Hiker’s toenail sounds like a badge of honor, but it’s actually a common foot problem for hikers. Officially called subungual hematoma, hiker’s toenail refers to the bruising and damage your toenails can sustain from the repeated trauma of hiking.
Bruised toenails are more common than you might think for anyone who enjoys long-distance hiking. Left untreated, hiker’s toenail can lead to pain, discomfort, and even potential complications.
But the good news is that hiker’s toenail is often preventable, and effective treatments are available. Read on to learn about the causes of hiker’s toenail, how to prevent it, and what treatment options will help you keep your feet healthy out on the trail.
What causes hiker’s toenail?
Hiker’s toenail happens when you hike, but it’s more than just a hiking problem. It’s a combination of things going wrong with your foot, your footwear, and the trail itself.
Mechanical factors
The main reason hiker’s toenail happens is the repeated trauma of your toes hitting the front of your boot. This is especially true when you’re hiking downhill with a heavy backpack.
Even without a heavy pack, all the rubbing and vibrating against the inside of your boot can cause trauma over time.
Another big issue is how well your boots fit. If they’re too small, your toes are constantly under pressure. If they’re too big, your foot slides forward with each step, slamming your toes into the front of the boot.
Also, if your boots aren’t wide enough, that can make things worse.
Contributing factors
Even if you have good boots, incorrect lacing can cause problems. If your laces are too loose, your foot can move around too much inside the boot.
The length of your toenails matters, too. If they’re too long, they’re more likely to get banged and pressured inside your boot. Cutting them too long is almost as bad as not cutting them at all.
Finally, your foot type can play a role. If you have flat arches, that can make your foot unstable, leading to more impact on your toes. Flat feet can also lead to pronation, which affects how your toes sit inside your boot.
Prevention: Protecting your toenails on the trail
Hikers’ toenail can be painful, but it’s also avoidable. Here’s how to protect your feet and toenails on your next hike.
Proper boot fitting
The best way to protect your feet from hikers’ toenail is to get fitted for hiking boots by a professional.
Go to a reputable outdoor store and try on shoes in different sizes. Be sure to wear the socks you plan to hike in. It’s also best to go in the evening, when your feet are likely to be a little swollen from the day’s activity. Wear the shoes for at least half an hour to make sure they feel good.
A proper fit in the toe box is also essential. You want enough room for your toes to move freely. Look for hiking shoes that are known to have a wider toe box.
It’s also a good idea to size up half a size to accommodate foot swelling, especially if you’ll be on a long hike.
Lacing techniques
How you lace your boots can also help prevent hikers’ toenail. You want to make sure your foot isn’t sliding forward in the boot.
Use all the eyelets on your boots and try using a surgeon’s knot to lock your heel in place. You can also adjust the tightness of your laces depending on the terrain.
When you’re going uphill, loosen the laces a bit. When you’re going downhill, tighten them to keep your toes from slamming into the front of the boot. You may also need to re-lace your boots during the hike to adjust for swelling.
Foot care practices
Good foot care can also help prevent hikers’ toenail. Keep your toenails trimmed short and straight, especially before a hike.
Choose moisture-wicking socks that fit well and provide cushioning. Make sure the socks protect your toes, the balls of your feet, and your heels.
If you need extra support, use arch supports or orthotics to improve your foot alignment and reduce pressure on your toes. You can use arch support inserts or buy shoes that have good arch support built in.
Treating hiker’s toenail
If you think you have hiker’s toenail, here’s what you should do:
Initial treatment
- Rest and elevation: Stop hiking and rest your foot. Keep it elevated to reduce any swelling.
- Ice: For the first two days, apply ice packs to your injured toe for 20 minutes at a time, several times a day.
- Pain relief: Take an over-the-counter pain reliever, such as ibuprofen or acetaminophen, if you need it.
Advanced care and considerations
As you recover, keep a close watch on your toe.
- Monitoring for infection: Keep an eye out for signs of infection, such as more pain, redness, swelling, or pus. If your toenail falls off, be sure to keep the area clean and protected with a bandage.
- Medical consultation: If you have severe pain, signs of infection, or a detached toenail, you should see a healthcare professional.
Important safety note: You may have heard of piercing your toenail with a hot needle to release the blood underneath. I strongly recommend against that. Don’t pierce any part of your body without the supervision of a healthcare professional.
Healing and Recovery
So, how long will it take that throbbing toenail to feel better? A bruised toenail will typically heal within a couple of weeks, but if you’ve got a severe injury, it can take four months to a year for complete regeneration.
If your toenail falls off, don’t panic. A new toenail will eventually grow back, but be patient; this can take several months. If the entire nail detaches, you might need to see a doctor for professional medical help.
Once you’re on the mend, don’t forget the importance of preventing future injuries. Take a good look at your hiking shoes and socks. Are they the right fit? Are they contributing to the problem? Making small adjustments to your gear can save you a lot of pain in the long run.
Frequently Asked Questions
How do I stop my toenails from curling up?
Curling toenails (onychogryphosis) are often caused by trauma, improper nail trimming, or genetics. Ensure proper shoe fit with adequate toe box space, especially to prevent issues that could necessitate considering the safety of a fungus nails pedicure. Regular trimming, possibly by a podiatrist, is essential. In severe cases, a doctor might recommend treatment options like nail softening or even surgical removal.
How to treat a toenail coming off?
If a toenail is partially detached, keep the area clean and dry. Gently trim any loose edges that catch on socks. Apply an antibiotic ointment and cover with a sterile bandage. See a doctor if there are signs of infection (redness, pus, pain) or if the detachment is significant. Never forcefully remove the nail.
Should you soak a detached toenail?
Soaking a detached toenail can increase the risk of infection. It’s generally better to keep the area dry and clean. If you do soak it (on doctor’s orders), use a mild antiseptic solution and ensure the area is thoroughly dried afterward.
How do you treat hiking toenail loss?
Hiking toenail loss is usually due to repetitive trauma. Treatment involves cleaning the area, applying antibiotic ointment, and covering with a bandage. Ensure proper fitting hiking boots to prevent future occurrences. Consider using thicker hiking socks or toe protectors.
Should I cut my toenail if it is lifting?
Yes, you can carefully trim a lifting toenail if the detached portion is causing discomfort or catching on things. Use clean nail clippers and trim only the loose part. Avoid pulling or tearing the nail, as this can cause further trauma and increase the risk of infection. If you’re unsure, consult a podiatrist.
In Summary
Hiker’s toenail is both preventable and treatable, so it doesn’t have to ruin your hiking trips. The most important things you can do to prevent it are to make sure your boots fit well, use the right lacing techniques, and take good care of your feet.
Taking care of your feet before, during, and after your hikes is the key to having more comfortable and enjoyable experiences on the trail. Follow the tips we’ve discussed, and you’ll significantly reduce your risk of getting hiker’s toenail and keep your feet healthy for all your adventures.