Blisters are one of the unfortunate worst things about being a runner. But whether you’re a new runner or an experienced one, you know they’re inevitable.
You’ve probably already got a blister kit ready to treat those nasty ones on your heels and toes after a race, but what happens when you get a blister under your toenail?
Your toes have sensitive nerve endings, and they’re also quite prone to injury from bumps and bruises. A normal blister is bad enough, but one under the toenail also affects the nerves in the nail bed, which are extremely sensitive.
Here’s more information about how they happen and some runner-approved tips and tricks for dealing with them when they do!
How Do Runners Get Blisters Under Their Toenails?
Blisters are caused by friction. This is easy to understand when you develop a blister on your heel or somewhere else due to chafing. But what about when a blister develops under your toenail?
These blisters usually develop if you wear shoes that are slightly too big or too small for you or if your toenails are too long.
As you run, your foot slides forward, but your toes or nails hit the front of your running shoe. As the bones of your toe slide forward, the nail and nail bed are now moving backward, as they bounce off the front of your shoe.
When this happens, it causes something known as soft tissue shear, which means the tissue between the bone and the nail stretches and causes friction. Blisters can develop right in that sensitive spot between the skin and the nail.
What Do These Blisters Look Like?
Once a blister starts to form underneath the nail, it’s unmistakable. The swelling of the blister will either cause the nail to lift or the blister will balloon out of the sides and bottom of the nail, causing a strange club-like appearance of the toe. It may be a white color, or it may be reddish-black.
In some cases, you may find that your toenail goes black and you can see a blood blister underneath the nail. In other cases, no blister forms. Instead, it’s an injury to the nail bed that causes bleeding but doesn’t blister.
Often, the toenail eventually falls off, which allows the sensitive skin underneath it to heal properly.
How to Prevent Getting Blisters Under Your Toenail
The best way to handle blisters is to prevent getting them in the first place! Here are a few simple things you can do to lower your chances of developing blisters in the first place.
Keep Your Nails Short
Long nails can be a contributing factor to developing blisters under your toenails. Keeping your nails short can make a big difference, so get into the habit of practicing good foot hygiene!
If your nails are shorter, there’s less chance of them bumping up against the front of your shoe as you run, causing tissue shearing.
Wear the Right Shoes
Both shoes that are too big and too small can contribute to damaged toenails.
Choosing the right size of shoes will go a long way toward preventing painful blisters. If you can, we recommend getting your feet professionally measured, which you can do at a sports or running store near you.
That way, you can get the exact right size shoe for your feet. There should be about half an inch of space between your toes and the front of the shoe, giving your toes enough space to wiggle easily without bumping up against the shoe when you land.
Try Toe Props
Toe props are devices that help to reposition your toes so they’re in a more natural position. This is particularly helpful for those who have hammer toes or claw toes, which can be prone to damage.
You can get custom-made toe props that fit your feet and reduce pressure that could otherwise lead to friction and pain. They’re usually made of firm foam or silicone.
Watch Your Downhill Form
Running downhill can place more pressure on the front of the toes, as they’re more likely to bump up against the front of your shoes. If possible, avoid downhill running completely.
But it’s not always possible to skip the downhills, especially if you’re running competitive races. If you have to run downhill, try to shorten your stride so your feet don’t land too far in front of you, as this will reduce the impact and possible sliding of your feet forward in the shoe.
Try A Different Lacing Pattern
Using a lace lock technique can help lock your foot into the shoe and prevent it from sliding forward as you land. It’s a small step that can save you many blisters and a lot of pain!
How to Manage Blisters Under Your Toenail
It’s handy to know how to prevent blisters under your toenails next time, but what about if you’ve already got them? Here’s our expert runners’ advice on how to manage it.
Rest Your Feet For a Day or Two
Blisters under the toenail can be extremely painful. There’s no way to wear shoes comfortably, and walking or standing can be extremely painful. We advise resting your feet for a few days so that you can avoid the need to wear restrictive shoes and be on your feet.
While this may be difficult for some, we highly recommend taking a day off work so you can allow your feet to relax!
Trying to walk with blisters under your toenails can aggravate them and either increase your pain levels, or cause the blisters to pop, which will significantly increase your chance of infection.
Cover the Blister With Moleskin
If you do need to wear shoes, cover the blisters with a piece of moleskin. This is soft and reduces chafing, so it should help make wearing shoes bearable for short periods of time. Keep in mind, it won’t help reduce pressure on the blistered toes.
Take Pain Medication
You can take over-the-counter NSAIDs—like ibuprofen—if you need help managing the pain from your blisters. This should be done sparingly, and we recommend resting your feet if possible.
Soak Your Feet
You can try soaking your feet in warm salt water to relieve some of the discomfort. It can soften the skin, reduce the chances of the blisters becoming infected, and help them heal faster. It’s also quite soothing.
If All Else Fails… Pop the Blister
We don’t advise doing this unless the pain and pressure underneath your toenail are unbearable.
When you break the skin and drain the fluid inside a blister, it becomes an open wound, and it’s very susceptible to bacteria entering it and getting into the bloodstream, causing an infection.
But while we don’t suggest popping a blister for this reason, sometimes you don’t have a lot of choices. If you’re traveling and can’t get to a doctor to treat your blisters, or the pressure on your nail becomes unbearable, and you’re unable to drive yourself to a doctor, you can do it carefully.
We recommend preparing a sterilized needle and two warm saltwater baths. First, soak your feet for about 10 minutes in the water to soften the skin of the blister and make it easier to penetrate.
Then, use a sterilized needle to gently pop the blister. In some cases, you might need to poke the needle right underneath your nail. If the blister is unreachable with the needle, then you will need to see a doctor to release the pressure.
Wipe the fluid away with an alcohol swab or sterile gauze. Soak your feet in the second warm saltwater bath to cleanse and disinfect the area. After about 15 minutes, remove your foot from the bath, dry it thoroughly, apply an antibacterial ointment, and wrap it in a sterile bandage.
Clean it this way regularly to prevent an infection from setting in later!