What Is Runner’s Toe? The Bruise You Didn't See Coming

What Is Runner’s Toe?

Runner’s toe is a common overuse injury that happens when repetitive pressure and friction cause bleeding under the toenail, also known as subungual hematoma. It’s particularly common in long-distance runners, hikers, and people who wear tight or ill-fitting shoes during high-impact activities.

Often, the toenail turns black or dark purple, making it easy to mistake for something more serious. While it might look alarming, runner’s toe is usually harmless — though it can be painful and sometimes lead to toenail loss if not addressed.

Common Symptoms of Runner’s Toe

The signs of runner’s toe are usually hard to miss:

• A black or darkened toenail

• Throbbing or pressure under the nail

• Pain when walking or touching the toe

• Nail loosening or detachment in severe cases

These symptoms typically affect the big toe, as it absorbs the most impact during running.

How to Treat Runner’s Toe

For mild cases, rest and at-home care may be enough:

• Trim nails short to reduce further trauma

• Ice the toe to reduce swelling

• Elevate the foot to minimize pressure

• Wear open-toed or roomy shoes

If pain is intense or the nail is lifting, a podiatrist may relieve pressure by draining the blood under the nail. In rare cases, the nail may need to be removed to allow proper healing.

How Long Does Runner’s Toe Take to Heal?

Most mild cases heal within a few weeks, though full regrowth of a lost toenail can take several months. Wearing proper footwear and avoiding repeated trauma are key during recovery.

How to Prevent Runner’s Toe

• Choose proper footwear: Ensure shoes have enough toe room and aren’t too tight

• Trim nails regularly: Long nails increase pressure and friction

• Wear moisture-wicking socks: These help prevent sliding in the shoe

• Lace shoes properly: Secure the foot without cutting off circulation

Other Causes of Black Toenails to Know

Not all black toenails come from running. Other potential causes include:

• Fungal infections

• Trauma from dropped objects

• Melanoma (rare, but serious — always consult a doctor if unsure)

• Psoriasis or other skin conditions affecting the nail

The Takeaway

Runner’s toe might look worse than it feels, but it shouldn’t be ignored — especially if you’re active. Proper footwear, foot care, and monitoring symptoms can go a long way in prevention.

If you’re dealing with persistent pain, discoloration, or recurring nail issues, the expert team at Southwest Foot and Ankle Center is here to help. With deep experience in foot rehabilitation and sports injury care, SWFA Center provides accurate diagnoses and personalized treatment plans to keep you on your feet — pain-free and performing at your best.