Subungual Hematoma – Black Toenail

By Laura Moncur @ 5:00 am — Filed under:

Wendy Bumgardener over at About.com has an injured toe from hiking a trail with ill-fitting shoes.

Black toenail is a common injury among runners, but can be avoided with proper shoe fitting and lacing techniques. It is covered so often by running magazines that I’m surprised that I have never had trouble with it. I’ve worn Ryka running shoes ever since I first started running, so I’ve never had trouble. I’m also reluctant to change shoes because of black toenail horror stories.

Black toenail has nothing to do with fungus (that’s a different malady). It is an injury to your toe from constant pressure from shoes. It’s like a bruise under your toenail, except if it’s bad enough, you can lose the nail.

Here is a technical explanation of black toenail from Wikipedia:

If you want to avoid getting a black toenail, here are some resources:

After reading so many stories from people who have had black toenail, I’m surprised that I’ve never experienced it. I’ve had sore toes after hiking for too long in the wrong shoes, but I’ve been fortunate enough to not have this problem. If you have, don’t worry. It’s VERY common. As one runner said it:

“I use my toes to tell the seasons. If my first two toes are black then it is running season. If my little toe is black it is cross country skiing season. If I don’t have any black toes then I’m 10 pounds over weight. It is easy to run withseveral black toes than with 10 extra pounds.” – Jim Benike at UltRunR


5 Responses to “Subungual Hematoma – Black Toenail”

  1. Mark Says:

    I lost my right big toenail a few years ago during a long, steep descent from the mountains. The coloration actually goes through the whole spectrum. I just ignored it until it turned green, and then I went to the doctor to have it pulled out.

    Last month I lost 3/4 of my “index” toenail after another mountain trip. The leftmost sliver remains.

    I hike in running shoes or trail running shoes, which are a bit hard to tighten up tightly.

  2. jessica C Says:

    i have a black bruised toe nail on my right big toe. it hurts real bad and it basically falling off im just too scared to pull it off !

  3. Laura Moncur Says:


    It will fall off on its own. Don’t hurt yourself any further by pulling it off early. I used ALOT of Neosporin on my toe to keep it from getting infected. I don’t know if that helped or not, but it made me feel like I was doing something for it.


  4. Lauren Says:

    Hey there! Yea I just recently got a black toenail from moving. During the moving process I wore an old pair of sneakers that were a bit too snug. A few days later my big toenail started hurting really badly and I thought I had just dropped something on it without realizing it while moving the furniture. Well, sure enough it’s about a week later and it’s all black, blue, and red underneath… I let it drain out by poking a little hole under the toenail with a needle (it didn’t hurt at all) and got all the “gunk” out then used a q-tip to get some peroxide under there. It doesn’t really hurt at all anymore, but it’s definitely hollow under there now… Yay…

    I’m not too worried about it though because I do a lot of hiking and I’ve lost (and re-grown) both pinky toenails and my “index” toenail several times from doing a lot of downhill hiking.

    For anyone else who gets a black toenail though, don’t worry to much. Sure it will hurt a lot at first, but like someone else said in another post, it starts feeling better as it begins to look worse. If you want to try to drain the “blood clot” from underneath, just wait until it reaches the tip of the nail then get a steralized needle and poke a little hole and massage the fluid out. Kinda gross, I know, but it at least makes it “look better”. Whatever you do though, DON’T cause yourself more pain by trying to pull it off or loosen it when it’s not ready. Just leave it alone and nature will run its course. 🙂

  5. black T Says:

    I’ve had a black toe nail for 3 months now. I was doing a lot of hiking and was also wearing new shoes to work. I hope my toenail won’t fall off and that it will just grow out…

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