Run Well Juliet McGrattan (microsoft ebook reader TXT) 📖

few days to settle and if it’s bothering you try applying a cold flannel or ice pack to the skin. Calamine lotion can be soothing, but avoid any perfumed skin creams or washes in case they irritate it. Particularly troublesome heat rash might improve with hydrocortisone cream or antihistamine tablets, but it’s best to speak to your pharmacist before you try these and always get confirmation of the diagnosis if things aren’t improving.

Q I get these weird blotchy, itchy spots on my skin sometimes, usually after a run or after a ­post-run shower. They go away the same day, but what are they?

A This sounds like urticaria, the medical term for nettle rash, hives or wheals. The spots are usually pink or white and raised from the skin. They appear in response to a trigger and the number of things that can cause them is huge. Exercise, heat and water appear on this list, all of which may apply to runners! Other causes include stress, certain foods and viral infections. The trigger causes the release of histamine from mast cells in the skin which leads to the rash appearing. If they’re mild and disappear within a few hours, then there’s no need to treat them. If they’re persistent, causing discomfort or continue to spread, then antihistamines will help. If you keep getting urticaria then see your GP to discuss possible causes and treatments. Although rare, if rapidly developing urticaria is associated with lip and tongue swelling or difficulty breathing, then this may indicate a life threatening allergic reaction, called anaphylaxis, and you should dial 999 for an emergency ambulance.

Toenails

Q I ran my first marathon a few days ago and three of my toenails have turned black. Do I need to worry?

A There’s no need to panic. Black toenails are well known to long distance runners and, while they can look pretty gruesome, they’re usually harmless. The black colour is blood from the delicate nail bed that has become trapped under the nail. It’s essentially a bruise. The medical term is a subungual haematoma from ‘unguis’, the Latin word for nail and haematoma, meaning a collection of blood. Don’t be alarmed if the nail falls off. This is often inevitable. However, let it stay in place as long as possible so it can protect the nail bed, and don’t pull it off. A new nail will gradually grow up from the base, but it may take six to nine months before it’s fully grown. Make sure there’s enough room for your toes in your running shoes so your nails aren’t repeatedly bashing against the end of the shoe, particularly when you run downhill. You might need to go up a full size. Socks which are too small won’t help either. Try using the heel lock for lacing your shoes (see here) to stop your feet slipping forwards.

Q My big toenail has really thickened up. My GP says it’s caused by trauma to the nail, but could it be a fungal infection?

A Both fungal infections and nail trauma can cause a nail to thicken, discolour (usually yellow) and become flaky. It can be hard to tell the difference, but if there is uncertainty scrapings can be taken from the nail and sent to the laboratory for microscopic examination and culture. Even then, the result can be misleading. Fungal infections don’t actually need to be treated. There are no serious consequences, but they can spread to other nails. Cosmetically they are unpleasant and the nail can become a bit tender, which makes running hard. If treatment is required, then sadly, there’s no quick fix. Although it tends to be the same fungus as athlete’s foot that causes nail infections, anti-fungal creams can’t penetrate the nail. Either nail lacquers with repeated nail filing or oral antifungal tablets are needed, and these can take six to nine months to work. It’s a long process and you should discuss the possible side-effects of anti-fungal tablets, including the risk of liver damage, with your GP. Traumatised nails are more likely to get infected, so make sure your trainers are big enough and practise good foot hygiene to prevent athlete’s foot.

Q I keep getting a really sore area on the edge of my big toe, where it meets the nail. Sometimes it weeps and bleeds, and when it’s bad I can’t run because it’s so sore. What can I do?

A This condition is called paronychia, from the Greek ‘para’ (around) and ‘onyx’ (nail). It’s due to an infection which nestles itself between the skin and the nail. This is more likely to occur if the area has been damaged, which can happen to toenails with the repetitive impact of running, as well as by ingrown nails. When it happens suddenly, it’s usually caused by bacteria – staphylococcus aureus is the usual culprit. Redness and swelling develop in the skin alongside the nail and there’s often a collection of pus under the skin. This type of paronychia can be treated at home by applying warm, wet compresses or soaking feet in warm salty water several times a day, and using antiseptic creams or sprays. Sometimes, however, it requires antibiotics or drainage of the pus, so it’s important to see your doctor if it isn’t getting better, particularly if the pus isn’t draining, the redness is tracking up your toe, or you feel unwell with it.

Slower growing and longer-term paronychia infections are often caused by fungi, so they’re an extension of athlete’s foot problems. The treatment is foot hygiene, antifungal creams and possibly tablets if these aren’t helping. You can help to prevent paronychia occurring by keeping your feet as clean and dry as possible, wearing the right size running shoes and treating any athlete’s foot early. If your paronychia is caused by ingrown nails, it’s important to learn how best to trim your nails.

Did you know?

Paronychia is three times more common in women than it is in men. This may