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How to Keep Black Toenails From Ruining Your Runs by Jenny McCoy, Runner s World Editors © Getty Images Find out what’s causing your black toenail or missing toenail and what you can do to run pain-free. Black toenails in runners are often caused by repetitive trauma, which can result from running or from wearing any type of ill-fitting footwear. Keeping your toenails short, sizing up a half size in shoes, or wearing a thinner sock can help prevent black toenails from occurring in the first place. In mild cases, no treatment is needed, and the black nail will simply grow out. But if you’re in a lot of pain, your doctor can drain the blood from your nail, which relieves the pressure.

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