I Just Stubbed My Toe! Is it Bruised or Broken?

by Dr. Emily Splichal, DPM MS 

We’ve all done it at some point or another.  Walking to the bathroom in the middle of the night.  Putting the kids to bed.  I’m talking about the painful and infuriating misfortune of stubbing a toe!  

This seemingly minor injury can hurt so bad in the moment and is followed with the question of did I bruise it or is my toe broken?

Is it stubbed, bruised, broken, or sprained?

Before you make a mad dash to the Urgent Care, we want to set a few guidelines you can follow on how to treat at home and when to seek medical advice.  

First we’ll start by saying that a majority of stubbed toes are just bruised or sprains.  Besides the pain to the touch and swelling, any bruising or obvious deviation of the toe may signify a more serious injury. 

Stubbing the toe can result in several different injuries including: a toe sprain, bone bruise, fractured toe and bleeding under the nail (subungual hematoma).  

Treating a Bruised Toe

A toe sprain and bone bruise are most commonly what is experienced in a midnight toe stub and is best treated with 15 minutes of icing followed by a buddy splinting technique for a few days. 

To buddy splint the toes, simply tape the stubbed toe to the adjacent toe to create stability and reduce stress on the inflamed toe. Generally, a bone bruise or toe sprain will resolve in a few days to a week.

Treating a Broken Toe

In the case of a more serious injury, any suspected fracture of the toe would need to be x-rayed.  Depending on the severity of the toe fracture it may need to be relocated, which is referred to as a closed reduction and is performed by the medical doctor.  

This would be followed by a buddy splint and often times a stiff walking shoe or a post-op shoe. 

Symptoms of a broken toe include:

• swelling around the toe and sometimes into the foot
• discoloration, such as black or blue bruising, around the toe
• a change in the shape of the toe, if a bone is out of place
• trouble moving the toe
• significant pain when walking or putting weight on the toe
• a loss of feeling in the toe or foot

Treating an Injured Nail

It is not rare to experience an injury to the nail bed at the same time as the stubbed toe.  Injuries to the toenails can be very painful, especially if the toenail breaks deep in the nail plate. If the injury is serious enough to bleed, the blood can pool under the nail and is referred to as a subungual hematoma.

Common nail injuries after stubbing a toe:

• a cracked or broken nail
• bleeding along the edge of, or underneath, the toenail
• swelling or pain under the toenail
• pus or fluid under the toenail

The treatment for a nail injury may include draining the blood or fluid from under the nail, partial or total nail avulsion or removal or observation.  If any damage is done to the nail bed it is important to note that it can take months for a toenail to grow out so be patient during this process. 

Remember as frustrating as a stubbed toe may be, a majority of these injuries are mild and will resolve in a few days.    However if you do suspect a fracture it is always good practice to see a medical professional versus trying to treat on your own at home.