Bodyworks: Black Toenail (Sub-Ungual Haematoma)

How to recognise it, how to overcome it

Posted: 5 June 2000
by Patrick Milroy

You’ll notice a painful, hot toe after a run in new shoes or without socks. This may then cause discomfort in any shoes.

Your nail turns dark red or black due to blood underneath. This happens because the constant bruising during your run causes the blood vessels under your nail to leak. No medical investigations are required.

What else could it be?
A mild case could be confused with an ingrowing toenail, fungal nail infection or other disease such as psoriasis.

If you’re courageous enough, make a needle red-hot and let it burn through the centre of the nail, about 3-5mm up from the base to relieve the pent-up blood underneath. You can squeeze out the rest of the blood by hand.

Medical treatment
If you’re lacking bravery, let your doctor perform the above operation! They may then prescribe antibiotics to prevent infection, and you can take paracetamol for pain.

Can you run through it?
Yes, to an extent, though pain will prevent you from overdoing it. If you don’t treat the problem, it will bleed more and you’ll probably lose your toenail.

Recovery time
You should be able to run a few days after treatment, especially if you use a plaster to tape the nail down (this may later drop off to be replaced by new growth). To prevent recurrence, make sure that your shoes are comfortable, spacious and properly worn-in – and wear socks.

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black toenail

Discuss this article

I hope I am not alone here but I seem to be losing my toe nails (very attractive !!) Been running aprox 8 mths doing 20-25 miles a week, I have bought running shoes socks the works but my feet are a mess. Is this just part of the deal or has anyone got any tips ??

Answers on a postcard please ...Raine

Posted: 30/03/2003 at 19:34

Ive got 4 or 5 left you are welcome to if they will fit!!!!!!
Posted: 30/03/2003 at 20:17

My toenails look disgusting. Looking forward to the Summer, open toed sandals, nail varnish etc etc.....nice

Are you wearing the right size shoes Lorraine? I got mine from a decent running shop. I think you still get poorly toe nails though, even if the shoes are correct. I know I do.
Posted: 30/03/2003 at 21:36

It's pretty certain your shoes are not fitting properly. It's time to change them anyway (400-600 miles) because the cushioning will now be 'dead' and increase injury risk. Go to a decent running shop and get advice. As a guide, you should have an end of finger thickness between the toes and the end of the shoe when both are cold. Your feet expand quite dramatically when running and by as much as 10% during a marathon.
Posted: 30/03/2003 at 22:10

I got my shoes from Runners Needs and they fit well. My feet are definitely a mess still though. Although only one black toenail (over 40 miles a week running). Am too looking forward to wearing sandals!

You should see my boyfriend's toes! I think he has one or two toenails left.
Posted: 31/03/2003 at 11:03

Wear the mark of a runner with pride.

Am often in process of losing/regrowing toenails, usually 2nd toe. Recommend also to ensure socks not pulled on too tight, pull 'em back down to leave 1/2 inch slack at toes
Posted: 31/03/2003 at 11:25

Now there's an offer I can refuse.
Posted: 31/03/2003 at 12:06

I am a chiropodist for the local health sevice.

I would recommend you uptake your protien and calcium intake by 10% i.e. red meat etc.

The best thing is to soak your feet in full fat milk after you run, this will ensure the toenails will absorb the calcium and therefore healthy feet.

Hope this works for you it does for my clients.
Posted: 06/04/2003 at 18:54

Can you drink the milk afterwards or is it only suitable for visitors.
Posted: 06/04/2003 at 19:00

I presume that's if it hasn't turned to cheese, otherwise it would depend on whether you were feeding the visitors.
Posted: 06/04/2003 at 19:18

Thats ok then!!!!!!!!!
Posted: 06/04/2003 at 19:21


know how you feel as I'm about to lose my right big toenail for the second time in 12 months (did anyone tell you they take 10 months to grow back?)

The advice about size of shoe is really important. I'm normally a size 5 - 5.5 but my running shoes are 6.5 (New Balance which seem to come up small).

This might be really gruesome but you need to have a look at your toenails as soon as you realise there is damage and see if there is a) blood or b) other fluid swelling under them. The best way to avoid losing them is to relieve the pressure under the nail as soon as you realise there is some building up, then tape them down with sports tape. this prevents the nail lifting away from the nail bed as if this happens near the cuticle the nail 'dies' at the root and falls off. Chiropodists might have a fit reading this but it does work.

Relieving the pressure for me involves a 1mm drill bit and a needle (both sterilised). If you've not thrown up yet and are still interested I can tell you how to do it but it is NOT for the faint-hearted or squeamish. However, guarantees instant pain/swelling relief if you hit the right spot.

Bear in mind that if you damage your nail bed permanently your nails might not grow back at all!
Posted: 08/04/2003 at 11:20

But New Girl on the Blocks - what do you do if you're vegan?
Posted: 08/04/2003 at 14:01

good to hear i'm not the only one .i lost the toenail on my 2nd toe(it's longer than the big one)a new nail is growing but it has a strange dent in it ....will it ever be normal again? sigh!
Posted: 08/04/2003 at 16:33

Friend regularly lost hers despite good well fitting shoes. Has only stopped since switch to marathon training in Sauconys instead of NBs, in spite of massive mileage increase.
Posted: 08/04/2003 at 17:49

Re soaking your feet in milk ..... I've always been of the opinion, that manufacturers put vitimins in shampoo as a sales gimmick and the only benefit you'd get is if you actually drank it (don't follow this advice). Hair and nails are dead cells anyway. I too lose nails regularly but I was told last Saturday at the Paris Marathon Expo, my shoes are one size too small. Im needing new shoes very soon so I'll give it a try.
I wonder, if I rub Guinness on my chest next time I'm out for a pint will I get drunk quicker?
Posted: 08/04/2003 at 21:08

Jim the Plum that did make me laugh out loud.

I currentlyhave two black tonails- yes my shoes fit and I lace them specially to stop foot slipping to front of shoe. Unfortunately my toes curl under so the nails do suffer and after several times of them falling off they are thickened and quite frankly horrible. No one tells you this will happen when you start running. The other people who suffer are dancers and I have said before that you can buy jelly toes which are caps of bandage with a squashy silicone gel inside which fit over individual toes and really do help prevent blood blisters etc they are made by a company called Bunheads.

to cheer you up though I did see the three pairs of most ugly feet ever on The Peoples Book of Records a couple of weeks ago and mine came nowhere near being a peoples record.
Posted: 08/04/2003 at 23:04


where do you get those Bunhead things from. Am in desperate need due to poorly big toenail on right hand side - not sure whether due to original bruising or over-enthusiastic drilling (see earlier post) but cannot suffer torture any longer and keep up marathon training at the same time.

Do the REALLY work?

Helen - you said your friend switched to Saucony. What sort and which NB did she have before as mine are shredding my feet?
Posted: 10/04/2003 at 09:08

I've been a beginner for years now and have never had any problems with my toenails. I've worn Saucony shoes (size 8 though my normal size is 6!) since my first waddle, third pair now and wouldn't consider any other brand. Interesting to see the name coming up a couple of times in this thread.
Posted: 10/04/2003 at 12:29

I'm so so so relieved to read this thread. I thought it was just me. Have found inspecting black toenail alarmingly intriguing but now my boyfriend wants to pull it off ( never having shown such a foot fetish before I am somewhat alarmed). My shoes fit properly and are comfy but the toenail's a goner.....can you get acrylics for toenails??
Posted: 10/04/2003 at 18:47

i have never had black toenails....good fitting shoes and socks however afte the GNR last week i had my first......i popped blood blister and relieved pressure and washed and kept it clean no loss of toe nail and ready to start running again tonight....

first time i have ran for two+ hours in these shoes and i do beleieve it is shoe dependant.....each time i replace my shoes even though they are ASIC i get blister in differnt place.

started with 1060 on inside of fott then 2060 was little toes then 2070 is middle toes

this i believe is how the different shoes flex with the plastic on the upper........

find a pattern your happy with an stick to it.........
Posted: 01/10/2003 at 16:52

I've been running years and have never had the problems described, you people must have some weird foot disease or just weird feet ;¬)
Posted: 01/10/2003 at 19:11

OH MY GOD!! i feel so sick after reading this thread, especially the drilling part!! My 2nd toes have gone slightly bruised on the nail after doing the GNR but luckily nothing as bad that it requires drilling! I wear Saucony Grid Trigon, a size bigger than my usual shoe size, and they've always been great. I think if my nail ever fals off I'll be sick! Euughhhh
Posted: 02/10/2003 at 08:58

Hurrah - I'm not alone!
Posted: 03/10/2003 at 22:13

I've just lost my right big toenail and my left one is currently trying to grow back but VERY slowly. My boyfriend says I have the mankiest feet he's ever seen. I'm not happy! I've never heard of Saucony but will be doing appropriate research in desperate attempt to save my relationship (and feet!)
Posted: 06/10/2003 at 12:14

You can get fake toenails from Claire's accesories (my friend lost hers just before her wedding, hence how Iknow this weird fact)
Posted: 06/10/2003 at 12:46

I'm also very relieved that its such a common problem! I've lost three nails so far and thought I was a freak!! I've tried new trainers a size bigger, that just resulted in blisters. Now I'm on to another pair which I bought after a long consultation with an expert. Still having the same problem though. I'm looking out for the bunheads, until then will just put up with the pain!!
Posted: 29/11/2003 at 15:58

This is more of a common problem than I thought. It doesn't affect me but my Sister-in-l suffers badly from black toe nails when skiing. She's tried alsorts but not the milk thing. I'll mention it to her and WILL remember not to accept a milky drink next time I'm over there.
Posted: 27/04/2004 at 16:57

I read recently that you should tryon running shoes in a range of sizes, stop when you get to a pair that feels too big, then buy the one the next half size down. I'm running in shoes two sizes bigger than my usual shoe size and have a full set of nails. The second toe on each foot tends to get sore every now and again, and it's when I've put my socks on in a rush or sometimes when I do a longer run and get tired and start to tense up.
Posted: 28/04/2004 at 13:19

I am cured (of black toe nails). I used to get them from long runs (half marathons). I went to a specialist running shop (The Derby Runner) and they were excellent. After assessing the wear on my old running shoes, they recommended a specific make of shoe for my feet and a shoe size slightly larger than my old shoes. This was two year's ago and I've been fine since. My advice is go to a good running shop.
Posted: 17/05/2004 at 18:12

For those people looking for Jelly toes - suppliers are listed on this site.

Posted: 18/04/2008 at 11:05

They also sell something that may help in the Betterware catalogue.

Don't know if they'd be what you're looking for, but they'll stop your toes bending over and might be worth a try for the sake of a fiver.

Posted: 18/04/2008 at 11:15

Hi!  I am a State registered Podiatrist based in Northampton in the Midlands.

After reading through the various comments,  these ailments you mention are very familiar to us and if you visited your local podiatrist just  once a year we can  give you some very helpful advice on preventative  measures for your particular foot type.

.i.e. There may  be an underlying biomechanical  dysfunction causing a particular form of trauma/discomfort  and often these trauma incidents can be greatly reduced if not eradicated.

As regards nail deformities ' Toenail Reconstruction' is now available.This allows a disfigured  or missing nail to be reconstructed back to it's former shape. This not only results in an improved  appearance but gives the nailbed protection whilst the new nail safely grows underneath.

Hope this is helpful to you all.

Posted: 03/04/2009 at 21:29

Kerri - pay for your adverts like everyone else.
Posted: 03/04/2009 at 21:30

Thank you for your kind remark! 

I have been asked to place details on this forum from some of your members who have received toenail correction from me, advising that this is something that your members would be very happy to know about because it's inexpensive and people are unaware that it's available.

I was actually responding to a previous thread asking if there were acyrlics for toenails. 

 I do not need to advertise as I am extremely busy and have people travelling great distances to have this done.It is no skin off my nose...I am simply trying to help. 

I  will remove my website  as I have caused such offence.

Posted: 03/04/2009 at 21:45

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