A group of runners with the picture looking at their shoes while running on the street.

What Is Runner’s Toe?

Running can take a toll on your feet. And if you’ve noticed you suddenly have discolored toenails or painful, dark-colored toenails, you might be dealing with something called runner’s toe. 

What is runner’s toe?

A woman walking with her running shoes on.

Runner’s toe is a common condition in which your toenail turns black from repeated physical activity, like running. The medical term for it is “subungual hematoma,” but It’s also sometimes called:

  • Runner’s toenail
  • Jogger’s toenail
  • Tennis toe

Runner’s toe is caused by the repeated trauma of hitting the inside of your shoe or rubbing against it while you run. Usually, the area around your toenail will begin to turn black or dark purple due to bleeding under the nail. 

Most often, runner’s toe will affect your big toe, but it can happen to all five toes, depending on their size and positioning inside your shoe.1 Long-distance runners, trail runners, or people who run downhill are most likely to get runner’s toe, but beginner runners who aren’t using proper running form or technique may also get it.

Generally, men are more likely than women to experience running injuries like runner’s toe. Risk factors like age, previous physical activity, running more than 20 miles per week, and re-starting a running routine after a break may make you more likely to get runner’s toe. Whether you run indoors with Vingo or outdoors, you may experience this uncomfortable condition.

Symptoms of runner’s toe

A man tying his running shoes before his training session.

Some of the most common runner’s toe symptoms include:

  • A dark red-colored toenail
  • A black toenail
  • A painful and dark-colored toenail
  • Pressure under your toenail
  • A loose toenail or one that falls off
  • Swelling or tenderness under the tip of your toe
  • Discomfort when walking or running while wearing shoes

Sometimes, a black or dark purple toenail can also result from a fungal infection, which is also common among runners. Fungi grow in damp, moist environments, so the inside of your running shoe has the optimal conditions for that to happen, especially if you run frequently or for long periods.

If you aren’t sure whether you have runner’s toe or a fungal infection, it’s best to see your doctor.

Treatment for runner’s toe

A female runner on a dock running.

If you notice any symptoms of runner’s toe, there are a few ways you can treat it:

  • Do nothing and wait for it to grow out: If you notice your toenail is black or dark purple but don’t have any pain or other symptoms, it’s probably okay to leave it alone. It may stay black for several months, but eventually, it will grow out and disappear completely. Keep any affected nails trimmed short, and wear appropriate socks and footwear while running to protect your toes from further injury.
  • Rest: If you have chronic issues with runner’s toe, you may want to take some time off from running and rest. Or maybe scale back the intensity of your running regimen for a little while to give your toe a chance to heal.
  • See your doctor: If you’re having a lot of pain, we recommend seeing your doctor to rule out any other potential issues. They may recommend a procedure called nail trephination, which involves drilling a small hole in the nail to drain the pooled blood.2

If your toenail falls off, it’s best to clean the toenail bed with soap and water and bandage it to protect it while it heals. You can also apply some vaseline to help it stay moist and heal quickly.

During the healing process, watch for any signs of infection and see your doctor again if you notice any of the following:

  • Swelling and redness
  • Fever 
  • Excessive pus or fluid
  • Sharp pain or a throbbing feeling in your toe

How long does runner’s toe take to heal?

A male runner on a forest path.

Draining the blood pooling beneath your toenail can help relieve the pain immediately, but it can take weeks or months for the darkened toenail to grow out and go away completely.

Will runner’s toe go away on its own?

A female runner tying her shoes.

Most cases of runner’s toe will go away on their own, but you’ll likely have to wait a few weeks or months for the discoloration of your toenail(s) to fade.

Is it okay to run with runner’s toe?

A male runner on a dock during the sunset.

If your toenail isn’t causing you any pain, it’s okay to keep running with runner’s toe. But if it’s painful, it’s better to rest or see your doctor if you’re worried about it.

To continue running with runner’s toe, trim the affected nails short and wrap or bandage them to prevent further trauma. Avoid pulling your toenail off if it feels loose. Instead, let it fall off on its own when it’s ready. Pulling it off prematurely could damage your nailbed or cause an infection.

How to prevent runner’s toe

Being a long-distance or avid runner doesn’t mean you’re doomed to get runner’s toe. There are several ways you can prevent this painful condition:

Make sure your running shoes fit correctly. 

A runner on a track.

The best thing you can do to prevent runner’s toe is to ensure your running shoes fit well. Your toes should not be smashed into the front of your shoes, and you should have enough room to wiggle them comfortably. Investing in high-quality shoes designed for running can also help you avoid issues like runner’s toe.

Run with proper technique.

A couple running together on a path.

Having proper running technique by picking up your feet instead of sliding them forward will help reduce your risk of injury. It can take some time to develop the proper form, but if you stick to it, it will become like second nature.

Wear high-quality running socks.

A runner tying his shoe on a bridge.

Sweat-wicking socks are the best option for runners. If you don’t wear the right socks while running, your toes may get sweaty, allowing them to slide more easily into the front of your shoes. Wearing sweat-wicking running socks will give you the maximum cushion and moisture absorption possible to help prevent runner’s toe.

Gradually increase your mileage.

A runner tying her shoes before her training session.

Suddenly amping up your training program can be hard on your body in a few ways, including increasing your risk of developing runner’s toe. Instead, avoid running injuries by gradually increasing your mileage for a slower transition into long-distance running. Otherwise, your body (and toes!) may struggle to adjust.

Trim your toenails.

A woman getting her toenails trimmed

This advice is simple enough, and you may already do this, but keeping your toenails trimmed short will help prevent runner’s toe. With shorter toenails, the front of your toe will have contact with your shoe instead of your toenail, preventing unnecessary trauma to your toenail or nail bed.

Consider using toe protectors.

You can also pick up toe protectors like these. They’ll provide extra cushion for your feet and help cut back on the friction to prevent issues like runner’s toe and blisters. Simply stretch them over your toes to get complete protection on all sides.

Key Takeaways:

Runner’s toenail is an uncomfortable condition where your toes repeatedly slam against the toe box of your shoe while you run. This can cause minor physical trauma and blood to pool beneath your toenail, causing nail discoloration and pain. Most cases of runner’s toenail will go away on their own, but in some instances, you might need medical treatment from a doctor. Taking precautions to prevent runner’s toe can help you avoid this condition.

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  1. Lindberg, S. (2021, January 8). Common Foot Problems of Runners. Healthline. https://www.healthline.com/health/runners-feet 
  2. Streitz, M. J. (2023, March 15). How To Do Nail Trephination. Merck Manuals Professional Edition. https://www.merckmanuals.com/professional/injuries-poisoning/how-to-do-skin,-soft-tissue,-and-minor-surgical-procedures/how-to-do-nail-trephination 

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