After calling around I’m out of luck for healthcare in rural northern New England. So maybe someone has some advice on here.
Had a good 70.3 this past weekend. Ended up with a big blood blister under my right big toenail. The pressure is making it very sore. I had this 6 years ago after a full Ironman and popped it myself and got it infected. Went on antibiotics and couldn’t swim for a while. I don’t want this to happen again. I have a full Ironman in less than 6 weeks. When it happened 6 years ago I was close to more healthcare options but we moved to a very rural location 3 years ago. Finding heatlhcare is difficult which is the downside to living here.
Who has had this? Did you pop it yourself? Or did you leave it alone? If you did pop it, were you able to swim??
Thanks in advance. Please post only helpful and kind responses.
OMG I found someone who will see me at 8am tomorrow. But still would love to hear about similar experiences.
FWIW I was running in the Saucony Endorphin 3 Pro race shoes. Ran a few times in them before the race and they felt fine. First time racing in carbon plated shoes. I have been running in the Endorphin Speeds (have 3 pairs) and no problems since last fall. Even got the runshield for our wet messy snowy winters. I raced in the Saucony Endorphin 3 Speeds for Indian Wells 70.3 last Dec and no problems
Yeah, this’ll happen in some more extreme situations. I’ve had perhaps a dozen of them in the past 30 years. I have always treated them the same way:
Put a needle uder a flame - steril? I don’t know I’m not a germ expert. I’m probably risking amputation of the whole leg.Slip the needle under the nail - if I do it right I feel nothing and the whole goal is just to lance the membrane of the blister.Apply pressure to the top of the nail - I’ve gotta have a tissue handy because it’s astonishing how much fluid comes out and embarassing (read: disgusting) if it shoots a stream across the room.Apply some ointment in the area of the hole: I’m partial to neosporin but I’m sure there’s many options.Repeat every 8-10 hours for 3 days. Several weeks later when the nail’s dangeling and getting hung up on socks and shoes - remove it before it gets torn off
Yeah, this’ll happen in some more extreme situations. I’ve had perhaps a dozen of them in the past 30 years. I have always treated them the same way:
Put a needle uder a flame - steril? I don’t know I’m not a germ expert. I’m probably risking amputation of the whole leg.Slip the needle under the nail - if I do it right I feel nothing and the whole goal is just to lance the membrane of the blister.Apply pressure to the top of the nail - I’ve gotta have a tissue handy because it’s astonishing how much fluid comes out and embarassing (read: disgusting) if it shoots a stream across the room.Apply some ointment in the area of the hole: I’m partial to neosporin but I’m sure there’s many options.Repeat every 8-10 hours for 3 days. Several weeks later when the nail’s dangeling and getting hung up on socks and shoes - remove it before it gets torn off
Ian
Thank you!
When I popped mine 6 years ago in Mont Tremblant post race, I am not sure if I used something like Neosporin. Chances are I didn’t and that is probably why it got infected. I did it in our hotel suite the next day after the race. And probably lacked medical supplies. (not smart, I know)
How long do you wait before you swim again after you do the above? I have an Endless Pool which is chlorinated and has a UV light so pretty clean. But I also want to open water swim soon too.
I’ve found that the need to repeat lancing and draining is required over the first 24-36 hours and then you’re set. That pin hole seals up right away so you’d be able to swim really soon after: 2-3 days tops.
I also endorse the hot metal… I used a small paper clip. Heated it up until it got orange and then be careful because it slides right through your nail.
Have never had any issues with infection and the nail falls off eventually. Had to address two toes after my first full IM last year… instant relief once you put a whole in the nail.
I think you were unlucky to get an infection. I have drained these both through the nail and through the blister, and the latter seems to empty it more effectively. I think it’s important to squish out the fluid as completely as possible, and you may need to repeat it once or twice over a couple of days. I also find it helps to firmly “bind” the nail down subsequently with Elastoplast, as it’s no longer properly attached, and when you do longer runs it can lift and become uncomfortable again.
To further enhance what Ian said. You can, after draining it, fill the syringe up with H2O2 and gently push that into the now drained blister to clean it. Probably need a max of 10cc
Or you can use rubbing alcohol.
Having done both in the past one feels better than the other. I’ll let you choose which!
After calling around I’m out of luck for healthcare in rural northern New England. So maybe someone has some advice on here.
Had a good 70.3 this past weekend. Ended up with a big blood blister under my right big toenail. The pressure is making it very sore. I had this 6 years ago after a full Ironman and popped it myself and got it infected. Went on antibiotics and couldn’t swim for a while. I don’t want this to happen again. I have a full Ironman in less than 6 weeks. When it happened 6 years ago I was close to more healthcare options but we moved to a very rural location 3 years ago. Finding heatlhcare is difficult which is the downside to living here.
Who has had this? Did you pop it yourself? Or did you leave it alone? If you did pop it, were you able to swim??
Thanks in advance. Please post only helpful and kind responses.
You can melt the nail with a hot needle - it goes right through. Then the needle will go through the blood boil.
Yeah, this’ll happen in some more extreme situations. I’ve had perhaps a dozen of them in the past 30 years. I have always treated them the same way:
Put a needle uder a flame - steril? I don’t know I’m not a germ expert. I’m probably risking amputation of the whole leg.Slip the needle under the nail - if I do it right I feel nothing and the whole goal is just to lance the membrane of the blister.Apply pressure to the top of the nail - I’ve gotta have a tissue handy because it’s astonishing how much fluid comes out and embarassing (read: disgusting) if it shoots a stream across the room.Apply some ointment in the area of the hole: I’m partial to neosporin but I’m sure there’s many options.Repeat every 8-10 hours for 3 days. Several weeks later when the nail’s dangeling and getting hung up on socks and shoes - remove it before it gets torn off
Ian
This right here is the right answer. I have toenails that seem to revolt any time I subject them to any long term abuse. Those blisters under the nails are awful. Have some sort of antiseptic close by (alcohol, peroxide) to keep your instruments sterile. Heat works, but you have to get it really hot to kill the bad stuff. Keep your hands sterile. If you can get at the blister from the front, just enough to puncture it will allow it to drain. If it’s under the nail and enclosed, you can go through the top of the nail with a hot needle. You have to be careful (obviously but you should be able to just melt the nail and get it to drain.
Edit: sorry I posted before reading all the replies. Looks like it’s been pretty well covered by others here. Blisters suck!
My husband burst mine using a paper clip, unbent , in a soldering iron (instead of the bit)
I told him if I yell back off
Anyway worked great. Went through the nail met the fluid and he backed off. Didn’t feel a thing.
A friend went to a doctor who went under the nail.
Apparently that hurt 🤕
MD here.
A few options.
Firstly, it hurts like buggery even with a small amount of blood under there, relieving that pressure makes a world of difference.
Your aim is to put a small drainage hole through your nail to allow the fluid to drain out. Best to get it earlier than later once it has congealed a bit.
Options:
Hot paper clip: something most people will have access to. Heat it under a gas flame etc until it is red hot and then gently let it melt its way through to the fluid. Hurts a bit more as you need to apply some downward pressure.
Trephine a hole: basically, if you have a hypodermic needle (not a sewing needle)-you can hold it and basically twist it back and forwards and it will start to drill a hole through your nail. Painless as basically requires no downward pressure to do. But you need a hypodermic needle as these are bevelled and will act like a drill.
Like option 2 above, if you have access to some very fine drills you can use a similar approach to put a small hole in by just hand turning it.
Option 1 is most commonly used by people without access to a hypodermic needle but hurts a little with the downward pressure, but the relief you get from letting the fluid go is immense.
Once it is drained there is no real worry re infection, you can just carry on. Very good chance you will lose part of that nail moving forwards. The nail growth is really slow.
Good luck. A classic example of how a few mL of fluid can cause a world of pain!
I have soft feet and get blisters all the time, took years to get tougher feet, coincidentally that was when I started running a whole lot more. Anyways, you pop every blister yourself and you will be fine. Just what is your pain threshold. Also without a photo hard to provide much more advice than given.
I love burning holes in people’s toenails. Or trephining subungal haematomas, as we say to give the procedure a veneer of respectability. (The clinic and the dungeon are distinguished mainly by semantics.)
If the haematoma is big, and you know what you’re doing, it’s completely painless. In fact it’s better than that, it’s negative painless, the pain drops from ten to zero immediately.
I use an electrocautery tool, which uses a battery to heats up a coil of wire formed into a very narrow loop shaped into a tip. But probably the same could be achieved with a fine-tipped soldering iron. Am I recommending going at your own foot with a soldering iron? No, for the avoidance of doubt.
But someone appropriately trained, qualified and insured, and also sober, might:
take their weapon of choice and lightly apply its glowing tip to the top of the nail plate, from above, directly over the centre of their haematoma.
It doesn’t need any pressure. The hot tip basically burns or melts a hole in the keratin of the nail, until it strikes old blood.
And then- splurt- you have a gusher, if the pressure is high enough. Or maybe an anticlimactic bleb of blood appears if not.
Then they must stop immediately or they will burn a hole in the actual toe. And that will hurt. If they accidentally do that, the pain needle goes from ten to zero and back to ten again in the blink of an eye. Maybe twelve. And the person who’s toe it is might swear at them or hit them. Ask me how I know.
As long as you don’t burn a hole in their actual toe, the only bad thing about it is the smell, which is like Hannibal Lecter’s last BBQ. You’ll need the windows open for an hour at least. On the plus side though, this can clear the waiting room- it’s amazing how many people suddenly feel better when they smell burning flesh eminating from their doctors office.
The toenail will have a scar like Harry Potter’s forehead for a few months until the nail grows out, but that’s their problem.
I dropped a plate while putting the dishes away in the cabinet over the kitchen counter
I stuck my foot out to keep it from hitting the floor full force and breaking. Since It was Summertime, I had no shoes on. The plate fell straight down, with the edge hitting my big toe like a very dull guillotine, and harmlessly rolling away
It wasn’t long before a bruise began to form, starting right below the cuticle, but never quite reaching the opposite end of the nail
The rest of the Summer was “Is today the day it comes off?”
Interestingly, as weeks went by, the nail came undone from the back before the front, so it kinda hinged forward like …
So I saw someone at a new express/urgent care center that is also a primary care facility. The express care is new. The doc (maybe a PA but not sure) saw my toe. She didn’t think it was infected. Also didn’t think it should be tampered with and drilled or drained. It’s not quite as sore as it was yesterday. I don’t even feel it sitting at my desk now.
I think I’ll be able to run by the weekend in my non-race shoes. She did suggest I could tape the toe for some mild compression.
Was hoping to have it drained and see all the stuff come out lol. Kinda gross. But now I don’t have to worry about missing swim workouts.
ETA: I did get a prescription for a topical antibiotic if something happens and it does get punctured or accidentally drained.
but you should be able to just melt the nail and get it to drain.
