We love running and runners, but that doesn’t mean we don’t take our bodies seriously when they do hurt after a long day on the trail. Some runners even seem to regard injuries like black toenails as if they were trophies or a badge of honor, but that’s probably not the best approach.

Black toenails are a very common injury among runners—particularly those who race, or do long-distance trail running—so here’s what you need to know about treating it:

Treatment is not always necessary, but that doesn’t mean you should underestimate a black toenail.

Relatively minor cases that are not infected and have no fractures may clear up in time on their own. The nail will usually fall off in a few days and slowly regrow. However, if discoloration covers more than 25% of the nail surface, you experience significant pain or (especially) signs of infection such as fever, chills, or discharge, or there doesn’t seem to be any improvement after about a week, you should seek professional help.

Don’t try to drain the nail yourself.

In some cases, pooling blood under the nail (called subungual hematoma) may need to be drained in order to relieve pressure and pain, either by making a hold in the nail or, in more severe cases, removing it entirely. That said, doing it yourself is a bad idea and may make the problem worse (especially if the source of the discoloration isn’t even a subungual hematoma!) or lead to a nasty infection. Furthermore, an active laceration may need to be sutured. If your nail needs attention, take it to the professionals.

 In rare cases, a black toenail may not even be result of an injury at all.

Other possible sources of the discoloration include fungal infections, certain illnesses, or in the worst case, a tumor from malignant melanoma. Such causes will require their own treatment methodologies. If you can’t think of an obvious injury or cause, or you don’t see any improvement in the discoloration, please visit so we can find out exactly what’s wrong.

Even though treatment may not ultimately be necessary, having a podiatrist evaluate your condition can provide peace of mind—and if you do need treatment, that podiatrist will make sure it’s done properly and skillfully. Trust the doctors of Carolina Podiatry Group for care of all your foot and ankle sports injuries—we have three convenient offices to serve you, and you can request an appointment online or give us a call at 888-569-9559.

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