Painful Toes or Black Toenails While Running?

  • By Judith Sullivan
  • 29 Mar, 2017
04 Dec, 2015

Your Shoe Laces May Be the Culprit

You may not realise it, but the way you tie up your running shoes can have a significant effect on the overall health and comfort of your feet. Whether it’s due to the way the shoe is coming into contact with your foot or the relative tightness of the laces, your chosen method could be a contributing factor to any issues you’re experiencing.

Here are some of the most common conditions that can be improved by simply switching up the way you tie your laces:

Black or Painful Toenails

Black or sore toenails often occur when the front of your toes rub against your shoe or sock. The most likely scenarios that lead to rubbing are laces that are too tight or ill-fitting shoes.

These can both lead to fluid build-up as a result of damage to the nail tissue, causing pressure below the nail. This then causes blackening and pain.

To avoid this condition, try to ensure your running shoes are properly fitted or avoid lacing them too tightly.

Pain on your Upper Foot

Pain on the top of your feet is usually caused by the tendons that run along the upper foot becoming inflamed. These are extensor tendons and when inflamed, the condition is known as extensor tendonitis.

It is often caused by running shoes that have been laced too tightly, or poorly fitting shoes that create a pressure point on the upper foot, leading to swelling. The condition can result in a very painful experience for runners, due to the way the upper foot will likely rub against the shoe.

Applying ice to the area may reduce the pain temporarily, but it’s important to try new lacing techniques or better fitting running shoes to avoid it in the future.

Irritation and Blisters

Whether your shoes are too tight or too loose, if they’re just not right there’s a chance your feet will be slipping to areas of the shoe that don’t quite match up to your foot’s natural shape. This will cause various parts of the shoe to rub on and irritate the skin, leading to irritation and blisters.

If you’re experiencing any of the above, try altering your laces to find a method that works for you. If you’re stuck on ideas, a simple search for ‘ways to tie running shoes’ or similar will show you a number of diagrams that may be helpful.

Alternatively, a visit to your podiatrist could be the best option. A trained podiatrist will be able to show you the best way to fit your shoes and laces to your foot, as well as recommending the best running shoes and techniques to avoid injuries.

By Judith Sullivan 18 Jul, 2017
Andre was an associate podiatrist at Betafeet for five months.  His contributions to the practice were considerable.  Sadly we lost him to a higher professional and personal calling.

After a stellar educational background and career, Andre joined babylon Healthcare Services, UK based, with a view to helping them set up and deliver the first digital healthcare pilot services to the NHS.   Digital healthcare is a cluster of new and emerging applications and technologies that exploit digital, mobile and cloud platforms for treating and supporting patients. Digital Healthcare is being applied to a  wide range of social and health problems, ranging from monitoring patients in intensive care, general wards, in convalescence or at home – to helping doctors make better and more accurate diagnoses, improving drugs prescription and referral decisions for clinical treatment.

Rwanda then beckoned.

Since joining babylon Rwanda in April 2016, Andre has been instrumental in successfully setting up and launching Africa's fastest growing digital healthcare service.  According to Lindsey McConaghy, babylon's PR manager, 'Rwanda has a population of around 12 million but doctor numbers are in the hundreds. There’s an imbalance between supply and demand'.  

Digital Healthcare is not without its sceptics nor controversies - at what point do you let an app do the diagnosis?  Will GPs embrace technology in this way?

Here is Andre's report about his experiences in Rwanda:  

Rwanda is a small ambitious country known as the land of 1000 hills with a population around 12 million and a rapidly growing economy. It has rolling hills for as far as you can see, a rain forest, gorillas and volcanoes, making for quite the site to any visitor. However, it is also known for the 1994 genocide in which over 1 million people were killed in 100 days across the country.

This tragic event has led to some very big health issues, which the country still faces, but thanks to a range of donor funding and strong political leadership, the country is on its way to quickly becoming a middle-income country.

As countries shift from low incomes to middle income economies, health issues become complex, where the country can face a mix of communicable disease (ie. malaria, HIV, TB) and the introduction of non-communicable disease (ie. diabetes, high BP, cholesterol) with changes in lifestyles.

Now you are probably wondering what this has to do with podiatry?

Well, as clinicians we play a role in the overall wellbeing of every patient that walks through our door for treatment and we become advocates for a number public health issues. While our specialist area is focused on the foot and ankle, an understanding of the bodily systems is imperative for understanding the impacts on the lower limb. This allows us to transition from clinical practice to other work streams such as health policy, public health programmes, service management and research.

As a podiatrist with a public health background, the increase of diabetes and chronic conditions in developing nations has become of personal interest. In many of these countries, diabetes is poorly understood and without proper prevention and care, can lead to a large economic burdens on the healthcare system. In 2012, the UK alone spent a whopping £639 million on foot ulcers and £662 on lower limb amputations, so the prevention and monitoring of these conditions is of paramount importance in the developing world.

The quality of life for individuals with diabetes is also drastically affected if not controlled, impacting mobility, footwear and overall lifestyle. Additionally, chronic ulceration and limb amputation, creates an increases risk (approximately 80%) of mortality within the first 5 years post amputation.

How did all this lead me to Africa, I hear you say?

In April of 2016, I (sadly) departed from the Betafeet clinic to implement an mhealth project in Rwanda in partnership with the Ministry of Health. This project, allows patients across the country to speak with a doctor and receive a prescription via SMS through their mobile phone, reducing the travel time, wait time and expense of receiving care from one of the local physical hospitals. The system is also working on monitoring both communicable and non-communicable disease using artificial intelligence, engaging patients to take ownership of their health.

This could be a major milestone for a country with stretched resources. To put things into perspective, over 80% of the population lives in remote areas of the country and works in the ‘in-formal’ sector as subsistence farmers with an average income of 2-3 dollars per day, which is not very much. To receive care, a patient may travel over an hour to reach their nearest hospital where a doctor is present and then wait anywhere from a few hours to a few days to receive the care they need. However almost 80% of the population already has a mobile phone.

Appropriate access to clinical care is a large part of the prevention and management of many conditions and undertaking this project has been a great experience. As a clinician, I have had the opportunity to utilise my knowledge to develop operational pathways and input into the technology development to shape the way patients receive their care. 


It is with this experience I now look to move on to my next adventure focusing on Aboriginals and the utilisation of technology in the prevention of major non communicable disease such as diabetes.

Final comment from Reggie Simpson and Betafeet Podiatry

 We wish Andre the very best in his future and thank him for this interesting blog account.  We look forward to his next blog focused on his work with the Aboriginal population.  

By Judith Sullivan 12 Jun, 2017
By Reggie Simpson
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