Feet with no toenails

Toenail Injuries in Soccer


Toenail Injuries in Soccer

Feet with no toenails
GRAPHIC - 4 weeks after toenail avulsion

Can You Play Soccer After a Toenail Injuries?

Sometimes yes, most of the times no.  Having a toenail injuries can really hurt!  There are more nerve endings in your big toe than anywhere else in your body.

It is better to take time off and let your toe heal if it is hurting.  You are the only person who really knows how bad your nail feels.  Loose nails that are constantly being struck can result in greater damage and further injury.    If the nail has only lifted partially, you may be able to tape it down or secure it so that it does not shift.  The nail itself will still offer protection to the nailed  underneath.  You should also try to keep the nail trimmed short as it grows out, especially if it is partially lifted.

If the reason your nail is hurting is related to any type of infection, you should not play.  See a physician and let them determine if you need antibiotics or some other treatment.

Why Do Toenails Look Black?

Black toenails are usually the result of a direct trauma.  This could be caused by repetitive striking to an area.  Minor trauma repeated over a long period of time can also cause black toenails.  The nail looks black or purple because when the skin and nailed are injured, they bleed.  These can cause extreme pain because the blood causes pressure between the nail and nail bed.  This discoloration is called a subungual hematoma.  

Most of the time, this can be relieved by performing a simple trephination. A trephination involves drilling a small hole in the nail, so that the blood can be drained and the pressure relieved.  In order to work, a trephination usually has to occur within 24 hours of an injury or the blood will congeal and not drain. 

Does Trephination Hurt?

The nailbed itself does not have any nerves.  If you have a professional perform this procedure, there should not be pain.  In fact, once the blood if released, the pain is usually significantly less than when the pressure was there.  

There are several tutorials online providing instructions for doing these at home.  My recommendation would be to see an urgent care physician or a physical therapist.  Both should have tools to handle the trephination quickly and painlessly.

You will be able to see the small holes in the nailbed through which the blood was released.

What is Nail Avulsion?

Nail avulsion is a commonly performed surgical procedure to address a toenail injury.  It can involve removing a portion of the nail plate, or the entire toenail.  Most serious soccer players have had to deal with these at one time or another.  Unfortunately, it is a common concern.  Because of trauma, the nail may need to be completely removed or partially removed.  Your toe will most likely be sore after the treatment.  In some instances, you might require stitches.

If your entire nail is removed, you might have oozing and bloody discharge for up to a week.  You will need to soak and dress it daily.  You’ll most likely need to apply antibacterial cream for the first few days.  After that, while the bed of your nail is pink, you should apply a healthy coat of vaseline and continue to dress the toe.  The vaseline will help keep the nail bed soft and actually aid in healing.  

One day post nail avusion surgery. Toenail injuries
GRAPHIC - One day post nail avulsion surgery

Toenail Injuries

Usually if a toenail is removed it is the result of an injury or trauma.  If you jam a toe hard enough, it can force the nail away from the bed.  Repetitive rubbing or stubbing a toe can cause the nail to detach.  Wearing shoes that are overly tight can also contribute to an injury.  Many serious soccer players like to wear shoes that are 1 – 2 sizes small because they believe this helps them feel the ball better.  It may, but it also sets them up for increased risk of foot injury

Can You Play Soccer When Missing a Toenail (or two)?

It may take 6-8 weeks before your toe feels good enough for you to play, following a partial nail avulsion.  Professionals usually recommended that you wait 10 – 12 weeks after a total nail avulsion.

Toenails typically grow 1 mm a month, but physicians usually say that it may take 12 – 18 months for toenails to grow in fully.  In some instances, the nail may not look the same.  You don’t have to wait for the entire nail to grow back, but you need to wait until the area is strong enough that it is not causing you pain.  In some cases when you should not play with a missing toenail. Your doctor may recommend that you stay out if your missing nail is due to infection or if the area is very painful.

Some things you can do to protect your toe as you return to training include getting gel covers for your toe.  Look for toe guards.  Some orthopedists recommend wearing double socks and getting shoes that are larger while you are returning to play.  It is always best to consult your doctor or a physical therapist / athletic trainer when recovering from an injury or surgery..

Ofcourse if you are not feeling any pain and you can comfortably wear cleats and shoot without pain, you may be able to play.  If you’re unsure if you should play without a toenail, you should consult your doctor/athletic trainer.

What Causes Toenail Injuries?

There can be several reasons why you suffer from toenail injuries.  You may get stepped on by another player.  Ingrown toenails (sometimes a result of overly tight shoes or cleats) may be the cause. You might have a nail infection or fungus (sometimes caused by wearing wet, sweaty socks for too long)

Ingrown toenails occur when the nail begins to grow in towards the skin.  These can be extremely painful.  They may require regular maintenance if the shape of your toe causes them.  They must be treated properly or you run the risk of infection.

Soccer itself doesn’t cause ingrown toenails, but if you wear cleats that are too tight, you may get them.  If your cleat is too narrow, or even too small, your toenail may be continually pushed into the skin.  Ingrown toenails can be extremely painful.

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