The Center for Podiatric Care and Sports Medicine

Removing Toenails for Ultramarathoners: Helpful or Crazy?

Posted by on Wednesday, April 10th, 2013


Last week I wrote about toenails: why they exist, how they help us in our modern lives, and why they thicken as we age. While toenails may not be as indispensable as they once were – as rough horn-like projections that protected our toes from all sorts of environmental hazards – they still help protect our toe bones and give us something to paint in festive colors. But one group of extreme athletes are saying goodbye to their trusty little nails. And it’s all in the interest of greater efficiency, less pain, and better overall performance. But toenails are a body part! Are these people totally insane? When you consider all of the maladies of those innocuous-seeming little hardened keratin plates, maybe not.


Toenails are a hot bed (pun intended) of potential problems. This is particularly true for ultramarathoners who spend many hours running over rough terrain. Their toes suffer all manner of abuse: cuts, bruising, blisters, jams, stubs, dampness, and constant intense pressure. Any tiny abnormality of the nail or nail bed can lead to injury, infection, and most of all pain. And pain is bad when you’re an ultramarathoner. Very bad. Small injuries lead to larger injuries quickly in the midst of an all-day and all-night race. Hobbling along, picking your way through the trees, alone, in the rain… it’s not much fun.


Ingrown toenails are one of the ultramarathoner’s major concerns. They’re incredibly common, resulting from a toenail that curls inward, cutting into the skin of the toe. And they’re very easily infected. Any trauma to the nail or nail bed can cause them, and they often require surgery to correct. Trying to run a 250-kilometer, 7-day race on an ingrown toenail is like trying to polka barefoot on a razorblade. Or, at least, that’s what I imagine it would be like. I’m no ultramarathoner. The Marathon du Medoc where you drink wine the whole time is more my speed. But I do know one thing: ingrown toenails are incredibly painful.


Removing the toenail, as you might expect, completely eliminates the risk of ingrown toenails, and of many other toenail-related disorders like painful fungal infections. The removal process is rather grisly (the toes are given a bath in strong acid that dissolves the nail) but many athletes insist it ups their game considerably. They consider the toenails to be dead weight, something they just don’t need. The procedure does carry some risks. Sometimes the tip of the toe can become sensitive and sore, and sometimes (rarely) the toenail grows back anyway despite acid treatment or surgery. But one doctor who had a patient fly in from Russia for the procedure says: “I’ve never had a patient have any regrets.”


If you have any foot problems or pain, contact The Center for Podiatric Care and Sports MedicineDr. Josef J. GeldwertDr. Katherine Lai, Dr. Ryan Minara and Dr. Mariola Rivera have helped thousands of people get back on their feet. Unfortunately, we cannot give diagnoses or treatment advice online. Please make an appointment to see us if you live in the NY metropolitan area or seek out a podiatrist in your area.