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Ever had mild toe bang go away?

post #1 of 9
Thread Starter 

Has anyone heard of mild toe bang actually going away with several days' rest and lots of ice?


I'm down under in the New Zealand winter, trying my hardest to ski.  Due to boot problems (and attempts to solve same) my poor right big toe has been rather unhappy this season.  It's been crammed into way too little space at times AND also, at others, floated around in boots that were just a little too big for my feet.  Toe bang has been coming on very gradually over the past three weeks; I thought I had got the boot problem sufficiently solved before it got too bad, but two days ago I was unable to click into my bindings without excruciating pain.


I came home and put holes in the nail and got a reasonable amount of clear liquid out of the first hole (none out of the rest, in a different area of the nail).  Iced the sucker real good for the remainder of the day.  Next day (yesterday) I put on super-thin socks and very gingerly got back into the boot.  To my surprise, I was able to ski, but not what you would call enjoyably -- I couldn't relax and my stance was terrible, so I gave it away again.  In the afternoon I went to the doctor, who was fully booked so I saw the nurse instead, who, rather "interestingly", opined that what I actually have is an infection!   She has me on antibiotics and wants me to soak the foot in hot-hot water and baking soda.  I'm prepared to take the drugs but there is no way I'm prepared to raise the pressure in that toe.  I've continued icing it for say 30-60 minutes at a time, stopping if the cold-pain gets too intense, several times a day.


Comparing the two toenails, there is not that much difference between them.  The "banged" nail is ever-so-slightly darker in colour than the "good" one, and if I press on it or push the toe into the floor there is some pain, but not a whole hell of a lot.  This is very different from how it was last year, before I had to have it removed (due to skiing in packed-out liners).  It was much darker and the pain was much more intense.


So again, the question is: has anyone heard of mild toe bang actually going away, or am I wasting my time resting up and icing it?  How likely is it that after say a week of rest and ice (there's a storm front coming) I will find that the toe bang is just as bad and I should have had the nail removed this week?

I really would like to avoid having it removed again -- that would make it the fourth time this particular nail has come off (twice naturally and twice surgically), and I don't want to risk it regrowing thicker and/or curving upwards.  I have a friend who has this condition now and she's forced to ski in beginner boots because otherwise the pain is too bad!  On the other hand, if I'm likely to end up having it taken off again anyway, I may as well just get on with it and start the recovery process sooner than later.


TIA for opinions and experiences

post #2 of 9
Bruised and banged toes can be difficult. 

Is your stance correct?

It is possible to have a great fitting boot that gives you room and performance (ahhh... the great crux). 

I generally advise against messing with the nail, but sometimes you have to do it.  Talk to a MD/DPM if you think the nail is infected.  I like to create room in the toe box so that the toe has enough room to exist without mega pressure.  Are you willing to sacrifice a boot so that your work/vacation time in NZ continues?  Giving the toe enough room so that the pressure is relieved is a good idea, but when the problem heals, the room created to help it along may turn out to be too big- effectively destroying the boot.    When getting a boot tech to give some space in to toe, make sure you remind them to stay with DIN.  I've seen monkeys destroy boots with too big a dimple on the toe.  Right idea, wrong technique.

Was there a specific event that caused this problem? 

Catching a boot issue before it becomes a first aid issue is paramount.

In short:  Go away???  No.  Lessen/reduce/eliminate pain???  Yes.

Good Luck!
post #3 of 9
Thread Starter 

Thanks Stephen,


Yes I used to have boots just like you described...space AND performance...ah, those were the good old days (before they packed out, last year).  I've been in the process of trying to recapture that this season.  First with Intuition liners, which gave me NO space for my toes, even after having them moulded by a very good bootfitter -- and yes he did use a large and thick toe cap -- and then with buying a pair of Lange Exclusive 90s, which are apparently the comparable model to my beloved, wonderful CRL90s -- the Exclusives, weirdly, do not fit at all the same.  We've had to add "sinus pads" (sp?) -- along the front, where the leg meets the foot -- and heel bars, but I suspect that if my toe were not a problem I would pretty much be enjoying them now.  In between using the Intuitions and the Exclusives arriving in the shop from the importers I had a period of about 2 weeks where I used my CRL90 liners and was very careful not to get my weight back.


I believe that being firstly squeezed in the Intuitions and then slopping around in my CRL90s and the first day in the Exclusives have caused the toe problems this year.  There is no one obvious event this year, in contrast to last year where I was standing in the drying room after skiing and realised that my toe felt "somewhat weird" (as it thawed out!).   The nail has simply been getting ever-so-slightly darker over time and more sensitive to pressure when I tested it.


I'm positive that the nurse is full of **it, there is no infection.  Kinda hard to believe that a health professional in a ski town doesn't know how to recognise toe bang when she sees it, but there you go.

I believe my stance is pretty good -- I've seen videos of myself, and I'm reasonably satisfied with my tecnique.  There are of course times when my weight gets back (which is what caused last year's nail problem -- I was skiing in whiteout not many days after I had winded myself in an accident in whiteout) but in general I believe it's in the right place.


I have been wondering about getting my boot man to push out the toe box ever so slightly.  He's done it before and is aware of the problems and pitfalls.  I would rather not get it done, as Langes are notorious for leaking, more so after having been stretched in the forefoot area.  My CRL90s have duct tape all over the fronts and it would be nice to get away from having to redo it every summer.


In short:  Go away???  No.  Lessen/reduce/eliminate pain???  Yes.

Will the rest and ice will do this, or do we need to do the boot modifications?


Thanks again

post #4 of 9
Thread Starter 

Replying to my own thread so others who find themselves in a similar situation can maybe benefit from my experience...


In short: yes, it is possible for a mild case of toe bang to go away.  By this I mean really, go away.  It's 7 days today since I was unable to ski or walk in my ski boots, and as of yesterday morning the nail colour is almost back to normal and there is very little pain if I push on it.


I'm certain that the toe wasn't infected, so let's dispense with that little bit of silliness right away.  I took the antibiotics for 2 days and there was only minimal change; it's now 4 days after I stopped taking them and the nail is almost normal again.  The course was 10 days long, so it's just not credible that 2 days' worth did anything at all.


My toe bang came on gradually over a period of 3 weeks, so it's possible that this is one reason the healing has been able to happen.  However, I did get a reasonable amount of fluid out of the nail 7 days ago -- the first day that I was forced to stop skiing because of the problem.  My feeling is that getting fluid out is essential -- the fluid and the pressure that it causes is the problem, so getting as much of it out as possible is logically necessary.  This year's fluid was clear, whereas last year's was pinkish (blood mixed with clear liquid), and this possibly points to the damage being less serious and therefore more healable.


I did not soak the foot in hot-hot water, as advised to do by the "health professional" who pronounced the toe infected.  Instead, I iced and elevated it 4-5 times a day, leaving the ice on until the cold-pain was too intense to carry on any longer.  I also deliberately did not go for walks; I kept off it as much as possible.  I made a small ice pack with 4-5 ice cubes in a little bag, and attached it to the toe with an elastic bandage; I found this gave me precise control on the location of the ice cubes and held them tightly to the toe.  I had a single layer of the bandage between the skin and the ice pack.


For the first 3 days there was little if any improvement.  I had the feeling that it might be getting better, but it was very hard to tell.  However, on the fourth morning the pain on pushing on the nail was definitely lessened a little, and I cautiously went up skiing.  The toe was still sore the whole time in my boots, but it was possible to ski.  I did an hour and came back down.  The next day the pain on pushing on the nail was less again; overnight my boot fitter had stretched the toe boxes of my boots by about 1mm and beefed up the sinus pads (at the front of the region where the leg meets the foot), and although my toes were still touching the fronts of the boots, I had absolutely no pain.  Yesterday morning the nail colour was almost back to normal and there was only slight pain on pushing on the nail.  This morning there is essentially no pain at all.


In summary:

  • Saturday - skiied; toe not particularly sore (no more so than it had been on previous outings)
  • Sunday - toe excruciating in boots, unable to ski or walk in them; put several holes in nail with needle, got reasonable amount of fluid out of one hole only; fluid was clear (i.e. not pink or red)
  • Monday - tried wearing super-thin socks: possible to ski but only just; very sore; managed 3 runs; went to doctor, got antibiotics
  • Tuesday - took antibiotics, iced and elevated toe
  • Wednesday - same as Tuesday; final antibiotic mid afternoon; possible improvement? hard to tell
  • Thursday - pain on pushing nail definitely a bit less, able to walk in boots, so tried skiing: painful but not debilitating, managed 1.5 hours; boots stretched overnight and extra sinus pads added
  • Friday - pain on pushing nail less again; skiing painfree even though toes still contact fronts of boots; managed 1.5 hours before weather turned nasty
  • Saturday - nail colour nearly back to normal and very little pain on pushing nail
  • Sunday (today) - essentially no pain on pushing nail

YMMV.  This is my fourth experience of toe bang, and they were all different.  This time it was obvious even early on that it was a mild case, but it was still bad enough to prevent me from skiing.  Even on the day when I was unable to ski, I only had pain in the toe when I had my boots on, or when I pushed on the nail, although it did sometimes feel a bit weird when I put a sock/shoe on that foot.


I believe that the following were critical:

  • resting the toe heaps, not walking any more than I had to, minimal skiing and that only once improvement was obvious
  • lots of ice and elevation
  • getting as much fluid out as possible as soon as I was unable to be in boots 

I'm not convinced that stretching the toe boxes is necessary in every case.  Given that rest is essential for healing, if someone were, say, to get mild toe bang from slopping around in packed-out boots and then buy a pair of really well-fitting boots (even if the toes contacted the fronts of the new boots a moderate amount), there is no reason in my mind per se to stretch out the toe box. I believe that it was necessary for me, for my future in these particular boots, since this combination of liner and shell seems to be just a touch too short for me (and the very thin neoprene that is the only thing between my toes and the shell doesn't exactly help matters! -- Lange, what the h*ll is that all about???).  But I would wait until the toe had improved somewhat and then try a few gentle runs in them as-is before committing to making permanent boot modifications.


So: FWIW, I offer my experiences to the forum, in the hopes that it can help another Bear save a toenail someday.  Good skiing, everyone 

post #5 of 9
It sounds like you started the trip with swollen feet before you even put on your boots on Day 1, poss? 
post #6 of 9
Thread Starter 
Comprex, no I don't think so.  I did have foot problems (the same toe, plus ankle crush) in Utah a few years back, which at that point was the only time I had ever had problems with my Lange CRL90s.  I believe the altitude caused my feet to swell just a little.  Here we ski betwen 1,600m and 2,200m and I live at 600m, which is all a lot lower than over there.  (to roughly convert from m to ft, multiply by 3)

I started this season trying to ski in a pair of medium volume Intuition Luxury liners, the idea behind the purchase being good heel retention and a comfortable fit elsewhere.  Unfortunately, what happened is my poor toes and forefoot were crushed and I had near-zero heel retention.  (and yes, I did have the liners professionally moulded, and we used long, thick toe caps)  I believe the toe crush started this season's problems for that toe (which seems to be rather sensitive to crush and/or hitting the fronts of boots nowadays).

I got sick of the toe crush and went back to my old, packed-out CRL90 liners while I waited for my new boots to arrive here, and whilst I was careful to keep my weight forward, it's impossible to have your heel all the way back in the boot, all day -- I discovered that every time you get on a chair, for example, the slight push that you get in the back of the calves (even a gentle one) actually pushes your feet forwards in the boots -- so all those little pushes all the time just added up, I believe, to cause a mild toe bang.

It'll be interesting, now that the boots are dialed in, to see whether I have toe problems next year.  As I said, it does seem that that particular toe is now pre-sensitised.
post #7 of 9
 The nurse probably looked at the holes you put in the nail and assumed that it was infected or would become infected from you sticking a pin in it.  I don't think it was infected, at least not to begin with, but if it was I would expect you to see a marked improvement in two days with the right anti-biotic.  You should always finish the full course of anti-biotic drugs once started.  If you quit early you become a human breeding ground for resistant stains.
post #8 of 9
Thread Starter 
Originally Posted by tetonpwdrjunkie View Post

 The nurse probably looked at the holes you put in the nail and assumed that it was infected or would become infected from you sticking a pin in it.

Nah, it was the fact that it was slightly swollen and warmer than my other toes.  She never said anything about the holes in the nail, and seemed a little taken aback that someone would do such a thing!  Frankly I don't think she's seen many cases of toe bang, which is surprising in a ski town, but there you go.  Maybe she's new here -- I don't usually go to those doctors.
Originally Posted by tetonpwdrjunkie View Post

You should always finish the full course of anti-biotic drugs once started.  If you quit early you become a human breeding ground for resistant stains.

Yes, but only if there actually is an infection!    Otherwise there's no point taking them.
post #9 of 9

Nice bit of spam and way to go bringing up an old thread. I am sure she is going to fly from NZ to IL just to see you about her toe so she can wear sandals. Enjoy your short stay.

Originally Posted by larryPBO View Post

To avoid any kind of confusion, I will suggest you to visit Dr. Larry A. Keys at 1023 Madison Street, Oak Park, IL 60302.


Larry Keyes, DPM, is a board-certified podiatrist who specializes in the cosmetic and functional correction of long toes, hammertoes and corns. Dr. Keyes is an expert on the procedure he perfected over more than two decades, and he has helped thousands of women have more esthetically pleasing toes and feel good about wearing sandals.

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