Blister and Black Toe Nails

Before you read on watch this clip from the movie Run Fat Boy Run.

Black Toenails


Almost everyone who runs or walks a lot gets a black toenail. Getting your first one is a sign that you've moved your training into a higher level. While most runners blame a shoe that is too small, this is often not the primary cause. Certainly toe pressure from the shoe can make the toe hurt even more, but pressure from underneath seems to produce more black nails.


If a toe is under pressure from the shoe or a sock that is too tight or too thick, the sustained pressure, step after step, produces an impact or a friction problem between the toenail and the tissue surrounding it. When the tissue gets damaged, fluid accumulates. The red or black color is the result of a few blood capillaries that become broken in the process. The more fluid that accumulates, the more pain. The extra fluid, colored by some blood, accumulates below the toenail. When the pressure gets too great, the existing toenail will be separated from the new nail  which is located below the current nail. Even if it takes several months, the blackened outer nail will drop off, leaving the new nail below. Sometimes the pressure of the fluid, will warp the new nail, but it will get smoother as it grows out.
But most of the pressure that results in this "toenail injury" is produced by the regular action of the foot coming forward, thousands of times every 5K. Each time your foot swings forward, a little extra blood is pushed into the toe region due to the force of the foot coming forward. If you increase your distance regularly and very gradually, your toes will adjust to each new maximum distance and only complain when you extend farther. In a marathon training program, almost everyone gets at least one black toenail. Running faster than you should be running, at any time during a long run, will increase the chance of this injury.
Hot weather also improves your odds of getting one. When it's warm, your feet swell more than they would on cold days. Because there is more pressure, and more fluid, there are more black nails generated during the summer months.


You'll reduce the chance of a black nail if you ensure that you have enough room in your toe area when you fit your shoes. At least half an inch is needed, when you're standing in the prospective shoes (in the sitting position, the toes aren't all the way forward). If you've had a history of black toenails and summer is approaching (or here), you may want more toe room. When you add more room at the end, ensure that the arch of the shoe matches up with your arch. Also, run in the shoe before you buy it to make sure that your foot doesn't slide forward as you're running, which can aggravate the toe more than a tight toe box.
It's best to take no action on black toenails, if the pain is manageable. About 24 hours after the long or fast run which produced the problem toe, you can decide whether the pain is tolerable. It usually lessens each day thereafter. About 80 percent of the black toe problems are best treated by ignoring them. The damaged part of the nail is gradually pushed out, and the foot slowly returns to normal. If at any point you see the redness associated with infection, see a doctor.


If the toe hurts too much, especially 24 hours later, you should have the pressure released by a doctor.

Blisters

Blisters can seem like a small thing, but at the very least they can make your training extremely uncomfortable.  At the worst they can stop you from being able to walk or run altogether.  Read through the following information on how to prevent blisters and how to treat them if you get them.

Edited From Runner’s World.com

First Aid

If you have a large blister, drain it. If you don’t drain it, your blister will hurt, and it could puncture on its own, says Sheldon Laps, D.P.M., a Washington, D.C., podiatrist and foot surgeon.

To drain the blister, wash your hands, then wipe a needle with alcohol to sterilize it. Don’t put the needle in a flame, says Dr. Laps. You'll get carbon particles in your skin, he says. The carbon can further irritate the wound.

Once you've punctured the blister, carefully drain the liquid by pushing gently with your fingers near the hole. Then cover the blister with a tight bandage to keep bacteria from getting in.

You can take the bandage off periodically and soak your foot in Epsom salts (follow package directions) to draw out the fluid. After soaking, put on a fresh bandage. It’s a good idea to keep a bandage on until the skin tightens up again, Dr. Laps says.

If you've got a small blister, leave it intact. The skin acts as a protective covering over a sterile environment. Furthermore, if the fluid amount is small and you try to pop it, you could cause additional problems by making it bleed. Leave small blood blisters intact, also. Otherwise, you risk getting bacteria into your bloodstream.

For small blisters, cut a hole the size of the blister in the middle of a piece of moleskin, then place it over the blister and cover it with gauze. The blister will dry out and heal on its own.

A blister under a nail is best treated by a professional. If it’s under the base of the toenail, we take an electric file and drill a hole, Dr. Laps explains, adding, You never want to deliberately remove the toenail.

To prevent blisters, experts recommend:

• Moisten your feet. Just like sweaty skin, dry skin is also more prone to friction. Use skin creams and lotions liberally on a daily basis to maintain proper moisture.
• Choose blister-free socks. Synthetic socks wick moisture away from the skin. Cotton may be lighter, but it retains fluid. Socks with reinforced heels and toes also help reduce friction.
• Run with slick skin. Coat your feet with Vaseline or another lubricant before you run. Or use Second Skin, a padded tape that stays on even when wet. Both methods form a protective shield between your skin and sock.
• Double up. Wear two pairs of socks so the friction occurs between the two socks, rather than between the sock and skin. If your shoe now feels too tight, go up a half-size as long as your foot doesn't slide around, making blisters a possibility.
• Wear shoes and socks that fit. Shoes that are too small will cause blisters under the toes and on the ends of the toenails. There should be a thumbs width of space between the toes and end of the toe box. Your socks should fit smoothly, with no extra fabric at the toes or heels.