Blue Toenail - Painful For Hikers and Trail Runners

Blue Toenail - Painful For Hikers and Trail Runners

Blue Toenail - Painful For Hikers and Trail Runners

The symptom usually occurs during long hikes in hiking boots, mountain boots or trekking boots or after long running sessions with running and trail running shoes. Often one of the big toes or sometimes even both are affected at the same time. We are talking about the bruised toenail - a nail that looks like a bruise - except that the bruise is just below the nail.


Blue Toenail - Painful For Hikers and Trail Runners

Medical terminology refers to the blue toenail as a "subungual hematoma," which is a bruise under the nail. A subungual hematoma can occur on either one of the fingernails or one of the toenails.

Often a blow or pinching is the cause. Anyone who has ever missed their target with a hammer, got their finger caught in a door or dropped a bottle on their foot will probably still vividly remember the stabbing pain and the resulting injury with a blue nail.


With sturdy hiking boots, it is almost impossible to pinch or bump the toes in such a way that such a hematoma forms. Trail running shoes are also usually equipped with reinforced toe caps. However, the risk of hitting a nail blue while trail running is generally higher, because the trail running shoe offers less protection than a hiking or mountain shoe and trail runners are also faster in the terrain.

Unlike a sudden injury caused by a bump, blue toenails can also result from constant jarring and rubbing. For example, if you are constantly bumping your toes on the inside of the toe while running downhill, you are running toward a blue nail with every step.

However, since the injury in this form progresses insidiously and many small bleedings grow into a large blue nail by the end of the day, outdoor athletes are more likely to be surprised by a gradual injury when they remove their aching toe from their hiking boots after the hike.


A gradual injury and ultimately a blue nail is usually caused by a combination of the following circumstances. Sometimes even a single trigger is sufficient for this.


When hiking or trail running, if you bump your toes against the front of the shoe with every step, you are usually wearing shoes that are simply too small. It's not for nothing that outdoor athletes are advised when buying shoes to test them in different sizes, try them on with matching sports socks, wear them in the evening when feet tend to be at their largest at the end of the day, and feel free to wear the shoes on your feet for half an hour or even longer.

Shoes that are too small, too big, too narrow or too wide cause the foot to bump, slip or "float" inside the shoe. In addition to painful toes, feet and legs, this can also result in a subungual hematoma. New shoes usually need to be broken in for a few days before you can go on strenuous day hikes or multi-day tours without pain.


The best hiking or running shoe is of little use if it is not laced optimally. Ankle-high hiking boots and trekking boots are usually equipped with 2-zone lacing. This means that the lower area of the lacing at the instep and the area above the ankle can be laced to different degrees of tightness.

A "clamping" hook between the two areas allows individual lacing. Hikers should always make use of this option and lace the shoe in such a way that the foot cannot slide forward or can only slide forward slightly. Therefore, it also makes sense to adjust the shoe during the day again and again to the terrain (e.g. climbs & descents) and the situation.


The longer the running distance, the more steps hikers and trail runners take. If the fine vessels on the toenail are strained a little more with every step, at least all other factors that can lead to a blue nail should be excluded as far as possible. With suitable shoes, correct socks and adapted lacing, the best conditions for long hikes and runs are created.


What applies to shoes can of course also be applied to hiking socks, trail running socks and multisport socks. They simply have to fit, must not slip and in the best case they protect the toes, the ball and the heel with appropriate reinforcements. Blue nails and also blisters on the feet can be prevented in this way prima.


The best way to walk is in hiking boots and running shoes with short toenails. Nails that are too long not only increase the risk of a painful blue nail, but also increase the possibility of the nail coming off partially or completely. This is then really no longer pleasant.


If you feel pain on the nail after a hike or running session and then notice that the nail is already blue underneath, you should first immobilize the foot, elevate it and cool it. Of course, it is not helpful to wear the same shoe again in the near future. It is better to choose an open shoe (e.g. a trekking sandal) where the toes do not bump anywhere and the toe is well ventilated.

If the nail has completely or partially detached from the nail bed or detaches in the process, there could be a risk of infection. The resulting wound must be treated professionally. If you are unsure about this, it is better to consult doctor.

The doctor can also provide relief if the pain becomes too severe. In any case, the nail bed must be prevented from becoming inflamed as a matter of urgency, because this will then become even more painful.

 Blue Toenail - Painful For Hikers and Trail Runners


Even in the best case, that is, if the nail does not come off and is "only" blue underneath, it can take a very long time for the toe to heal completely. The blue nail grows out of the toe completely. This means that even if you have nails that grow back very quickly, it takes at least four months for the nail to completely regenerate. Often, however, it can take a year before there is nothing left of the injury.

It can be more difficult if the nail has fallen off, because the regrowing nail then often grows crookedly, crookedly and often also into the skin. Therefore, outdoor athletes with a severely damaged or completely detached nail should seek medical help in any case.

Most of the time, however, the nail does not come off and after a few days with very painful toes, the blue nail becomes more of an aesthetic problem that will take care of itself after a few months.

In any case, anyone who has ever had to struggle with a blue toe is well advised to take a close look at their equipment so that they can enjoy the mountains pain-free in the future.

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