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When marathon runners leave a toenail behind
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Carolyn Kaster / AP
You wouldn't believe how many of these guys are missing toenails. Taken at the Marine Corps Marathon in Arlington, Va., Sunday, Oct. 31, 2010.
A few weeks before her first marathon, Kristel Crame bought a trendy purple polish to cover her toenails, one of which she'd bruised on a long training run.
But as she started her at-home pedicure, "I noticed a toenail seemed a bit loose. It seemed like the bottom part was connected and the top part was all lifted up," she said. Even stranger: A new, normal toenail was growing underneath the unhinged one.
This month, as runners across the country put the finishing touches on their marathon-training regime, thousands will share the experience of losing a toenail. Also known as "black toenail" and "runner's toe," it's a harmless occurrence, according to Dr. Marybeth Crane, a Texas podiatrist and board certified foot surgeon who has run dozens of marathons and triathlons over the past 32 years.
For many runners, when the old-and-busted toenail falls off, they find what seems to be a "backup toenail" underneath. But we don't actually have replacement toenails waiting in the wings: When a toenail is bruised, it stops growing but stays attached.
"We actually have matrix cells in the nail bed, that's where the new toenail comes from, and it literally pushes off the old one" as it grows, Crane explains. The dead toenail stays on to protect the sensitive skin.
Nail bruises can be caused by anything from ill-fitting shoes and socks to a plodding stride or hammer toes. Even perfectly fitted shoes can be a problem: Over the course of a marathon, feet can swell half a size or more.
Crane calls black toenails "one of life's minor annoyances" that can be avoided by keeping toenails clipped, buying long-distance shoes a half-size large and ensuring the toe box accommodates your foot properly.
Though losing a toenail poses no harm, Crane has two important cautions. First: No bathroom surgery. "All of the Internet is going to tell you to light a match on a needle and stick it under the toenail" to drain the bruise. Do that and you’ll likely get an infected, swollen toe that needs medical attention.
Second: If your toenail develops a dark line that does not grow out or disappear, see a doctor right away. "There is a very rare form of melanoma that will happen underneath the toenail" that can be deadly if left untreated.
With all her expertise and precautions, even Crane has lost a few toenails over her decades-long running career: Four, actually. As for Crame -- the runner -- she now coaches beginning marathoners in Seattle, making sure to school them on the art of losing a toenail.
Are you a distance runner who's in mourning over a lost toenail? Do tell.
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Getty Images Stock
Clearly, she's embarrassed to turn around, lest we see her "runner's face."
Runners, beware. A New Jersey cosmetic surgeon has pinpointed something more nefarious than shin splints, stress fractures and even dead butt syndrome: "runner's face."
This is what Dr. Brian S. Glatt, a board-certified plastic surgeon in New Jersey, calls that skinny, Skeletor-esque look some dedicated runners may unwittingly develop, as they're likely distracted with all the miles they have to cover to prepare for their next race. Glatt describes the horrors thusly, in a press release issued today:
Runner’s face generally occurs in both men and women ages 40+ who exercise to improve their body, and in doing so end up with a skeletal and bony face. When exercising, an athlete burns off fat beneath the layers of his/her skin. The marked loss of fatty tissue results in a loss of volume which leads to a prominent appearance of the bones, accelerated development of skin laxity and deepening of wrinkles. Though you may look like a 20-year-old from the neck down—your face will easily give away your age.
Full disclosure: I ran my first marathon in June, and I definitely did get that hollow-cheek look described in the release. (Although I'm 26, not 40-plus.) So Glatt kind of has a point, allows Dr. Tony Youn, a Michigan-based cosmetic surgeon and frequent contributor to msnbc.com.
"The general idea is that the leaner we are, the less fat we have in our face," says Youn. "One of the signs of facial aging is loss of facial volume. So losing weight or becoming very lean (like many runners are) can cause the face to look older."
"Runners face" is a cutesy, catchy term, but Youn points out this idea could apply to anyone who is thin for a variety of reasons -- playing a lot of sports, excessive dieting or anorexia, or genetics. And, Youn helpfully points out, rigorous exercise isn't the only thing contributing to aging -- sun damage does a fine job of that on its own.
Glatt suggests a Botox-Restylane (or other injectable filler) combo, which will smooth wrinkles and plump that gaunt face right back up. Youn says the treatments in Glatt's anti-runners face arsenal would certainly work.
"That being said, I've never told someone to stop running so they could look younger," Youn says. "That's just silly."
What say you, readers? Is the old adage true -- do you really have to choose between your bum and your face? And, if that's true -- which would you choose? A fit, fierce body, or a youthful face?
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Earlier today, Geoffrey Mutai ran the fastest marathon ever recorded -- the Kenyan man finished the race in an incredible 2 hours, 3 minutes and 2 seconds. (Update: Mutai's record-breaker won't be recognized, because today's racers were helped by an unusually strong tailwind.) Including Mutai, about 27,000 runners took over the streets of Boston today, racing in the 115th edition of the oldest annual marathon on the planet -- and after months of hard training, many have surely sustained a running-related injury.

STR / Reuters
Elite men runners start the 115th running of the Boston Marathon in Hopkinton, Mass., today.
In fact, injuries occur in 40 to 50 percent of runners every year, shows a 2010 study published in the journal Current Sports Medicine Reports. You've heard of shin splints, stress fractures and runners' knee -- but the weirdest injury we've heard of has to be "dead butt syndrome."
The silly "dead butt" nickname was made popular this winter when a New York Times blogger dramatically declared, "My butt is dead." Not nearly as hilarious as it sounds, the medical term for "dead butt syndrome" is gluteus medius tendinosis -- basically, one of the muscles that make up your behind becomes inflamed, causing searing hip pain.
The gluteus medius is located on the outer surface of the pelvis, and it powers the thighs forward. Without proper strength training, this muscle is unable to withstand the repetitive stress caused by the long runs that training for a half marathon or anything longer requires.
To beginner marathon runners, all the miles you're expected to log is daunting enough -- and the pros want you to add another exercise on top of that? But it's important to strengthen the lower abdominal muscles and the gluteus muscles -- otherwise, smaller muscles like the gluteus medius muscle end up too weak to bear the brunt of the increasingly ridiculous distances you're running. It's a reminder to runners that when training for a half marathon or longer, just running won't cut it; some kind of cross-training -- whether it's strength-training, swimming, biking, rowing or something else -- is necessary. Keep that butt alive!
You can find The Body Odd on Facebook, and follow Melissa Dahl @melissadahl.
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