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April 1, 1974

Tennis Toe

JAMA. 1974;228(1):24. doi:10.1001/jama.1974.03230260018003

To the Editor.—  Tennis toe is an abnormality of the toenails, usually of older players, which is caused by collision between toenail and sneaker.1 It is actually subungual hemorrhage beneath the hallucal nail, less frequently beneath the second toenail, and rarely beneath other toenails. It usually affects the toe which extends the furthest distally on the foot, this ordinarily being the first, but in the Figure the second. The condition is seen usually in players over 35.The simplest explanation is that the tennis player often stops short after a brief spurt. Synchronously, the foot shoots forward and the toes jam into the tip of the sneaker. The crushing force squeezes the subungual space and ruptures blood vessels causing hemorrhage. The newer European sneakers as well as some American sneakers with better traction and more shallow box toes are more likely to cause the problem. Contributing factors are hard