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2014 Winter Olympics: The Biathlon and Skiers Toe

Date: February 18, 2014 Category: Uncategorized


Biathlon is the name given to the Olympic sport that combines cross-country skiing with rifle shooting.  The sport has its origins in Norway as an alternative training exercise for soldiers.  The sport was a part of the first Winter Olympics in Chamonix, France but at that time was known by the moniker Military Patrol.  Events will often range in the distance skied with two or four shooting rounds interspersed depending on the event.  Shooting rounds are divided between standing and prone positioning.  With the skiing portion of the event comes the increased risk of trauma to the feet and toes which leads to today’s topic of Skier’s Toe.


What is it? Subungual hematoma (also known as Skier’s Toe, Runner’s Toe or Tennis Toe) is where there is bleeding under the toenail that occurs as a result of repeated trauma to the toe and toenailThis trauma is usually the result of footwear that is too tight or if the toenails are too long.  Additionally, dropping a heavy object on the toe can cause traumatic bleeding under the toenail. 

What are the symptoms?  Symptoms of Skier’s toe include pain and pressure in the toe due to blood collecting under the toenail.  Bluish or brownish discoloration of the toenail may also be present due to collected, dried blood underneath.  In some cases, enough blood can collect under the nail causing it to loosen from the toe or to fall off completely.  Additionally, there may even be redness and swelling in the toe along with discharge due to an infection occurring from bacteria entering the area where the bleeding originated from.

What is the treatment?  Skier’s Toe is treated by making a hole in the toenail to drain any remaining blood out from under the nail and thereby reduce pressure.  This is accomplished by the physician drilling a hole in the nail with a needle or by using a heated sterile paperclip or sharp instrument.  After draining, if the nail is partially attached, it may be taped down to prevent catching until a new nail is formed.  For nails that remain barely attached, a physician may remove the nail completely.  If there are any signs of possible infection such as redness and drainage, your physician may start you on oral antibiotics with frequent monitoring in the short term.  Any pain that is present with Skier’s Toe is usually well controlled with anti-inflammatory medication.

How can it be prevented?  Skier’s Toe can be best prevented by wearing appropriate sized boots that allow enough room for your toes and by keeping your toenails short.  Additionally, subungual hematomas can be prevented by avoiding dropping heavy objects on your toes.  If you are involved in activities or work that requires heavy lifting, steel-toed footwear may be a consideration to prevent injury from dropped objects.

Random useless trivia about Biathlon:   Although it was a part of the first Winter Olympics in 1924 under the name Military Patrol, Biathlon was not contested again as an official Olympic sport until the 1960 Games in Squaw Valley, California.

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