The infected toe

Common toe problems and remedies.

I come to you today with some sage advice: Don’t Google “Infected Toe” unless you are prepared to be unsettled.  But, that being said some people like those videos.

Those of you who have been hanging around with me for awhile know that I am an unrelenting victim of Earth’s ironies and life imitating art.

Last week after my long run in the slush, the big toe of my right foot started to be sore.  By midweek it was obvious that it was infected.  It was swollen and hurt like hell.  By Saturday I was at the clinic getting some antibiotics.

It’s a bit ironic because one of the characters in my new serial podcast about the apocalypse has an infected toe.  I’ve never had an infected toe.  I’ve lost that toenail many times but I’ve never had it get infected.

Foot problems are the bane of runners. Foot problems are super-frustrating because even if you’re super-fit and otherwise ready to compete and train, a simple foot problem can knock you, well, off your feet.

Infected toenails are not super common in runners.  Infected toenails tend to much more common in the general populace.  They are usually due to an ingrown nail, caused by bad footwear choices or by degenerative disease like diabetes where circulation problems in the feet cause the conditions favorable for infections.

When the toe gets infected, what’s happening is that a bacteria gets into the toe and starts to spread from that, well… toehold.  The diseases or the ingrown nail create irritation and the conditions that allow the bacteria to get started.

In my case you can see how running long distance in wet shoes, in slippery conditions, caused the toe to get smashed into the side of the shoe.  This caused the nail to get irritated in the corner, which gave the bacteria a way in.

It probably didn’t help that those are old shoes with 600-700 miles on them that got soaked repeatedly throughout the last month.  Yeah, they probably had bacteria in them already from being wet all the time.  I basically made them into the Hoka SpeedGoat version of a Petri dish.

Then, of course, I ran when I knew the toe was irritated already.

Part of this is my physiology.  I have an inherited big toe.  My big toe extends much longer than the other toes. As the leader of the pack, it takes all the abuse.  I’m also right-side dominant, meaning that my right foot is slightly longer than my left.

The net result is that most shoe people would try to move me up a half a size.  But, having tried running in a ½ size bigger shoe, I don’t like it at all.  Feels like they are floppy clown shoes.  I would rather have shoes that fit and let that big toe rub a little.  I’m already a size 12. That’s a big enough shoe.

I know that at some point in training for an ultra-distance race I’m going to lose that toenail.  I try taping it but the repetitive catching eventually does it in.

But this is the first time it has become infected.

What do people do to cure an infected toe?

It depends on what the cause is. With me there is no underlying problem.  Except that I’m a guy who runs 2 hours in the slush in old shoes when my toes is already sore… Other than that there is on ingrown nail or disease.

I get a course of antibiotics, which I hate – but better to rebuild my biome than get blood poisoning or lose the toe.

For people who have an underlying problem like an impacted, or ingrown, toenail the doctor has to cut that part of the toenail out. Then the area is cleaned out with anti-bacterial stuff.  And then, they get the antibiotics.

I got off easy.  I get to take some pills and soak my foot in warm water and Epsom salts.

There is an old English saying that goes, “For want of a nail the shoe was lost, for want of a shoe the horse was lost and for want of a horse the battle was lost.”

You can’t run without your feet.

Lessons learned here are:  Keep your shoes dry and clean.  I’m bad at this but I’m going to look into some better ways.  Frankly, I thought that with the cold-dry weather my shoes would dry quickly and didn’t put much thought into it.

First thing you can do with wet shoes is to pull out any orthotics or insoles and dry those separately.  It’s also good to loosen up the laces – let the air in.

Second thing you can do is stuff the wet shoes with newspaper or paper towels.

I would not recommend putting your shoes in the dryer, I think the heat is bad for them.  Of course there are specific shoe dryers that you can get.  I’m not sure my need to dry shoes is greater than my need to not have more single-use devices in my life.

You can, however throw your shoes into your washing machine.  Just put them in with some old towels and regular clothes washing soap.  Maybe even a dash of bleach or other oxygenating stuff to kill the bacteria.  Make sure to take the insoles out and loosen up the laces.  It won’t hurt the shoes and you just air dry them.

There’s also a good trick I saw that haven’t tried yet, but I think I will.  You take some coat hanger wire and hang the shoes on the front of a regular floor fan.  I’m not sure you want to do that in the house during the summer when your shoes smell like dead goats.

Finally, and I’m not kidding, some websites actually have people putting their wet shoes into rice to dry them.  You know, like the cell phone trick?

“Honey, did you put goat meat in this casserole?  It has a bit of an earthy flavor to it?”

“Don’t, have any idea what you’re talking about, must be the sauce.”

And by the time you are listening to this I will be back running again, in my new Hokas, finishing up the 10-day course of antibiotics.

Until next time, when I figure out a way to avoid training due to a hangnail – keep your feet clean and respect your toes.