How Diabetes Affects Toenails: Common Issues and Prevention Tips

Written by Erica Halpern on October 16, 2025

Diabetes is a chronic condition that affects many parts of the body — including your feet and toenails. Proper foot care is especially important for people with diabetes because they are at a higher risk of developing complications that can impact mobility and overall health. Understanding how diabetes affects toenails can help you prevent problems and maintain healthy feet.

Why Diabetes Impacts Toenail Health

People with diabetes often experience poor circulation and nerve damage (neuropathy) in their feet. These issues make it harder for wounds and infections to heal and can reduce sensation, so small injuries or infections may go unnoticed. Toenails can also become more vulnerable to damage, infections, and deformities.

Common Toenail Problems in People with Diabetes

1. Fungal Infections

whimsical depiction of fungal toenail with mushrooms growing out of nails

Diabetes can weaken the immune system, making it easier for fungal infections like athlete’s foot or toenail fungus to develop. Fungal toenails may become thickened, discolored, brittle, and painful.

In addition, good circulation is required for the natural moisturization processes in the toenails and feet. Diabetes disrupts blood flow to the feet, which means they can’t properly moisturize themselves. This dries out the toenails and causes them to become brittle. It also dries out the skin, which can cause small cracks and abrasions. Fungus can then more easily penetrate through brittle cracked toenails and abrasions. Once it does, it’s harder for your body to fight the infection due to diabetes’ affect on the immune system.

2. Ingrown Toenails

Reduced sensation means small cuts or ingrown toenails might not be felt immediately, increasing the risk of infection. Ingrown toenails can cause redness, swelling, and pain if left untreated.

3. Toenail Discoloration and Deformities

Using ointment to help curled, thick toenail

Poor circulation and infections may cause toenails to change color, thicken, or become deformed. This is because circulation is required to facilitate the toenail growth process. When this process is disrupted, it causes nail cells to build up on top of each other rather than beside each other, which causes thickening and an irregular toenail shape. This can make nail trimming difficult and increase the risk of injury.

4. Delayed Healing

Any cuts or injuries around the toenails heal more slowly in people with diabetes, increasing the chance of complications like ulcers or infections.

Tips for Preventing Toenail Problems with Diabetes

Practice Good Foot Hygiene

Wash your feet daily with warm water and mild soap.
Dry your feet thoroughly, especially between the toes.

Keep Toenails Trimmed and Clean

Cut nails straight across to prevent ingrown toenails.
Avoid cutting nails too short or rounding the corners.

Wear Proper Footwear

Choose shoes with a wide toe box and good support.
Avoid tight or narrow shoes that can cause pressure and injury.

Regular Foot and Toenail Checks

Inspect your feet daily for cuts, blisters, redness, or swelling.
Have a healthcare professional, like a chiropodist, examine your feet regularly.

Manage Blood Sugar Levels

Accessories for light exercise with diabetes

Keeping blood glucose under control supports overall foot health and healing.

When to See a Foot Specialist

It is recommended that people with diabetes include a chiropodist in their healthcare team and see them on a routine, ongoing basis for diabetic foot care. When it comes to diabetes, prevention is the best treatment.

If you notice any signs of infection, persistent pain, changes in nail appearance, or wounds that don’t heal, it’s essential to seek professional care promptly. Early intervention can prevent serious complications, including foot ulcers and infections that may lead to amputation.

Prevention is the Best Treatment

Protect your feet and toenails by scheduling diabetic foot care with Feet First Clinic. Our experts specialize in diabetic foot care and can provide personalized advice and treatment to keep you on your feet safely.

About Author: Erica Halpern

Erica is the operations manager at Feet First Clinic. Since 2021, she has been writing, researching and editing website and social media content. She also oversees Feet First Clinic’s daily and strategic operations to ensure the best possible experience for our clients. Her goal is to ensure patients are equipped with the knowledge and solutions they need to help with their pain.

Learn more about Erica Halpern

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July 24, 2025

Runner’s Toenails: How Running Affects Your Toenails

Running is great for your overall health—but your toenails might disagree. Many runners deal with painful or unsightly toenail problems, especially after long distances or hill training. Issues are so common that "runner's toenails" is a commonly used term to describe all the toenail damage. Understanding how running impacts toenail health can help you prevent injury and keep your feet in peak condition. View this post on Instagram A post shared by Feet First Clinic (@feetfirstclinic_) Common Toenail Issues Runners Experience Black Toenail from Running (Subungual Hematoma): One of the most recognizable issues, a black toenail develops when repeated impact causes bruising or bleeding under the nail. It’s often due to shoes that are too tight or downhill running. Toenail Lifting or Falling Off: Constant pressure on the nail bed can cause nails to lift or fall off completely—especially after a marathon or long run. This is usually painless, but it takes months for the nail to regrow. Thick Toenails After Running: Repeated trauma can lead to thickened toenails, which may resemble fungal infections. This thickening is the nail’s response to long-term micro-damage and may become permanent if untreated. Ingrown Toenails: Tight shoes or improper nail trimming can lead to ingrown toenails, which are common among runners and can become infected if ignored. What Causes Running-Related Toenail Damage? Improper shoe fit: Shoes that are too tight, too loose, or worn out can lead to friction and trauma. Long toenails: Long nails hit the front of the shoe with every stride, increasing the risk of bruising or lifting. Downhill running: Increases the impact on the toes. Sweaty feet: Create a moist environment that can encourage fungal growth. Inadequate socks: Thin or poorly fitted socks allow for extra movement inside the shoe. Runner’s Toenail Care: Prevention Tips Trim your nails regularly – Straight across, not too short, and never rounded at the corners. Wear proper footwear – Choose shoes with about a thumb’s width of space at the front, and consider a running-specific fit. Choose the right socks – Moisture-wicking and snug, with no bunching or seams that rub. Replace shoes as needed – Most running shoes last 500–800 km. Worn-out soles contribute to poor foot mechanics. Moisturize your feet – Prevent cracking and fungal buildup with a good daily foot care routine. When to See a Foot Specialist If your "runner's toenails" are persistently discoloured, painful, or thickened, it’s time for a professional assessment. What seems like a harmless black toenail from running could be a fungal infection, ingrown nail, or even an injury needing care. A chiropodist or foot specialist can safely treat nail trauma, provide custom foot care advice, and help you run pain-free. View this post on Instagram A post shared by Feet First Clinic (@feetfirstclinic_) Final Thought You train hard—don’t let toenail trouble slow you down. By caring for your feet proactively, you can avoid common nail issues and keep running comfortably year-round.

April 10, 2025

Curved Toenails? Here’s What You Need to Know

Curved toenails can indicate various underlying toenail conditions, each with unique causes and additional characteristics. They also don’t always look the same. Toenail curvature issues can range from having a severe Ram’s Horn toenail, accompanied by other symptoms like thickening and discoloration, or small pincer nails that pierce your skin. Let’s learn about curved toenail causes, and most importantly, how a chiropodist or podiatrist can treat curved toenails at a foot clinic so complications don’t arise. Why Do Toenails Curve? https://www.youtube.com/shorts/Z6VYvI6CJQs To understand the best ways of preventing curved toenails, it’s important to learn how healthy toenails grow. They should naturally grow forward in a slightly arched but mostly flat shape, following the contour of the toe. This process begins in the nail matrix, the tissue under the skin at the base of the nail, where specialized cells produce layers of keratin—the protein that makes up the nail. As new cells form, older cells are pushed outward, harden, and form the visible nail plate. Ideally, the nail grows evenly and straight across, guided by both the shape of the matrix and the direction of mechanical forces applied to the toe, like walking or wearing shoes. The nail bed beneath provides support and helps keep the nail anchored and flat as it grows. A balance between nail thickness, width, and surrounding skin tension is key to maintaining this typical shape. Toenails start to curve when something disrupts this balance. Repetitive Trauma from Ill-Fitting Footwear One common reason is uneven pressure and toe crowding. Tight footwear or repetitive trauma can push the nail’s edges downward or inward over time. That’s why one of the best ways of preventing curved toenails, or virtually all foot conditions for that matter, is purchasing and wearing only shoes that fit properly, allow your toes to splay comfortably, and have ample cushioning, arch support and shock absorption. It’s better to have a small selection of solid, high-quality shoes that support foot health than several pairs of low-quality, poorly designed shoes that cramp your toes. https://www.youtube.com/shorts/rwNLRZ-MN_M Genetics Genetics also play a role in abnormal toenail growth; some people naturally have a more curved nail matrix or a narrower nail bed, both of which can encourage curling. If keratin production is uneven—say, one side of the nail grows faster than the other—the nail can begin to twist or curve as it extends. Underlying Health Conditions Inflammatory conditions, infections, poor circulation, or chronic diseases like diabetes can also interfere with normal nail growth by altering cell turnover in the matrix or causing changes to the skin and tissue around the nail. As a result, curved toenails are often not just a cosmetic issue—they can signal deeper structural or health-related concerns. Curved Toenail Causes Whether your curled toenails are the result of a sinister condition or simply a genetic growth pattern you’ve inherited, preventing them from getting worse is key. No matter the cause, proper trimming (straight across with simple nail clippers) and wearing shoes that fit well are two of the best things you can do from home to prevent painful complications and live life as comfortably as possible. Below you’ll find some of the most common causes of curved toenails: Ingrown Toenails (Onychocryptosis) Ingrown toenails are tricky as they look deceptively mild. But complications, like painful infections, can arise if you ignore them. They develop when the edge of a curved toenail grows into the surrounding skin, causing swelling, redness, and sensitivity. They can look curved, but they also look like a small “extra nail” on the edge of the main nail. It most commonly affects the big toe, and naturally curved toenails (involuted nails) are more likely to become ingrown because their growth pattern is already unusual. Trimming the nails too short or rounding the edges can also encourage the skin to fold over the nail edge, allowing it to grow inward instead of outward. Repeated pressure or trauma from sports, stubbing the toe, or restrictive footwear (in the toe box, like narrow, pointed high heels) can also disrupt normal growth and set the stage for an ingrown nail to form. https://www.youtube.com/shorts/B5a3yIgokh8 Pincer Nails (Trumpet Nails) Classified by podiatrists and chiropodists as “the most painful type of ingrown toenail,” pincer nails, or trumpet nails, occur when the sides of the toenail curve inward toward each other, sometimes so dramatically that the edges look like they want to meet underneath the toe! This shape creates a pinching effect on the nail bed and surrounding tissue. While some people are born with a naturally curved nail structure that gradually tightens over time, others develop this condition due to external pressures. Long-term use of tight shoes, particularly those with narrow toe boxes, is a major contributing factor. Certain systemic conditions, such as autoimmune disorders or circulatory problems, may also affect the nail matrix and contribute to this unusual curvature. Additionally, aging can play a role, as nail shape and growth patterns tend to change over time. Onychogryphosis (Ram’s Horn Nails) View this post on Instagram A post shared by Feet First Clinic (@feetfirstclinic_) Onychogryphosis is a condition where the toenail becomes dramatically thickened and begins to grow in a distorted, curved, or spiraled shape that resembles a ram’s horn. It often affects the big toe and progresses gradually over time. The nail’s irregular growth is usually the result of uneven cell production in the nail matrix, where one side grows faster than the other. The most common causes include repetitive trauma (like years of wearing ill-fitted shoes), long-standing fungal infections, or neglect of nail trimming. It’s more frequently seen in older adults or individuals with limited mobility who may struggle with basic foot care. Certain systemic conditions, including psoriasis and vascular disorders, may also interfere with healthy nail growth and lead to this thickened, curved form. Curved Toenail Pain Relief and Solutions: Nail Disorder Treatment Toenail curvature can cause pain and nagging discomfort that disrupts your daily life. Remember, the nail should not be growing this way, and it’s up to you to take the first step towards finding a solution. Chiropodists and podiatrists offer several effective treatments to address curved toenails, tailored to the severity and underlying causes. Below are some common treatments available at foot clinics: Proper Fitting Footwear Wearing shoes that are the correct length 0with a wide toe box is crucial for preventing and alleviating discomfort associated with curved toenails. Footwear that allows ample space for the toes reduces pressure on the toenails, minimizing the risk of them growing into the surrounding skin. Properly fitting shoes not only aid in preventing the development or worsening of curved toenails, but also provide some pain relief for existing conditions that need accommodation. Ensuring that shoes complement the natural shape of the foot without squeezing or compressing the toes is a simple yet effective measure in maintaining toenail health. Medical Pedicures Medical pedicures are performed by trained chiropodists or podiatrists and focus on the health and hygiene of the feet and nails. Unlike cosmetic pedicures, these procedures address underlying issues and focus more on nail maintenance and health than aesthetic appearances (although the nails always look clean and fresh afterwards!). During a medical pedicure, the specialist will carefully trim and reshape the toenails using sterilized instruments, reducing the risk of further complications. They are a common treatment for people with diabetes who cannot cut and clean their nails properly without assistance, and who need an extra set of eyes and expertise to spot abnormalities. OnyFix Nail Correction System The OnyFix system is a non-invasive, highly innovative, and pain-free treatment designed to correct curved toenails—especially ingrown toenails. It involves applying a specialized composite material to the nail, which hardens and acts as a brace, guiding the nail to grow in its natural shape without exerting direct force. This method is suitable for various nail shapes and is particularly beneficial for patients seeking an alternative to surgical interventions. The Onyfix system allows individuals to continue their daily activities without restrictions, including swimming and wearing nail polish. https://www.youtube.com/shorts/LoCcoKOhV7E Nail Avulsion Surgery In severe cases, such as with ram's horn toenail, surgical intervention may be recommended. This procedure involves the partial or complete removal of the affected toenail under local anesthesia. By removing the deformed nail, the underlying tissue can heal properly, and a healthier nail may regrow. Alternatively, a solution called phenol may be used to prevent nail regrowth.

April 3, 2025

Why Poor Blood Flow Causes Toenail Problems

Healthy toenails need healthy circulation, but when blood flow is compromised, they can become brittle, discoloured, or grow slowly. Additional toenail conditions can also develop. Poor circulation and toenail problems are closely linked, especially for those with health problems like diabetes or peripheral artery disease. Understanding why poor blood flow affects toenails can help you take the right steps to protect your foot health and prevent complications. https://www.youtube.com/shorts/3JAUqiqJfus The Importance of Blood Circulation In order to understand the link between poor circulation and toenail issues, we have to start by understanding what blood flow is and what it does. The circulatory system, comprising the heart, blood vessels, and blood, serves as the body's transportation network. Its primary function is to deliver oxygen and essential nutrients to cells while removing waste products like carbon dioxide. The heart pumps oxygen-rich blood through arteries, which branch into smaller arterioles and capillaries, reaching every tissue and organ. This process ensures that each cell receives the necessary components for energy production, growth, and repair. Efficient blood circulation is vital for overall health. Oxygen transported by red blood cells is crucial for cellular respiration, the process by which cells generate energy. Nutrients absorbed from digested food are distributed via the bloodstream to support various bodily functions. Key nutrients delivered by the bloodstream include: Glucose: A simple sugar derived from carbohydrates in our diet, glucose serves as the primary energy source for cells, fueling various physiological processes. Amino Acids: These are the building blocks of proteins, obtained from the digestion of dietary proteins. Amino acids are crucial for tissue growth, repair, and the synthesis of enzymes and hormones. Fatty Acids and Lipids: Essential components of cell membranes and energy storage molecules, fatty acids and lipids are transported to cells for incorporation into cellular structures and for energy production. Vitamins and Minerals: These micronutrients support a range of cellular functions, including maintaining bone health and facilitating nerve transmission. Hormones: Although not nutrients in the traditional sense, hormones are vital signaling molecules transported by the circulatory system to regulate various physiological activities, such as metabolism, growth, and mood. Impaired circulation can slow down healing processes—even for seemingly innocent and minor problems like cuts and scrapes. Likewise, organs and tissues deprived of adequate circulation can suffer damage over time, increasing the risk of conditions such as peripheral artery disease, stroke, and heart attacks. Toenail Health and Circulation: The Connection The circulatory system delivers oxygen and essential nutrients to the nail beds, supporting the growth and maintenance of strong, clear nails. When blood flow is compromised, the nails may not receive adequate nourishment, leading to various issues such as brittleness, discoloration, and slowed growth. In some cases, poor circulation can cause nails to develop ridges, indicating underlying vascular problems. Reduced blood flow can also increase the risk of infections like toenail fungus (onychomycosis). A weakened circulatory system impairs the body's ability to combat pathogens, making the toenail environment more susceptible to fungal overgrowth. This often results in yellowed, thickened nails that you can’t treat without the help of a chiropodist or podiatrist. They must remove the infected portion of the nail so they can apply the correct medicine. Poor blood flow on its own may not cause a problem with your foot health, but it can contribute to the following toenail conditions: Slow or halted nail growth: Inadequate blood flow deprives the nail matrix of essential nutrients and oxygen, resulting in reduced or ceased toenail growth. This can be very frustrating if your toenail falls off or cracks and you’re waiting for it to grow back, leaving your feet vulnerable. Brittle and discolored nails: Insufficient circulation can cause nails to become brittle and change color, often appearing yellowed or darkened. Thickened nails: Poor blood flow may contribute to the thickening of toenails, often via toenail fungus, making them difficult to trim and maintain. Poor blood flow also affects the nail growth process, which can cause nail cells to pile on top of each other and lead to thicker toenails. Ingrown toenails: While not directly caused by poor circulation, individuals with compromised blood flow, such as those with diabetes, are at higher risk for complications from ingrown toenails, including infections and delayed healing. Diabetes, Toenail Health and Circulation Diabetes can lead to two significant complications affecting foot health: diabetic neuropathy and peripheral artery disease (PAD). Diabetic neuropathy results from prolonged high blood sugar levels damaging the nerves, particularly in the legs and feet, causing numbness, tingling, or a loss of sensation. This diminished sensitivity means that innocent injuries, such as cuts or blisters, may go unnoticed, increasing the risk of infections and complications like ulcers, or in severe cases, life threatening problems like gangrene, which require amputation. This is also the case for seemingly minor problems with the toenails. Simultaneously, PAD causes blood vessels to narrow and harden, reducing blood flow to the extremities. This impaired circulation hampers the delivery of oxygen and essential nutrients needed for healing, making the feet and toenails even more susceptible. Regular foot inspections and nail care with a chiropodist or podiatrist, maintaining proper hygiene, and promptly addressing any abnormalities are crucial steps for diabetics to prevent toenail-related complications stemming from poor blood flow. https://www.youtube.com/shorts/QFWBwM6mGqM?feature=share Foot and Nail Care for Poor Circulation Maintaining proper foot and nail care is essential for individuals experiencing poor circulation, as reduced blood flow can lead to various complications. Here are some recommended practices and treatments: https://youtu.be/5PCZuM5E6RU Regular Exercise: Maintaining good circulatory health through regular exercise, a balanced diet, and avoiding smoking is essential for ensuring that the body's systems function as well as possible. One of the best circulation maintenance tips for foot health is working the muscles in the lower extremities. Exercises like toe splays, toe flexes and raises, massage ball rolls, pen pick-ups and seated toe pulls can work wonders. Click here to learn the five best foot exercises to improve blood circulation. They’re particularly helpful in the winter, but are useful all year round. Regular Self Inspections: Conduct daily checks for cuts, sores, or changes in nail color and texture to detect issues early. Moisturizing: Keep feet hydrated to prevent cracks and fissures that can lead to infections. Learn how to moisturize properly here. OnyFix Nail Correction System: For those with ingrown or involuted toenails, the OnyFix system offers a non-invasive, pain-free solution. This innovative treatment involves applying a composite material to the nail, which helps guide it back to its natural shape as it grows, without the need for surgery. It's suitable for various nail shapes. Medical Pedicures: Unlike traditional cosmetic pedicures, medical pedicures are performed by trained foot care professionals, such as chiropodists or podiatrists, in a sterile environment in a foot clinic. They focus on health, addressing issues like nail trimming, callus reduction, and infection prevention. They are especially helpful for dealing with irregular shaped toenails caused by poor circulation - cutting and maintaining these on your own can be very difficult. For people with diabetes, who are at higher risk for foot complications due to poor circulation and neuropathy, medical pedicures are a common and recommended treatment. These specialized pedicures help prevent complications like infections or ulcers by ensuring meticulous foot care. Proper Footwear: Wear well-fitting shoes that provide adequate support and reduce pressure points to promote better circulation. Proper Nail Trimming: Trim nails straight across and avoid cutting them too short to prevent ingrown toenails. And if your toenails are too thick or difficult to cut on your own, book an appointment with a foot specialist.

March 20, 2025

Ram’s Horn Toenails: What They Are and How to Treat Them

Ram’s horn toenails? Sounds like a serious foot issue! And it is—this condition, medically known as onychogryphosis, causes thickened, curved nails that can become painful and difficult to manage over time. It doesn’t just affect nail appearance; it can lead to discomfort, infection, and mobility issues if left untreated. Fortunately, onychogryphosis treatment options from a chiropodist or podiatrist are available to help you manage comfort and nail health. What Are Ram’s Horn Toenails? View this post on Instagram A post shared by Feet First Clinic (@feetfirstclinic_) Ram’s horn toenails (onychogryphosis), one of the many types of toenail conditions, is classified as a nail disorder or nail disease where the toenail becomes extremely thick, abnormally curved, and overgrown, often resembling the spiraled shape of a ram’s horn. This happens because the nail plate—made of keratin—grows unevenly due to disruptions in the nail matrix, the part of the nail bed responsible for new cell production. Instead of growing outward smoothly, the nail thickens, hardens, and may curl or twist due to uneven pressure and irregular cell turnover. They have a similar appearance to a severe fungal toenail infection. The texture of a ram’s horn toenail is usually rough, ridged, and extremely hard, making it difficult to trim with standard nail clippers. Over time, the nail can develop a yellowish, brownish, or even grayish hue due to keratin buildup and potential fungal infections. In severe cases, the nail may grow so long and misshapen that it presses into the surrounding skin, causing pain, tenderness, and difficulty wearing shoes or walking comfortably. Because the thickened nail loses its normal flexibility, it can crack or split, increasing the risk of infection. The appearance of onychogryphosis can also affect confidence and make it difficult to find shoes that accommodate their size and abnormal shape. Although onychogryphosis most commonly affects the big toe, it can develop on others as well. It tends to progress gradually, meaning that early signs—such as mild thickening or slight discoloration—can go unnoticed until the nail has significantly changed in shape and texture. Causes of Ram’s Horn Toenails https://www.youtube.com/shorts/3JAUqiqJfus These toenails do not generally form spontaneously without an underlying cause or risk factor. Let’s take a look at what generally causes this nail disorder. Risk Factors for Ram’s Horn Toenails: Trauma and Ill-Fitting Footwear Repeated or acute trauma to the toenail can disrupt normal nail growth, leading to thickening and deformation. Continuous pressure and friction, such as from ill-fitting footwear, can cause microtrauma to the nail bed, contributing to the development of onychogryphosis. Essentially, the toenail thickens and starts growing in a different direction to protect itself. Age In general, our feet become more vulnerable with age due to several physiological changes that can occur, which can predispose us to onychogryphosis. For instance, reduced peripheral circulation, common in older adults, impairs blood flow to the extremities, leading to diminished oxygen and nutrient delivery to the nails. This alters the nail's natural growth process, causing nails to grow slower and nail cells to pile up on top of each other (rather than growing out). As a result, they thicken and can change shape. Additionally, decreased mobility in the elderly may lead to inadequate foot care, contributing to nail abnormalities. https://www.youtube.com/shorts/gEi59gq5g54 Diabetes Diabetes significantly increases the risk of developing onychogryphosis, particularly due to the effects of diabetic neuropathy. Diabetic peripheral neuropathy reduces sensation in the feet, so individuals may not notice pressure, injuries, or trauma to the toenails, which can lead to deformities like onychogryphosis. Without the ability to feel discomfort, they may unintentionally cause damage to the nail, leading to thickening, curling, and other changes associated with the condition. Additionally, poor circulation caused by diabetes can impede healthy nail growth, making the nails more prone to abnormalities. Peripheral Vascular Disease (PVD) As already discussed, poor circulation affects the nail growth process and can lead to nail deformities. In particular, peripheral vascular disease involves the narrowing of peripheral arteries, reducing blood flow to the limbs. The diminished circulation can cause various symptoms, including slow or unusual nail growth. Without proper blood flow, the nails may become thickened and misshapen, potentially progressing to onychogryphosis if left untreated. Cognitive Impairment Relating back to age as a risk factor, conditions such as dementia can lead to neglected foot care due to cognitive decline. Individuals with dementia may forget or be unable to perform regular foot hygiene practices, increasing the risk of nail deformities like onychogryphosis. Self neglect, or infrequent cutting of toenails for a significant amount for any reason, is also a risk factor. High-Friction Sports and Activity Participating in high-friction sports like running, soccer, or ballet can increase the risk of developing onychogryphosis. Repetitive pressure and friction from constant movement or improper footwear during these activities can cause trauma to the toenail, leading to thickening, curling, and potential deformity. Runners, for example, often experience repeated impact on their toenails, particularly the big toe, which can cause them to become damaged or misshapen over time. Additionally, athletes who wear shoes that are too tight or too loose, which cause friction and rubbing, are more likely to develop toenail issues. As is the case with ill-fitting footwear, over time, the nail thickens and changes growth direction in order to protect itself from the repetitive trauma. Hyperuricemia High levels of uric acid in the blood is often associated with gout, but it can also contribute to the development of onychogryphosis. Elevated uric acid can lead to the deposition of urate crystals in joints and tissues, including the nails, which can cause inflammation and damage. This buildup may result in nail thickening, distortion, and a rough appearance. While gout primarily affects joints, the condition’s systemic nature can also have an impact on nail health Fungal Infections Also known as onychomycosis, fungal infections cause thickening and nail distortion. These infections often thrive in warm, moist environments and can infiltrate the nail, leading to changes in color, texture, and shape. In diabetic patients, onychomycosis prevalence is notably higher, reaching up to 31.5%, due to factors like elevated blood glucose levels and compromised immune response. Psoriasis / Psoriatic Arthritis Psoriasis or psoriatic arthritis can cause nail changes in roughly half of affected individuals. Proper management of psoriasis through medical treatments can help alleviate these nail changes and improve overall nail health. Treating Ram’s Horn Toenails: Nail Care for Curved Toenails https://www.youtube.com/shorts/QFWBwM6mGqM Routine Professional Nail Care It’s very important to visit a Podiatrist or Chiropodist, both types of foot specialists in Ontario, if you have Ram’s horn toenails. This is because it is far too difficult, even dangerous, to manage them yourself. Their thickness, abnormal shape and unsightly appearance and positioning on your foot make it impractical to try cutting them with standard nail clippers, and is not advised. A chiropodist or podiatrist can tend to your nails properly with specialized tools designed to maintain nail disorders. They can also perform toenail debridement, smooth out nail edges, clean out debris, and apply sprays that help with discoloration. Other nail care treatment options may vary depending on the severity of the condition. In more extreme cases, surgical interventions such as nail avulsion—removal of the nail plate—may be considered. If an infection is present, a chiropodist or podiatrist can prescribe the appropriate antifungal or antibacterial treatments to address the underlying cause (you can't treat fungal infections from home). In addition to the specialized care provided by podiatrists and chiropodists, treatment for Ram’s horn toenails can also include regular monitoring to track any changes in the condition. They may suggest specific at-home care practices, such as gentle cleaning and moisturizing, to support the overall health of the nails and surrounding skin. For individuals with chronic conditions, like diabetes, it is especially important to maintain close contact with a foot care specialist to ensure the toenails remain manageable and complications are avoided. Diabetes patients who neglect their foot health can experience severe ulcer formation. Onyfix Onyfix is just one of the many unique ways a foot specialist can help treat curved, curled or Ram's Horn Toenails. It's a non-surgical treatment that involves the placement of a band across the toenail. This band then corrects the nail's growth pattern and shape. It's great for Ram's Horn Toenails because it will help flatten out the toenail on the nail bed and "train" the toenail to grow in the correct direction. Proper Fitting Footwear But all the treatment in the world won't matter without eliminating one of the most common causes of curved, curled and abnormal toenails: ill-fitting footwear. As we already discussed, ill-fitting footwear causes repetitive trauma on the nailbed, which disrupts the toenail's growth process. Prioritizing footwear that minimizes pressure and allows for adequate toe room to alleviate discomfort and prevent further nail distortion is key. Opting for shoes with a wide toe box provides ample space for the toes to spread naturally, reducing friction and pressure on the affected nails. Shoes may also require extra depth, and orthopedic footwear may be required for sufficient comfort. Featured Photo By PixaBay

February 20, 2025

Different Types of Toenails

Toenails are more than just a cosmetic feature; they’re protective shields that provide insight into overall toenail health, general health and well-being. Their shape, texture, and condition can indicate underlying issues, simple genetic traits, or the effects of lifestyle habits. In this article, we will explore the various types of toenails based on shape, thickness, texture, as well as medical and foot conditions. How do Toenails Grow? Nails grow from a specialized area of skin called the nail matrix, located beneath the cuticle at the base of the nail. This matrix contains rapidly dividing cells that produce keratin, a tough protein that forms the structure of the nail. As new cells are generated, older cells are pushed forward, gradually hardening through a process called keratinization. The visible part of the nail, known as the nail plate, rests on the nail bed, which supplies it with nutrients and oxygen through a network of capillaries. The lunula, the pale crescent-shaped area at the base of the nail, is the visible portion of the matrix, where active growth occurs. Healthy nail growth depends on factors like blood circulation, nutrition, and overall health, with fingernails typically growing faster than toenails. You can learn more about toenail anatomy here. Toenail Shapes https://www.youtube.com/shorts/Z6VYvI6CJQs Toenails can naturally grow in different shapes due to genetic factors, footwear, medical conditions, and nail care routines. Below are some common toenails types (and some not-so-common types as well). 1. Normal (Flat or Slightly Curved) Toenails Healthy toenails are typically flat or slightly curved, with a smooth surface and a light pinkish hue. They are neither too thick nor too brittle and grow evenly without splitting or cracking. If your toenails are entirely white with no pinkish hue, it may indicate anemia. 2. Curled Toenails Some people naturally have curled toenails, where the edges curve gently. This shape is common and generally poses no issues unless the curvature is extreme, leading to a higher risk of ingrown toenails. Toenails that are excessively curled are called involuted toenails. It’s important to note you should never purposely try to round the sides of your toenails with toenail clippers — always cut straight across. 3. Square Toenails Square toenails are straight across with sharp (but not too sharp!) or slightly rounded corners. This shape is often preferred for reducing the risk of ingrown nails, as it prevents the nail from growing into the surrounding skin. When you trim your nails, or get them trimmed by a specialist like a podiatrist or chiropodist during a medical pedicure, the end result should resemble a square shape on all nails. 4. Spoon-Shaped (Koilonychia) Toenails Koilonychia is a term for spoon-shaped toenails that curve inward, creating a concave appearance. They can be a tell-tale way to discern the difference between healthy toenails vs. unhealthy toenails. This condition may be a sign of iron deficiency, anemia, autoimmune disease, lupus and poor blood flow to the hands and feet. Regular health check-ups and iron-rich diets can help prevent or manage this issue. 5. Clubbed Toenails Clubbed toenails are thickened and rounded, often appearing swollen and accompanied by broadening of the tip of the toes. This can be a sign of chronic respiratory or cardiovascular conditions. If toenails appear clubbed, a medical evaluation is recommended. Toenail Thickness & Texture https://www.youtube.com/shorts/3JAUqiqJfus The thickness and texture of toenails can reveal a lot about their health. 1. Thickened Toenails Thickened toenails are often due to fungal infections. Thick nails infected with fungus require professional care from a Chiropodist or Podiatrist for proper maintenance and treatment because the infection is trapped and buried beneath the thickening — you won’t be able to treat it at home successfully. More on fungal infections later! 2. Brittle Toenails Brittle toenails tend to split or crack easily and may be caused by dehydration, prolonged exposure to moisture, or certain medical conditions like hypothyroidism. Moisturizing and maintaining proper hydration can help prevent brittleness. 3. Toenails with Ridges Vertical ridges on the toenails are common with aging and are usually harmless. Horizontal ridges (Beau’s lines) that look like indented grooves may indicate trauma, illnesses like viral infections or heart disease, severe stress and more. If Beau’s lines appear one day, you should talk to your family doctor. Subtle bands or stripes running along the nail can also be a signal you need to eat more protein. 4. Pitted Toenails Pitted toenails have small indentations or depressions in the nail surface. This condition is often associated with psoriasis, eczema, or alopecia areata. Treating the underlying condition can help improve nail health. The Most Common Toenail Conditions Beyond shape and texture, toenails can be affected by various conditions that may cause discomfort or indicate a medical issue. 1. Ingrown Toenails https://www.youtube.com/shorts/ZsFQqCkVf40 Ingrown toenails occur when the edge or corner of a toenail (usually the big toe) grows into the surrounding skin, causing pain, redness, and swelling. Ill-fitting shoes are a common cause; when shoes are too tight, they squeeze the toes together, increasing pressure on the sides of the toenail toenail, which disrupts the natural toenail growth pattern and forces it into the skin. High heels or narrow-toed shoes are particularly problematic because they alter the natural position of the foot and toe alignment, leading to more friction and pressure on the nail. This can result in the nail digging into the surrounding tissue, exacerbating the risk of infection and discomfort. Additionally, improper trimming of toenails (e.g., cutting them too short or in a rounded shape) can also contribute to ingrown toenails, especially when combined with tight footwear. Sometimes, there may be a genetic component to ingrown toenails. Certain nail shapes and growth patterns are hereditary (i.e.: involuted toenails) and can make a person more prone to developing ingrown toenails. Chronic ingrown toenails may lead to infection, so it’s a good idea to visit a foot clinic at the first sign of discomfort. A Chiropodist can safely treat the ingrown toenail - often without surgery. OnyFix is also a great, modern option that’s completely non-invasive and stimulates a normal nail growth pattern. Both of these services are performed by foot care professionals. https://www.youtube.com/shorts/LoCcoKOhV7E 2. Fungal Toenails (Onychomycosis) Fungal infections can cause toenails to become thick, yellowish, and crumbly. This condition is common in people who frequently visit places where fungal infections breed, like moist, shared locker rooms and showers, public pools, nail salons and more. You can also get fungal toenail if you’re prone to athlete’s foot (which can then spread to the toenails). Older people, as well as people who wear shoes that trap foot sweat (and exacerbate it) are also more at risk. Keeping your nails clean and away from contagious areas is a key prevention tip. Antifungal treatments and maintaining good foot hygiene can help control fungal infections, but it’s important to see a foot specialist to properly treat it. It is difficult to treat fungal infections on your own (unless it's in the very early stages) because the infection occurs beneath the nail, making it hard for topical treatments to penetrate deeply enough to eliminate the fungi. The nail acts as a natural barrier, trapping the infection in the nail bed and protecting the fungus from over-the-counter creams or home remedies. Sometimes our nails being so protective can be a double-edged sword! A Chiropodist or Podiatrist can perform nail debridement (removing infected parts of the nail to allow proper treatment) before applying a prescription-strength topical antifungal medication. 3. Discoloured Toenails Toenails can change colour due to various reasons. Here are some common discolourations that stray from the natural pink hue, and why it happens: Yellow or brown nails: Often a sign of fungal infection and accompanied by nail thickening. This can also be caused by wearing nail polish; the chemicals are absorbed by the structure of the nail, causing yellow staining. White spots: Can indicate several issues. They can happen due to minor trauma, kidney issues, yeast infections, cirrhosis, or they may signal something more innocent, like nutritional deficiency— often zinc. If your toenails are entirely white with no pinkish hue, it could possibly be anemia. Black, red or purple: Generally caused by trauma (subungual hematoma). The dark colour is essentially bruising underneath the nail. People often notice a black toenail after stubbing it or dropping a hard object on it. Trauma can also cause toenail damage, like cracked toenails. 4. Detached Toenails (Onycholysis) Sometimes your toenail can start to fall off, which can be alarming. Onycholysis occurs when the nail separates from the nail bed, often due to trauma, fungal infections, or psoriasis. Treatment depends on the underlying cause. 5. Ram’s Horn Toenails (Onychogryphosis) This condition results in extremely thick and curved toenails that resemble a horn. It is more common in elderly individuals or those with poor circulation. Regular trimming and professional care from a chiropodist or podiatrist are essential for management.

February 6, 2025

Why High-Stack Running Shoes are So Popular

The HOKA trend is the rise in popularity of HOKA's high-stack running shoes, or running shoes with extra cushioning, extra height, a high heel stack and a rocker sole. They aren’t the first popular running shoes trend, and they certainly won’t be the last. Although people exclusively associate this type of trendy running footwear with HOKA, many other brands like ASICS and Saucony make footwear with the same high-stack shoe technology. Today, we’re diving into why these shoes offer more than just style—they come with real benefits. But they’re not for everyone, so we’ll also cover who should steer clear of this particular design. https://www.youtube.com/shorts/ySn158c143c What are High-Stack Running Shoes? High-stack running shoes, often called “super cushioned” or even “chunky,” by those who don’t know the terminology. They have transformed modern footwear design for many high-quality brands. Often attributed to HOKA for “starting the craze," these shoes feature thick midsoles packed with advanced cushioning foam technologies that enhance energy return, provide sufficient shock absorption, and improve comfort over long distances. Despite their benefits, high-stack shoes aren’t without controversy. Some runners prefer lower-profile shoes for better ground feel and stability, while others find high-stacks beneficial for injury prevention and endurance. Their chunky aesthetic has also sparked mixed opinions—some love the bold look and the added height without having to wear a true high heel while others see them as clunky. High-Stack Shoe Technology The defining feature of high-stack shoes is their thick midsole, which can measure over 40mm in some models. These midsoles use lightweight, resilient foams such as Pebax or EVA blends that provide exceptional cushioning while maintaining responsiveness. The goal is to reduce muscle fatigue by absorbing more impact, allowing runners to maintain performance with less strain on joints and soft tissues. Another key factor in their performance is the rocker geometry, rocker bottom shoe or rocker sole—curved soles designed to promote a smooth heel-to-toe transition. This feature helps conserve energy, particularly during long runs, by reducing the work done by the calves and ankles. ASICS Gel Nimbus 27 The Benefits of High Stack Shoes High-stack running shoes offer several benefits for foot health, especially for individuals dealing with arthritis, diabetes, and metatarsalgia. Here's a breakdown of their advantages: Enhanced Cushioning: High-stack running shoes feature extra cushioning, which absorbs shock and reduces impact on the feet during movement. This is particularly beneficial for people with conditions like arthritis, where joints are sensitive to pressure and movement. Pressure Redistribution: The additional cushioning and rocker sole work together to redistribute pressure across the foot. In the case of diabetes or metatarsalgia, this can help alleviate excess pressure on specific areas of the foot, such as the forefoot or metatarsal heads. For those with diabetes, reducing pressure can help prevent the skin damage that leads to ulceration, as it lowers the risk of tissue damage and enhances comfort. (However, people with diabetes and balance issues may wish to avoid rocker soles - more on that later). Joint Protection: The rocker sole limits the motion of foot joints. This helps manage conditions like osteoarthritis and hallux limitus (big toe arthritis). By restricting unnecessary movements, it prevents excessive strain on the joints, protecting them from further damage. This is especially useful for the big toe joint, where excessive motion can lead to increased pain and discomfort. It's also highly beneficial for people with high arches. People with high arches tend to experience joint rigidity (particularly hallux limitus) and lack of shock absorption. The rocker sole offsets the restricted mobility. Improved Biomechanics: The curved design of the rocker sole encourages a smoother, more efficient gait. The shape propels the foot forward with each step, facilitating a natural walking motion and reducing strain on the joints. This is particularly beneficial for those with ankle, midfoot, or big toe arthritis, as it helps maintain normal walking patterns without overloading the affected areas. Pain Reduction: Rocker soles are especially effective in reducing pain associated with conditions like hallux limitus and metatarsalgia. By minimizing motion at the big toe joint and redistributing pressure under the ball of the foot, these shoes can significantly reduce the discomfort felt during daily activities like walking or standing. https://www.youtube.com/shorts/qByZ0GRFoaQ When to Avoid High Stack Shoes Here are some individuals who might want to avoid them or consult a foot care professional, like a Chiropodist or a Podiatrist, before wearing them: People with Balance Issues The rocker sole on high-stack shoes can make them less stable for individuals who struggle with balance or proprioception (awareness of body position). Those at a high risk of falls, such as elderly individuals or those with severe neuropathy, may find that the rocker sole from stacked heels throws off their balance. People with Diabetes Complications from diabetic neuropathy can lead to balance issues. Therefore, while the cushioning of a stacked heel is great for addressing joint issues, the "rolling" effect of the rocker sole is not suitable for people with diabetes. Individuals with Ankle Instability The increased midsole height and curved design can reduce ground feel and make it easier to roll an ankle, especially on uneven surfaces. People prone to ankle sprains or with a history of ankle instability might be better suited to lower-profile shoes with more lateral stability, or stability shoes with posting in the midsole (like the ASICS Gel-Kayano), which is constructed to cradle the foot and control ankle movement. In shoes like the ASICS Gel-Kayano, even though there is a stacked heel, the foot actually sits below the sole to provide stability. https://www.youtube.com/shorts/osC-UmBtgNk

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