Tennis Toe

toes2You play tennis long enough and hard enough and you get it… the discolored toe nail (and maybe the nail dies and eventually falls off).

I regularly have the problem and it can become quite painful. It usually comes from ramming your toes into the front part of your shoes when stopping hard on the court.

Here are some tips on how to prevent and deal with it …

Shoe Size: Try buying shoes a half size bigger than you normally do, which will give you more room “up front”; and not too wide, so that your foot doesn’t slide around.

Shoe Bottom: When I mentioned my problem to Roy Emerson at camp one year, he said they used to save their oldest tennis shoes – with worn smooth bottoms — to use on the hard surface courts; so that the shoes wouldn’t grab the court as much.

Lacing: When lacing up your shoes to play, pull the top ones as tightly as possible/comfortable to prevent your foot from sliding forward.

Socks: Try wearing two pairs of socks, which will give you more cushioning up front – and, help prevent blisters too.

Nails: Keep your nails trimmed as short as possible; and if your big toe has a “thick” nail, also file that down from the top to reduce the impact area.

Surface: Avoid playing on hard courts as much as possible.

Nail Fungus

Often confused with the pounding-caused tennis toe is Nail Fungus, which according to WebMD.com is:

“Onychomycosis is a condition that occurs when a microscopic fungus enters either a fingernail or toenail. Fungal infections occur in toenails more often than in fingernails.
Anyone can get nail fungus, but infections are more common in people over the age of 60. For people who have diabetes or a weakened immune system, nail fungus can present serious risks.

What Causes Nail Fungus?

Usually, nail fungus occurs when fungus enters the nail through a small trauma (cut or break) in the nail. Nail fungus is not caused by poor hygiene. Nail fungus can be spread from person to person. It may be hard to determine exactly where or how a fungal infection is acquired. However, a warm, wet place (for example, a locker room) is a good place for a fungus to grow.

What Are the Symptoms of Nail Fungus?

A nail fungus infection can make nails thick and discolored. Uncommonly, you may feel pain in your toes or fingertips.

How Is Nail Fungus Diagnosed?

Your doctor may be able to tell if you have a nail fungus infection by looking carefully at your nails. He or she may scrape some tissue from under a nail and look at it under a microscope or send it to a lab to determine what kind of infection you have.

How Is Nail Fungus Treated?

Treatment for a nail fungus may include topical creams or oral medications (antifungal drugs), but topical antifungal drugs likely won’t cure the infection. Rarely, surgery may be required. Although seldom done, removal of the infected nail can be performed to permit direct application of a topical antifungal. Oral drugs, such as terbinfine, can cure about 50% of nail fungus infections.”

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5 thoughts on “Tennis Toe

  1. 1/2 size larger shoe and two pairs of socks did the trick for me. More cushion for my sore feet was also a side benefit.
    Topical nail fungus clear laquer has helped keep my nails looking decent.
    Great article George

  2. Your commentary and advice is quite good. You sound almost like a retired dermatologist.

    Michael – Thanks, Doc! george

  3. Agree with all your comments on tennis toe. Because of a narrow foot (with fallen arches), I found that New Balance is one of the few brands that offers a narrower size – which has helped prevent the foot slide forward within the sneaker.

    Dag – and i use New Balance for the wider sizes! tks, george

  4. George, great article…my Dad played tennis (doubles) up to 5 months before he died at age 90. Our toe nails under the microscope have small pores where the fungus jumps in when you play tennis. It’s dark and moist in your shoe (why moss is on the north side of a tree in the midwest) and with the microtrauma of playing (even in a shoe that fits) it’s a set up for yellow fungal toes (we call it “having the funky toe”. I am a family physician and invented Dr Paul’s Piggy Paste a safe easy otc gel applied daily and covered with a bandaid solves the problem 75% of the time in 3 1/2 months ( available in Naples at Walgreens). Don’t let your toes stop you from playing tennis…check out piggypaste.com

    Dr. Paul, I will buy some and try it out! Where do you play your tennis? Thanks, george

  5. Slightly off topic, but I had/ have a condition called Hallux Rigidus, which is basically an arthritic condition where a bone spur forms over the MTP joint in one’s big toe — the big joint where the toe attaches to the foot. As a result, one cannot invert one’s toe to spring off when walking or running. In street terms, it hurts like hell to push off your front foot and you wind up walking or running on the back/side of your foot. It obviously impedes movement in tennis and, when it was first diagnosed in both of my toes circa 2000, my only options were to have surgery to cut out the bone spurs, live with it, or get the toes “fused” or allow them to fuse naturally (in which case I would then need special sneakers, called rockers, to run). If you are active, a replacement toe joint, which is apparently available, is not a good option, because unlike artificial knee and hip joints, they tend to wear out or break rather quickly, and the toe doesn’t have enough bone mass to hold them in place well and once such a joint has been installed and needs to be removed there is not enough bone mass left for a replacement. I opted for the surgery to cut them out, although I was told that a likely after effect would be the bone spur pain goes away (which it did) but the underlying arthritis pain would get more severe (which it also did). I was also told that the bone spurs would eventually grow back, which I am noticing to be increasingly true as I get older. This means I will have to make another difficult decision eventually about possibly more surgery, including maybe having to get the joint fused the next time out. The bottom line is if any readers have or think they have this condition, get yourself to a good orthopedic foot doctor or a well qualified podiatrist who has experience with this condition. It can be addressed, but none of the options allow for a 100% recovery. So, you learn to cope.

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