Black toenail, also known as tennis toe or runner’s toe, is an injury that causes the region under the toenail to become black. Black toenail often occurs as a result of applying excessive pressure on your feet through exercise or physical activity. Wearing ill-fitting shoes that are too tight and walking or running before stopping suddenly are also common causes of black toenail.
The most obvious signs and symptoms of black toenail include a black or dark red discoloration of the area under the affected toenail. Usually the big toe or the second toe is affected.
Additional symptoms include pain and warmth while applying pressure to the toe, along with foul odor and discharge from the toe. As the black toenail heals, it will loosen and fall off from its original place.
Black toenail is caused from bleeding under the affected toenail. Bleeding under the toenail may occur from a number of causes, such as:
- A blunt injury – dropping a heavy object on the toe or stubbing it against a hard surface
- Downhill running
- Poor fitting foot wear or trainers – especially those with small toe boxes that are tight around the toes
- Misshapen or overly long nails of the toes
- Fungal infection
In some cases medical treatment may not be required – especially for mild injuries due to trauma. Black toenails eventually fall off and heal on their own. If, however, you are in doubt, consult your doctor about the required treatment.
Your health care practitioner will diagnose the condition and determine the severity of the injury to determine what treatment will be necessary. If there is no need for drainage of fluids or medication, the toe will be left alone to recover on its own. However, if the doctor sees that the toenail injury may be a severe one, treatment may be administered. Treatment is generally the removal of the affected toenail or drainage of fluid beneath the toenail. In case of lacerations or abrasions, the wound will be properly cleaned before getting treated.
- Removal. The nail will be removed and the affected region under the nail will be cleaned to remove hematoma (collection of blood under the nail). A protective barrier may be applied to prevent infection
- Needle. A sterile large-gauge needle may be used by your doctor to produce a small hole on the nail and drain the fluid
- Cautery. This is a battery operated device that will burn a hole in the affected nail to allow blood to drain
After medical treatment from a health care professional, you can expect the hole to grow out on its own. Ensure that you see a doctor as soon as you notice any changes to your nail colour so that symptoms can be improved quickly and easily.
Your doctor may recommend soaking your foot in lukewarm water and Epsom salt for 10-15 minutes, twice per day. After patting dry your foot, apply an antibiotic ointment followed by a dry, sterile bandage as directed by your doctor.
Recovery time will depend on the cause, the type of treatment and your ability to respond to treatment. On average, black toenails often take a few months to completely recover.
Follow these steps to prevent toenail injuries:
- Keep toenails short and trimmed
- Wear proper fitting shoes with big toe boxes (space at the front of the shoe)
- Wear protective footwear
- Be cautious while moving heavy objects
- Keep your feet and toenails dry and clean
- Avoid walking barefoot as much as possible
- Always wear clean socks and avoid reusing and sharing with other people
- Let your shoes air out before between each usage
- Treat toenail injuries during the initial stages
If you are concerned about your toenails, or are recovering from the removal of a damaged toenail, please contact Happy Physio on (08) 9272 7359. Our health professionals can assess the fit of your shoes, and the behaviour of your feet, as well as provide you with exercises to assist in the healing of your toes and feet.