standing upright, almost completely detached from the toe. The fact that I lost a toenail doesn’t upset me as much as the fact that I lost it at the beginning of sandal season. Now every time I wear a pair of sandals, I have to wrap my big toe with a Band-Aid.

I tested public reaction by walking out naked — without covering the big toe — to some grimaces. It is almost comical how people move away from you at the sight of a nail-less toe, as if it was contagious. Admittedly, a toe without a nail is not a pretty sight, so I vowed to keep it covered.

Why am I telling you this sad story? I hope to solicit some sympathy, and I also want to explain why those black toenails happen and what runners can do to avoid them.

Generally, black toenails don’t hurt, although the pain can be felt shortly after the injury occurs, as in my case. The toe gets bruised from bumping at the tip of your running shoe, especially when you do a lot of downhill running or if your shoes are too small.

Runtheplanet.com offers a treatment which sounds painful. With a certain degree of self-mutilation, take a sterilized needle, drill a hole through the nail and drain the blood underneath to remove the pressure.

Luckily, Mother Nature provides an alternative — do nothing. Keep the ugly black thing hidden from public view and wait until it falls off on its own. I can testify that this method works.

Most importantly, how to prevent the black toenail: Wear running shoes that fit properly. Your shoes should be at least half a size larger than your street shoes. At a local Sportchek, I was admiring a new specimen of ASICS gel shoes when salesperson Mo came along. He said he knows everything there is to know about ASICS running shoes. I exhausted all my questions and Mo was still going strong. With my offending toe secure in my sock, Mo had me try on a pair, fitting the heels all the way to the back of the shoe. Then he measured the width of a thumb between my longest toe and the tip of the shoe. He looked me in the eyes and said: You need to have a thumb-width of space between your toes and the tip of your shoe, or you can bruise the toenails so bad that they turn black and fall off.

I wanted to ask him — Mo, where have you been this spring, when I was buying my old shoes? Instead, I left the store with a new pair of ASICS.

Zoran Bozicevic also produces a podcast for runners and runners to be at runcast.net.