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Play podiatrist for me: big toe nails ache

Time of past OR future Camino
April 2025 CF
Hello, I would like to hear from those who have had to deal with this issue. Has anyone? The toenails on both of my big toes hurt just enough to be annoying (but NOT while I am walking.) I have not seen this issue on the forum, my searches always find the blisters and black toenail and losing toenail posts. I assume when walking long distances that feet will be tired and achy for a while, but just the tops of the big toes? And for days?

I am seeing a podiatrist, but the progress is slow so far. My feet actually feel great when walking, and they feel fine right after my walk. The time frame when I notice the ache is a couple hours later, and it lasts a day or two after a walk. I am wearing a shoe known for a wide toe box, and it's 1.5 sizes bigger than my normal size, and otherwise feels great.

Here's my theory, which is probably wrong. Maybe my big toes are tall? So the tops of my nails contact the top (not the front) of the toe box. But I cannot feel the toes touching anything while I am walking. Any thoughts on that theory?

I don't think it's typical "Black Toenail" which I learned here can be caused by repeated banging of toe tip onto front of shoe often when going downhill.

Things that do not help:
- It is not an ingrown toenail
- It is not These Shoes in particular. This same type of pain is worse when I try other shoes. But I would be interested in trying shoes with a "tall" and wide toe box if that's a thing.
- I've tried the stock insoles, and the podiatrists brand of decent non-custom orthotics
- I have tried the Heal Lock lacing method, and that did not help.
- I usually walk with liner injinji toe socks, and another sock. I have tried just one sock. All are the same results, except Maybe a bit worse if the socks are thick. But it's hard to tell since they usually hurt each time. Maybe I'll try some more training walks with just one thin sock again because too much sock in the toe nail area seems like a good diagnosis.
- I usually apply aquaphor to my toes and feet (about the same as vasaline) but I've tried without, and it doesn't make the ache any better.
- It's not a lack of nail trimming, they are nice and trimmed.

I've thinking of carving out much of the big toe cushion area of an orthotic, to see if that creates more toe height room.

When it first started happening, one of the nails got injured a little bit, never black and blue, but separated partially just about 1/4 of the toe nail on upper corner. After that, a small wide bump formed in the nail as it grew out. Podiatrist jumped on that thinking it was fungal. But I am having doubts that is related. I am applying anti fungal coating to them twice a day, but that is not making a difference. Plus my nails look fine, they do not look like disgusting fungal infected nails. Podiatrist is new, he has a partner who I have seen years ago, with more experience. I will try to get her to take a look as well.

More details on me. I'm 6' 200Lb, 59yr, in OK shape. In the last year I have increased my walking to many walks per week. Sometimes 12 miles (20km) walks, but i am not yet in good Camino fitness level of 15+ miles per day repeatedly, I hope to get to that level soon. Anyone else experience this type of pain?
 
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I wonder whether your toenails might be 'involuted' which is very different to ingrown. This causes pain and pressure which starts under the toe nail and presents pretty much the way you've described.....I only say this because I've experienced it. Ask your podiatrist if they're familiar with involuted nails. If he's fairly new to the game he may not be aware. If they're involuted, the good news is it's fixable. If that's not it, @Dani7 may be onto something.
 
The one from Galicia (the round) and the one from Castilla & Leon. Individually numbered and made by the same people that make the ones you see on your walk.
wonder whether your toenails might be 'involuted' which is very different to ingrown. This causes pain and pressure which starts under the toe nail and presents pretty much the way you've described.....I only say this because I've experienced it
Hi! I have just paid £300 for partial nail avulsion on both sides of both my big toe's.
Not any real issue when walking; but some time after they hurt to touch the upper surface of the nail!
They took six weeks to heal after the procedure but now no pain.
Defo get advice from your foot dentist:)
 
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Hello, I would like to hear from those who have had to deal with this issue. Has anyone? The toenails on both of my big toes hurt just enough to be annoying (but NOT while I am walking.) I have not seen this issue on the forum, my searches always find the blisters and black toenail and losing toenail posts. I assume when walking long distances that feet will be tired and achy for a while, but just the tops of the big toes? And for days?

I am seeing a podiatrist, but the progress is slow so far. My feet actually feel great when walking, and they feel fine right after my walk. The time frame when I notice the ache is a couple hours later, and it lasts a day or two after a walk. I am wearing a shoe known for a wide toe box, and it's 1.5 sizes bigger than my normal size, and otherwise feels great.

Here's my theory, which is probably wrong. Maybe my big toes are tall? So the tops of my nails contact the top (not the front) of the toe box. But I cannot feel the toes touching anything while I am walking. Any thoughts on that theory?

I don't think it's typical "Black Toenail" which I learned here can be caused by repeated banging of toe tip onto front of shoe often when going downhill.

Things that do not help:
- It is not an ingrown toenail
- It is not These Shoes in particular. This same type of pain is worse when I try other shoes. But I would be interested in trying shoes with a "tall" and wide toe box if that's a thing.
- I've tried the stock insoles, and the podiatrists brand of decent non-custom orthotics
- I have tried the Heal Lock lacing method, and that did not help.
- I usually walk with liner injinji toe socks, and another sock. I have tried just one sock. All are the same results, except Maybe a bit worse if the socks are thick. But it's hard to tell since they usually hurt each time. Maybe I'll try some more training walks with just one thin sock again because too much sock in the toe nail area seems like a good diagnosis.
- I usually apply aquaphor to my toes and feet (about the same as vasaline) but I've tried without, and it doesn't make the ache any better.
- It's not a lack of nail trimming, they are nice and trimmed.

I've thinking of carving out much of the big toe cushion area of an orthotic, to see if that creates more toe height room.

When it first started happening, one of the nails got injured a little bit, never black and blue, but separated partially just about 1/4 of the toe nail on upper corner. After that, a small wide bump formed in the nail as it grew out. Podiatrist jumped on that thinking it was fungal. But I am having doubts that is related. I am applying anti fungal coating to them twice a day, but that is not making a difference. Plus my nails look fine, they do not look like disgusting fungal infected nails. Podiatrist is new, he has a partner who I have seen years ago, with more experience. I will try to get her to take a look as well.

More details on me. I'm 6' 200Lb, 59yr, in OK shape. In the last year I have increased my walking to many walks per week. Sometimes 12 miles (20km) walks, but i am not yet in good Camino fitness level of 15+ miles per day repeatedly, I hope to get to that level soon. Anyone else experience this type of pain?
Boy, you are one challenging patient. I can offer nothing except that I think you are on the right track with the height of your big toe. I also think you haven't found the correct/proper shoe. It wasn't until I was in my sixties that I found my 'proper' shoes, going to a shoe store that had someone we call 'The Foot Doctor.' He even took a video, from and back, of the person walking to see if the shoes provided proper balance and other factors. He also re-sized my shoes, much larger than I usually buy, and he also, with a Spock-like manner, focused on the person's very particular issues and/or foot problems.
How this is going to help you I do not know, but I am surmising you have not located a good 'foot doctor.' All you have done, so far and relatively speaking, is finding someone who take a foot measurement and recommends a particular shoe brand and size. As such, go find that 'foot doctor' in the sky that is waiting for you. All the best as this is a recurring issue for you. Chuck
 
I did get an appointment with foot doc soon. Hopefully she's more experienced than the last one. I'll also hunt around shoe stores for a shoe store foot shaman. So far, I have not had that kind of expert advice from anyone at REI, but also was not able to describe this particular issue then.
 
I have used something my podiatrist gave me -- it is basically a tube, made of a thin piece of foam that goes around your toe. Probably available at pharmacies, my doctor just gave me a short piece. It would, however, take up space, in your shoe. Agree with all the others that a podiatrist is the way to go.
 
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My friend has big toes that curve upward a little more than the norm - but never had any problems with it so didn’t consider it an issue. However walking her first Camino told a very different story.
A thought- What about doing some long walks with open toed hiking sandals to see if the problem still arises.
Hope you find a solution for your tender toes 🤗.
Buen Camino
 
Hi! I have just paid £300 for partial nail avulsion on both sides of both my big toe's.
Not any real issue when walking; but some time after they hurt to touch the upper surface of the nail!
They took six weeks to heal after the procedure but now no pain.
Defo get advice from your foot dentist:)

Yep, me too and it was a game-changer. I found a good podiatrist who identified the problem immediately and for a while I avoided the avulsion procedure and had a wedge cut in both nails every few months. Eventually I woke up to the benefit of a permanent solution and took the plunge with the first in 2018 and the other in 2022 and so glad I did. I've had no issues since. A good podiatrist is priceless.
 
My friend has big toes that curve upward a little more than the norm - but never had any problems with it so didn’t consider it an issue. However walking her first Camino told a very different story.
A thought- What about doing some long walks with open toed hiking sandals to see if the problem still arises.
Hope you find a solution for your tender toes 🤗.
Buen Camino
My thoughts also. Open toes on shoes/sandals. OP says this is worse with other shoes indicating the looser toe box helps. Try cutting the uppers loose in way of the toes on a pair of shoes. If this helps, resew the flaps loosely with dental floss. This is actually what I do when my Brooks blow out at the widest part of my feet behind the little toe after 2 weeks on a camino.
 
The one from Galicia (the round) and the one from Castilla & Leon. Individually numbered and made by the same people that make the ones you see on your walk.

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