Running After the Athletic Client

They may be swift of foot, but runners have particular foot problems. Perfect for the progressive pedicurist who wants to expand her market.

A reader wrote in about clients who run and the special needs they present as pedicure clients. I’m glad for the question because it gives me an opportunity to discuss this issue.

I find runners to be quite knowledgeable when it comes to their feet. They generally know what their needs are and will voice them to you. In general, I would say they are looking for comfort rather than beauty. Although the massage part of the pedicure is the same as is done for a regular client, when it comes to a runner’s toenails and calluses, they require a slightly different approach.

The toenails of a runner should be trimmed quite short. Trim them short enough so the fat pad on the tip of the toe extends slightly beyond the free edge of the nail. This will keep the nails from hitting the end of the shoe or catching on the sock and causing injury to the soft tissues under the nail.

I see many injured nails after marathons from just this problem. The individual has been training and getting ready for the race mentally for a number of weeks or months. She forgets that her nails are growing and neglects to trim them prior to the event. The nail may not look long, but it extends just beyond the tip of the toe. The protective cushion at the end of the toe is behind the free edge of the nail. The nail, which is rigid, hits the end of the shoe and doesn’t have the give than the fat pad does. So when a runner removes her shoe after the race, she’ll see that the tissues under the nail are bluish, and the nail is tender. Later, the nail bed turns black from the blood clot that has formed under the nail. In severe cases, the nail will even fall off. What happened is that the nail hit the end of the shoe with each stride the runner took. It does not hit hard enough to cause pain, but it hits often enough that, after many light taps on the end of the shoe, the rigid nail plate gets jammed into the matrix bed. The nail begins to loosen from the underlying tissues. Micro-hemorrhages occur under the nail plate, which lead to dark color when the blood clots. The matrix area behind the proximal nail fold will be quite tender for a while.

A runner’s socks can also cause a similar problem. A nail can catch on the sock, which can then either jam it back into the matrix bed or lift the plate slightly up off the nail bed with each stride. Whichever the cause—the shoe or the sock—all the little injuries add up to one big injury to the nail after the race.

The corners of the toenails should be rounded. This keeps them from catching on the sock and causing injury. It also helps to keep the nail from cutting into the nail groove and causing an infection. In rounding the nail, you only want to get the sharp point off. Do not cut back into the nail groove any more than is necessary to keep the client comfortable. The small metal files made to file along the edge of the nails are the proper instruments for this job. These narrow files are made to file in one direction and have the filing edge only on one side. Use it only to smooth the edge and corner of the nail. Do not use it to dig debris out of the nail groove. A small, fairly stiff nail brush should be used to assist in the removal of any debris along the nail groove. A stiff toothbrush also works well here.

I know it is controversial to round the edge of a toenail, a practice many believe causes ingrown toenails. I personally do not believe this and have never seen a satisfactory explanation as to how it causes an ingrown toenail. The only thing that forms the nail plate is the matrix bed. The nail shape is therefore determined by the shape of the matrix bed. How does rounding the free edge of the nail cause the nail to ingrow? Anyone who has ever had an ingrown nail knows that the nail cannot be cut straight across and be comfortable. The nail must be rounded so the point will not cut into the soft tissues. It is when one tries to cut too far back along the edge that problems arise. The nail may be loosened from its normal attachments or it is left rough and sharp, which allows it to cut into the soft tissues. Both of these conditions allow bacteria to enter the skin and cause an infection along the margin, creating what appears to be an “ingrown nail.” So go ahead and round the nails on the runners only enough to remove the sharp points in the free edge.

Cuticle care. Do not trim the cuticles on toenails. This rule applies to regular clients as well as for those clients who run. Use a cuticle softener to soften the cuticle and then gently push the cuticle back. Do not break the natural seal between the cuticle and the nail. This seal helps to prevent the entrance of fungi, bacteria, and other foreign substances into the nail fold and the matrix bed. In my practice, I see a number of patients with infections under the nail fold because of aggressive removal of the cuticle by their pedicurist. Remember that the foot goes back onto hosiery and shoes after the pedicure. This combination creates a warm, moist, and dark environment that contributes to perfect conditions for infections to occur. Recommend products for the cuticle that the client can use between visits and stress the importance of gentleness in pushing the cuticles back when they use these products.

Callus care. The main thing to remember about calluses is that they are nature’s protection for the skin. Runners place extra stress and pressures on their feet, which causes more callus buildup than with non-runners. The callus is there for a purpose—to protect the underlying tissues. Therefore, you should not attempt to remove the extra callus from the runner’s feet. Without it, blisters will form the next time the runner goes out and tries her usual distance. If you find the calluses are rough and cracking, you should smooth them with the foot paddle, but do not thin them any more than is necessary. Creams and lotions to make the calluses more pliable will help prevent them from drying out and cracking. Recommend these products to the client for home use between pedicures.

The massage. This is the part of the pedicure runners will appreciate the most! Develop a good massage technique and give the runner client extra time for this part of the service. Your extra efforts will be well spent both in client satisfaction and in developing new client referrals.

Educate the Client

Educate the client about why you trimmed her nails the way you did, and why you did not remove a lot of the callus. You should also talk to her about shoe fitting (“If The Shoe Fits,” NAILS Magazine, December 1994). In this manner, you demonstrate that you are knowledgeable about her sport. She will appreciate your service more if she knows it is customized for her. She will also refer her running acquaintances to you for this special service.

It seems to me that this is an open area for the nail professional to build up her pedicure clientele. Many of my colleagues promote themselves as specializing in sports medicine as it relates to the feet. The nail professional who would like to build a sports-related clientele should promote her foot services in a similar manner. Give a talk at the local running club. Promote a “Runner’s Pedicure” before a local marathon in your area. Promote the benefit of an “After the Run” pedicure to relax the feet and legs through your special massage technique. Be creative and have fun doing pedicures on a truly motivated and interesting segment of our society.

 

For a step-by-step Sport Pedicure demo and additional information about your athletic clients' special needs, read Going the Distance (Restoring Runners' Feet), previously published in NAILS. 

 

Godfrey F. Mix, D.P.M has been a podiatrist for 25 years. He is a member of the American Podiatric Medical Association, has served on the California Board of Podiatric Medicine, and is board-certified by the American Board of Podiatric Surgery, he is bringing his expertise to the nail industry as a consultant and speaker, and through this exclusive quarterly column in NAILS.