Smashed toe

by Josh
(United States)

I've been playing a lot of tennis recently and it seems as of my little toe on my left foot has been "smashed". Underneath the toenail it is a dark purple color as if it has been bruised and it is sore to the touch on the toenail. When I walk or simply stand it looks like my little toe has slidden underneath the toe right next to it. I don't know if that is normal or not but it seems like that could be a reason. Also I have been wearing the same type of tennis shoes for a couple years now and this is the first time that this problem has happened. Any help would be greatly appreciated and thank you in advance.

RESPONSE

Hi Josh,

If you want to be an athlete you have to accept the injuries (big and small) that go along with your sport.
The discolored, tender toe that you describe tells me that there has been bleeding under the nail. This is usually the result of what I refer to as micro-trauma. In sports like running, basketball and tennis where the front of your foot is constantly being jammed against the end of the shoe, the nail is lifted up each time until it finally lifts too much and then starts to bleed underneath.
Aside from the pain you also need to be concerned about the possibility of infection. At the very least, the nail should be cut back to relieve the pain. If you cannot do it, then you should see a foot specialist. In the meantime I would clean the area with soap and water and apply an antibiotic cream like Neosporin or Bacitracin with a bandaid.
As far as your other concern about the fifth toe riding under the fourth toe the first question I would ask is the same thing happening on the other foot? In most cases situations like this are strictly structural deformites meaning the toe has a tendency to go in that direction. I suppose a sport like tennis could exacerbate the problem and of course this bending of your fifth toe under your fourth toe could also be part of the problem with the nail.
So, what are your options? The simplest thing to do is to put a small sponge pad in between the toes in an effort to keep the toes apart. Additionally you can try one of those gel pads that fit over the toe and place it on the fifth toe. This may also help keep the toe in place. These devices are sold in drug stores.
If that does not work you could always try taping the fourth and fifth toes together using hypoallergenic tape. Sometimes putting a little cotton between the toes before you tape them can also be helpful.
You may have to experiment around until you find a "cure" in terms of keeping the fifth toe straight.
If this were to become a real problem and either reduce your ability to play tennis or you started to have pain when just wearing shoes, you might even consider a surgical procedure where the two toes are fused together. I have to tell you that most people find that option unacceptable. Even though it would solve your problem, it creates an unsightly cosmetic issue.

Marc Mitnick DPM
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