Symptoms
You’ll notice a painful, hot toe after a run in new shoes or without socks. This may then cause discomfort in any shoes.

Signs
Your nail turns dark red or black due to blood underneath. This happens because the constant bruising during your run causes the blood vessels under your nail to leak. No medical investigations are required.

What else could it be?
A mild case could be confused with an ingrowing toenail, fungal nail infection or other disease such as psoriasis.

Self-treatment
If you’re courageous enough, make a needle red-hot and let it burn through the centre of the nail, about 3-5mm up from the base to relieve the pent-up blood underneath. You can squeeze out the rest of the blood by hand.

Medical treatment
If you’re lacking bravery, let your doctor perform the above operation! They may then prescribe antibiotics to prevent infection, and you can take paracetamol for pain.

Is ultra-running bad for the heart?
Yes, to an extent, though pain will prevent you from overdoing it. If you don’t treat the problem, it will bleed more and you’ll probably lose your toenail.

Recovery time
You should be able to run a few days after treatment, especially if you use a plaster to tape the nail down (this may later drop off to be replaced by new growth). To prevent recurrence, make sure that your shoes are comfortable, spacious and properly worn-in – and wear socks.