Soccer players deal with many injuries, but some are more painful than others. A subungual hematoma is one of those injuries. It happens when blood collects under the toenail or fingernail due to trauma. In soccer, this often results from being stepped on, kicking the ball incorrectly, or sudden impact with an opponent's boot.
This injury may seem minor, but the throbbing pain and pressure can be severe. In some cases, a player might even lose the nail. Proper treatment helps relieve discomfort and speeds up healing.
This guide will explain what a subungual hematoma is, how to treat it, and how to prevent it in soccer.
What Is a Subungual Hematoma?
A subungual hematoma is a bruise under the nail caused by bleeding from damaged blood vessels. The injury results from direct trauma, which crushes the nail bed and leads to discoloration, swelling, and pain.
The term "subungual" refers to the area beneath the nail, while "hematoma" means a collection of blood outside the blood vessels.
Causes of Subungual Hematoma in Soccer
Several situations in soccer increase the risk of this injury. Players should be aware of these common causes:
1. Getting Stepped On
A defender or midfielder often finds themselves in tight spaces. In these moments, an opponent might step on their foot with full force. The hard studs of soccer cleats crush the toenail, leading to bleeding underneath.
2. Incorrect Kicking Technique
Kicking the ball with the wrong part of the foot can lead to injury. Striking with the top of the toes instead of the instep increases the risk. Repeated impacts over time can weaken the nail and cause trauma.
3. Sudden Stubs or Impacts
A player might accidentally kick the ground or collide with an opponent’s boot. This type of direct impact damages the nail bed and results in bleeding.
4. Tight Soccer Cleats
Wearing cleats that fit too tightly can put constant pressure on the toes. Over time, this can cause discomfort and make the nails more prone to injury.
5. Repeated Micro-Trauma
Some players develop subungual hematomas from repeated small impacts rather than one big injury. Running, cutting, and stopping suddenly in tight shoes can lead to ongoing stress on the toenails.
Symptoms of a Subungual Hematoma
The pain from this injury is usually immediate. Some of the most common symptoms include:
- Dark red, purple, or black discoloration under the nail
- Throbbing pain due to pressure from trapped blood
- Swelling and tenderness around the affected toe
- Difficulty putting weight on the foot
- Possible nail loosening or detachment
Pain usually worsens over the first few hours. The trapped blood creates intense pressure, making even small movements uncomfortable.
How to Treat a Subungual Hematoma
Early treatment helps reduce pain and prevent complications. Here’s what to do if you experience this injury:
1. Ice and Elevation
Apply an ice pack wrapped in a cloth to the injured toe for 10-15 minutes at a time. This helps reduce swelling and numb the pain. Elevating the foot also limits further blood pooling under the nail.
2. Rest and Avoid Pressure
Avoid running or kicking for at least 24-48 hours. Applying too much pressure worsens the pain and increases the risk of further damage.
3. Over-the-Counter Pain Relief
If the pain becomes too intense, ibuprofen or acetaminophen can help manage discomfort. These medications also reduce inflammation.
4. Drainage (Trephination Procedure)
If the pain is unbearable, a doctor may drain the blood trapped under the nail. This is done using a sterilized needle, cautery device, or small drill to make a hole in the nail.
The procedure:
- A small hole is created in the nail to allow trapped blood to escape.
- Immediate pain relief follows as the pressure decreases.
- The hole remains open, allowing fluid to drain naturally over time.
Players should not attempt this on their own. It should be done by a doctor using sterile equipment.
5. Keeping the Toe Clean and Protected
After drainage, the affected area must stay clean and covered to prevent infection. An antibiotic ointment and bandage help keep bacteria out.
6. Monitoring for Infection
Watch for redness, pus, or increasing pain. These signs indicate a possible infection. If they appear, a doctor should be consulted immediately.
Recovery Timeline
Most players recover within one to two weeks, but it depends on the severity of the hematoma.
- Mild cases heal on their own within a few days.
- Severe cases may take several weeks, especially if the nail falls off.
- If the entire nail detaches, regrowth can take six months to a year.
Players should return to full activity only when they no longer feel pain in the toe.
How to Prevent Subungual Hematoma in Soccer
While this injury is common, simple precautions can help avoid it.
1. Wear Properly Fitted Cleats
Soccer shoes should have enough room for the toes to move comfortably. Cleats that are too tight increase pressure, while loose ones allow excessive movement, leading to trauma.
2. Use Toe Protectors
Gel toe caps or padded socks add an extra layer of protection. These can absorb impact from kicks and accidental stomps.
3. Strengthen the Feet
Stronger foot muscles improve stability and reduce the risk of injury. Simple exercises like toe curls, balance drills, and calf raises help build foot strength.
4. Keep Toenails Trimmed
Long nails increase the risk of lifting or breaking upon impact. Keeping them short and smooth helps prevent painful injuries.
5. Practice Proper Kicking Technique
Striking the ball correctly reduces unnecessary impact on the toes. Players should focus on using the instep rather than the top of the toes.
6. Be Aware of Opponent's Movements
During tackles and crowded situations, players should remain aware of where opponents are stepping. Quick reactions help avoid unnecessary foot stomps.
Final Thoughts
A subungual hematoma is painful but manageable. Soccer players often experience this injury due to accidental impacts, poor cleat fit, or repeated stress.
Early treatment reduces pain and speeds up recovery. Icing, elevation, and, if necessary, drainage can help ease discomfort. Most cases heal within a couple of weeks, but taking steps to prevent recurrence is key.
By wearing proper footwear, strengthening the feet, and using smart techniques, players can keep their toenails intact and stay on the field. Soccer is demanding, but with the right precautions, injuries like subungual hematomas can be minimized.
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