Tennis Toe – What Does It Mean & How To Prevent or Treat It? | Pain Care

Tennis Toe – What Does It Mean & How To Prevent or Treat It?

Also known as subungual hematoma, skier's toe and runner's toe.

It is an extremely painful condition of big toe caused by the collection of small to large hematoma under the nail of toe.

The most common cause of tennis toe is repetitive injuries or blunt trauma to the big toe and that is why it found to be occurring more commonly in athletes.

Whenever our body gets external trauma, capillaries underneath the area of trauma get ruptured and leads to blood collection underneath the skin.

Same mechanism occurs in subungual hematoma, when big toe gets repetitive trauma it leads to collection of blood under the nail plate.

This collection of blood further causes blackish discoloration of toe nails.

Common Causes


Trauma is the most common reason behind the tennis toe.

People who tend to walk barefoot and athelets are more prone to develop subungal hematoma because of repetitive trauma, friction or pressure on nail plate.

Suddenly stopping or changing the direction while running or walking can expose big toe to sudden trauma.

Usually this happens while playing the tennis, so it is known as tennis toe.But it can also occur in other sports like in football, basketball, skiers & runners.

ill-fitting shoes

Can also be a reason behind this condition.A thing called 'Toe Box' from our shoes can put pressure on big toe or may develop friction leading to runners toe.


Pain, black & blueish discoloration of nail plate and tenderness in big toe are the few common symptoms of tennis toe.

Common in big toe

Usually found affecting big toe and in few cases second toe.

Big toe is the most common site for friction while walking bare feet and while playing tennis. In rare instances it may affect outer three toes of the foot.


​Throbbing pain is a common symptom of tennis toe.

Accumulation of blood under the nail plate occupy the space and start to put pressure on surrounding tissues giving rise to throbbing pain.

Black Discoloration

Black discoloration of nail plate is marked sign of skier's toe.

Blood collection either gives rise to red or blackish discoloration to the nail plate.


Conservative Measures

In the mild cases where pain is tolerable, conservative treatment can be used.

Like, using antiseptic to clean the toe and dressing will be applied to heal faster by preventing bacterial infection.

In mild cases nail plate will fall off or will be replaced by new and healthy within few weeks or couple of months.

Toe nail Removal

If the case is sever and infected or having bleeding along with other sign of inflammation like prominent swelling then your doctor will advice to remove the nail under the anesthesia for proper examination of nail bed.

Doctor may create a small hole through the nail to remove the hematoma and relieve the pressures & throbbing pain.

How to prevent tennis toe?

  • ​Keep your toenail clean and trim them regularly. Don't let them grow beyond toe level.
  • Use good fitting shoe. To avoid friction and pressure trauma use a shoe that have wide toe box.
  • Avoid walking on hard surface without shoe. Barefoot walking or running can lead to tennis toe.
Dr. Sachin

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