Ultramarathon runners are known for going to extremes. After all, running 50 to 100 miles across challenging terrains isn’t for the faint of heart.

But is this strategy actually helpful or even safe? Here’s our take.

 

Runner's toe

 

Runner’s toe is a common problem that plagues long-distance runners and other athletes.

Damage control: What to know about runner’s toe. Cleveland Clinic. May 24, 2023.

It’s caused by the relentless hammering of the toes against the sneaker toe box. The big toes are particularly vulnerable to the effects of this repeated impact and are prone to subungual hematomas or bleeding and bruising beneath the toenail. 

 

But while runner’s toe is certainly unpleasant, some athletes view it as a badge of honor.

Leonard B. Are you really an ultrarunner if you still have all your toenails?. Outside. July 6, 2022.

Taking off their toenails altogether has been a trend for several years among some of the most high-performing ultrarunners.

 

 

The original poster boy for toenail removal

 

Marshall Ulrich is an ultramarathoner who ran the equivalent of 117 marathons in a row at age 58.

McCluskey J. Marshall Ulrich, the man without toenails. ESPN. November 23, 2009.

Back in 2009, ESPN reported on Ulrich’s decision to remove all of his toenails 17 years prior.

 

Ulrich noted that his reputation for having no toenails started to precede his fame as an accomplished athlete.

However, he admitted that toenail removal surgery was painful and should be viewed as a last resort. Certainly, this final measure isn’t for everyone. Even among the ultramarathon community, those who elect to have their toenails permanently removed make up a small minority of the group.

 

Better solutions

 

Distance runners must take precautions to protect their feet, and the decision to remove toenails permanently should never be taken lightly. After all, people have toenails for a reason, and removal can introduce unnecessary complications.

Tips from the Cleveland Clinic to prevent runner’s toe include:

Damage control: What to know about runner’s toe. Cleveland Clinic. May 24, 2023.

 

• Add silicone pads to sneakers for extra cushion

• Get sneakers professionally fitted

• Keep the toenails trimmed short

• Never cover discoloured toenails with nail polish

• Seek flatter terrain to avoid running downhill

• Tighten shoelaces for a secure fit

• Wear moisture-wicking socks

If a damaged toenail must be removed, a podiatrist should be the one to do it. Runners should also be aware that black toenails can also be caused by other issues, including fungal infections from running in sweaty, wet sneakers or, in rare cases, melanoma under the nail. It’s always best to get a qualified medical opinion before jumping to conclusions about the cause of a black toenail.

Damage control: What to know about runner’s toe. Cleveland Clinic. May 24, 2023.

 

 

Is the human body designed for ultramarathons?

 

 

When it comes to such high-intensity exercise, the bigger question really comes down to whether people should voluntarily participate in such activities in the first place. Other potential hazards of ultrarunning include damaged joints and arthritis, overuse injuries, and organ damage to the heart, kidneys, and lungs.

Scheer V, Rojas-Valverde D. Long-term health issues in ultraendurance runners: should we be concerned?. BMJ Open Sport & Exercise Medicine. 2021;7:e001131.

While it’s an individual right to attempt an ultramarathon, choosing to do so means accepting the risks with the rewards.