infected runners toe?

I ran a marathon and now my two toes (second from big toe) are swollen, very red around the nail, the nail is extremely painful and slightly separated, looks like fluid swelling under nail, and cuticle is yellow and enlarged. the toe nail is not black, it's still regular flesh color, but it's all so painful and im wondering if it's infected and how I should treat it.

Thank you so much for your help

RESPONSE
Hi,
Welcome to the world of runner's injuries particularly to the feet.
Anyone who is a serious runner will at some time undergo what I refer to as repeated micro trauma to the toes particularly the nails.
When you are running especially down hill, the ends of the toes are repeatedly being jammed into the end of the running shoe.
Over the course of the run, there may be enough trauma to the nails that they will either lift up and bleed or the nail will be jammed backward and may creating ingrown nails, which in some cases can become infected.
Your condition seems to be the latter. If there is fluid under the nail that may very well be pus and of course that requires treatment.
My first piece of advice would be to see a foot specialist and have the potential infection cleared up, as they hurt and of course they could worsen.
Going forward, if you are going to continue to run, you run the risk of this recurring.

What I suggest to my patients is a couple of things. First of all, keep the affected nails cut short. The longer the nail the more direct trauma to the nail when you are running. Sometimes I even recommend putting tape over the nail, starting from the skin behind the nail, over the nail, and down under the bottom of the toe. This dramatically reduces the micro trauma to the nails.
Doing these simple steps will help cut down on infections both bacterial and fungal. If you see as many feet as I see you would be amazed at how deformed toe nails can become in the avid runner. For most its a trade off, they will accept this as the cost for running.
Additionally, make sure your running shoes are actually long enough; buy them at the end of the day when your feet are the most swollen.
Sometimes I even recommend adding a pad under the tongue of the running shoe. This prevents the foot from jamming into the end of the shoe, but keep in mind, sometimes this padding can cause irritation on the top of the foot.
So, at the very least go see a foot specialist and get the infection cleared up as well as specific advice in eliminating the problem in your feet.

Marc Mitnick DPM
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