How to Prevent the 5 Most Common Soccer Toe Injuries and Conditions

Soccer is one of the most popular sports in Seattle. It’s particularly widespread in families with young children and teens. But like any sport, soccer comes with risks—especially when it comes to foot and ankle injuries, and in particular, the toes.

I often see young soccer players with injuries that could have been prevented with the right knowledge and preparation. Today I’m going to talk to you about the most common toe injuries and conditions that plague soccer players, how they’re treated, and how to prevent them from occurring.

Turf Toe in Seattle Soccer Players

While turf toe gets it’s name because soccer and other sports are often played on artificial turf, it can occur on any playing surface. Dancers, gymnasts, and basketball players are also at risk. That’s because any sport that can cause the big toe to bend too far backward or hyperextend, can damage the ligaments and soft tissues around the MTP joint in the big toe—that's the joint where your big toe meets your foot.

Cause of Turf Toe in Soccer

The big toe is more likely to hyperextend in sports where sudden stops and quick direction changes occur during play. That’s definitely the case with soccer. Turf toe can also develop gradually from repeated stress and overuse.

Symptoms of Turf Toe

Sharp pain at the base of the big toe with tenderness to the touch
Swelling and bruising around the joint
Stiffness and limited range of motion, including difficulty walking

Other risk factors for turf toe are wearing improper footwear such as cleats that are too flexible, insufficient warm-up, and improper gait.

Diagnosing Turf Toe

To diagnose it I’ll check for pain and stiffness and do an X-ray and an MRI to identify any damage to the underlying tissues.

How to Treat Turf Toe

Rest—if you continue to play on an injured toe it will be more difficult to treat. I may even put you in a walking boot.
An acute injury will require icing, compression, and elevation of the foot to reduce swelling. If your physician approves it, an anti-inflammatory can also help reduce pain and inflammation.
Physical therapy to improve your range of motion

Prevention of Turf Toe in Soccer

To prevent a recurrence of turf toe it’s vital that you:

Purchase supportive shoes or cleats that are made for soccer. Keep in mind that cleats that are too flexible are more likely to lead to turf toe. More about how to purchase cleats at the end of this article.
Get any gait problems, such as overpronation, resolved by wearing custom orthotics provided by your podiatrist.
Engage in proper warm-ups – I recommend dynamic warm-ups - see video below.

Black Toenails in Seattle Soccer Players

Nearly every soccer player experiences a black or bruised toenail at some point. This happens when blood pools under the nail, usually from direct trauma or repeated pressure.

Causes of Black Toenails

Getting your foot stepped on during play
Cleats that are too tight or too short causing your toe to repeatedly hit the front
Toenails that are too long

Symptoms of Black Toenails

Black, red, dark purple, or blue discoloration under the nail
Pain and tenderness, especially with pressure
Throbbing sensation
Swelling around the nail
In some cases, the nail may start to come off.

How to Treat Black Toenails

Most of the time, your nail will grow out over several weeks to months with no difficulty. However, if there's severe pain or significant pressure building under the nail, we can drain the blood to relieve any discomfort. This is a quick, relatively painless procedure that can provide immediate relief.

Finally, never try to rip off a loose or damaged toenail. This can cause infection. Keep it attached with a bandage, and we’ll remove it at the office using sterile techniques.

How to Prevent A Black Toenail in Soccer

Then there’s prevention. While you can also do only so much to avoid other players stepping on your toes, you can take steps to avoid the other common causes of black toenail.

Purchase cleats that fit and aren’t too snug. Too often I see players that purchase cleats that are too tight with the belief that they will enhance their play. But don’t do it if you want to avoid a black toenail. Wearing cleats that are too long for your feet will also cause problems—your foot will move forward causing your toenails to hit the front of the cleats.
Keep your nails clipped short for the same reason.

Finally two other nail conditions can occur for the exact same reasons— ingrown and fungal toenails. I’ll talk about them next.

Ingrown Toenails in Soccer Players

Ingrown toenails occur when the edge of the nail grows into the surrounding skin instead of over it, leading to pain, redness, swelling, and sometimes infection.

Ingrown toenails can occur for the same reasons as black toenails when playing soccer.

Getting stepped on
Wearing shoes that don’t fit.
In addition, cutting toenails by rounding the edges can also cause an ingrown toenail in soccer players.

Symptoms of an Ingrown Toenail

Pain and tenderness along the nail edges
Redness and swelling around the nail
Drainage or pus—which is a sign of infection

How Podiatrists Treat Ingrown Toenails

The good news? Ingrown toenails can often be treated right in the office with a simple, minimally painful procedure. For chronic or severe cases, we use a technique that prevents that portion of the nail from growing back, providing a permanent solution. Learn more about treatment and prevention of ingrown toenails here.

Toenail Fungus in Seattle Soccer Players

Unlike a bruised toenail, toenail fungus—also called onychomycosis—won't just go away on its own. In fact, without treatment, it typically gets worse and can spread to other nails or even to other family members.

Causes of Toenail Fungus in Soccer Players

Fungi love warm, dark, moist environments—exactly what you find inside sweaty socks, cleats and damp locker rooms. And add that to repetitive nail trauma from cleats that are too tight and you have the perfect recipe for toenail fungus.

How to Identify Fungal Toenails

Yellow, white, or brown discoloration
Thickened nails
Distorted nails

It’s important to note that these can also be symptoms of trauma to the nail. An evaluation with a podiatrist will help with the diagnosis.

Treatment of Fungal Toenails in Seattle Soccer Players

Our office specializes in treatment of fungal toenails. We discuss our comprehensive fungal nail treatment plan here.

How to Prevent Toenail Fungus in Soccer Players

In addition to buying the right shoes and keeping your toenails clipped here’s how to help prevent toenail fungus in soccer players.

Rotate between 2 sets of cleats so each pair can fully dry between uses—this takes at least 24 hours or air out cleats after every practice or game.
Only use moisture-wicking synthetic socks, not cotton, which holds moisture against the skin
Change socks after each game.
Always wear shower shoes or flip-flops in communal locker rooms and showers
Use antifungal powder in shoes as a preventive measure or purchase a Shoe Zap to keep cleats free of fungus.

Athlete's Foot in Seattle Soccer Players

Athlete's foot is caused by the same fungus that infects your toenails. It shows up as dry, itchy, sometimes burning, peeling skin—most commonly between the toes, but it can also affect the soles and sides of the feet.

Treatment of Athlete's Foot

You can use over-the-counter antifungal creams and sprays to treat mild cases at home, but you’ll need to continue treatment for at least a week after symptoms disappear to fully eliminate the fungus. Many families stop too soon, and the infection comes right back.
If the infection doesn't clear up within two weeks of consistent home treatment, or if it's spreading or becoming painful, prescription-strength treatment may be needed.

Prevention of Athlete's Foot

In addition to all the other prevention strategies I’ve already mentioned, it’s important to:

Dry feet thoroughly after bathing, especially between the toes

How to Purchase Soccer Cleats for Your Child

So you might wonder what to look for in soccer shoes or cleats, since footwear that is too short or long can cause many of these toe injuries and conditions.

Always Measure Your Child's Feet

First, always measure your child's feet before buying new cleats—and I mean every single time. Kids' feet can grow as much as half a size in just a few months, especially during growth spurts. Don't assume you know their size from last season."

When trying on cleats, here's what you need to check:

Length:

There should be approximately one thumb's width—or about a half inch—of space between the end of the big toe and the front of the shoe
Have your child stand up while checking this, as feet expand under weight
Keep in mind that with too little or too much room, you’re child is more likely to have their toes hit the top of the shoe, causing injury and damage

Width

The foot should fit comfortably without the sides bulging over the sole
Too narrow causes compression and pain; too wide causes instability

Heel Fit:

The heel should be snug without slipping
There should be no gap between the heel and the back of the shoe

Test Shoes for Support

Hold the heel and toe and try to bend the shoe
It should bend at the ball of the foot—where your child's foot naturally bends
If it bends in the middle or arch area, it won't provide proper support
Hold the heel in one hand and the toe in the other
Try to twist the shoe like wringing out a towel
A good cleat should resist twisting—excessive flexibility can lead to injuries like turf toe

Just because a cleat looks flashy, carries a big brand name, or costs a lot of money doesn't mean it's good for your child's feet. Marketing doesn't equal quality. Stability, proper fit, and appropriate support matter far more than looks or price tags.

In Seattle many families have kids who play outdoors and/or indoors. Here are a couple of rules of thumb depending on the surface they’re playing on.

Firm Ground Cleats- firm ground cleats are a great all-around cleat for different types of outdoor surfaces.
Turf Cleats – these are meant for indoor soccer play only ; these are more like tennis shoes and tend to have a wider toebox
Brands – The Soccer Post in Woodinville and Everett (just outside of Seattle) recommends Adidas, Puma, or New Balance for those with a tendency toward ingrown toenails and other toenail problems. These shoes have a wider toebox.
How Often to Purchase Cleats - most kids will need to have their cleats replaced annually, biannually, or more frequently, particularly when they're still growing. The younger the child, the faster their feet can grow.
Check the Cleat's Condition - if teens have stopped growing, it’s still important to:
- check wear patterns
- ensure cleats are intact
- uppers haven’t worn out.

If any of these have changed, it’s important to replace them even if they still fit.

In conclusion, soccer and other sports can place a lot of stress on toes and toenails. Buying the right shoes and other hygienic practices are an essential part of preventing future toe and toenail problems.