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At Dubai Podiatry Centre, we have treated professional footballers for many years, and there is a very recognisable pattern of foot and toenail problems that develops because of the demands of their sport.

We commonly see:

  • thickened and damaged toenails
  • bruised or repeatedly traumatised toenails
  • retracted or curled toes
  • very large calluses along the medial side of the big toe
  • calluses and pressure lesions around the fifth toes
  • areas of thickened skin caused by repeated friction and shearing

More recently, however, we are seeing remarkably similar problems in another group of patients: avid padel players.

These are not necessarily professional athletes. They may simply love padel and play for one, two or even three hours on most days of the week.

Yet their feet can begin to look remarkably similar to those of professional footballers.

Why?

The answer lies in the combination of footwear, speed, sudden stopping and multidirectional movement.

Why Do Professional Footballers Wear Such Tight Shoes?

People are sometimes surprised when we explain that the extremely close fit of a professional football boot is not necessarily a footwear mistake.

It is part of the performance requirement of the sport.

A footballer’s boot needs to feel almost like an extension of the foot. There cannot be excessive movement between the foot and the shoe when the player is sprinting, changing direction, kicking, tackling and stopping suddenly.

It is rather like the relationship between a ballet dancer’s foot and a ballet slipper.

If we simply gave a professional footballer a boot one or two sizes larger to give the toes more room, we might solve one problem but potentially create another.

Imagine a footballer sprinting at high speed and suddenly stopping or changing direction.

If the foot can continue moving even a few millimetres inside the shoe, the body and shoe may change direction before the foot is completely stabilised within it.

That unwanted movement can compromise control and potentially contribute to instability.

For an elite athlete, where ankle and foot injuries can mean significant time away from training and competition, footwear fit therefore involves a careful balance between protecting the toes and stabilising the foot.

The Price the Toes Can Pay

Unfortunately, very close-fitting footwear combined with thousands of repeated high-speed movements can create significant pressure on the toes.

The toenails repeatedly contact the front and upper part of the shoe. Over time, they can become thickened, damaged or distorted.

The toes may retract or curl in response to the restricted space.

At the same time, friction and shearing forces create characteristic areas of hard skin.

We frequently see particularly large calluses on the medial side of the hallux — the big toe — and around the fifth toe on the outside of the foot.

For a professional footballer, some of these changes can almost become occupational wear and tear.

Padel Is Creating a Similar Pattern

Padel has become enormously popular, and we are now seeing foot problems in enthusiastic amateur padel players that are strikingly similar to those we have traditionally associated with professional football.

 

 

The foot is continually subjected to rapid changes in direction.

Unlike somebody who goes for a straightforward walk or run, a padel player’s foot is repeatedly moving forwards, backwards and laterally.

And when someone plays for one to three hours on most days, those forces accumulate.

The result can be thickened toenails, painful fifth toes, large calluses around the big toes and little toes, and toes that are repeatedly hitting or rubbing against the inside of the shoe.

The Important Difference: We Have More Options with Padel Footwear

This is where padel differs from professional football.

A professional footballer may have very little flexibility regarding how closely the boot needs to fit because performance demands require extremely close contact between the foot and footwear.

With the recreational or avid padel player, however, we usually have more room to intervene.

The obvious answer might appear to be: “Just buy a bigger shoe.”

But it is slightly more complicated than that.

More Toe Room – Without Allowing the Foot to Slide

We want enough room at the front of the padel shoe for the toes to extend naturally and avoid constantly striking the front and sides of the shoe.

In many patients, after properly measuring the foot while wearing the type of sports sock that will actually be used for padel, we may recommend going approximately one shoe size larger than the size they have been wearing.

However, simply creating more empty space inside the shoe is not necessarily the solution.

During rapid stop start and side to side movement, we do not want the foot sliding excessively inside the shoe.

So we need to achieve two things that initially sound contradictory: We want more space for the toes, but we don’t want more movement of the foot.

This is where the sock becomes surprisingly important.

The Sock Can Become Part of the Fit of the Shoe

For some padel players, we recommend a thick, highly cushioned, diabetic-style sports or tennis sock.

The purpose is not because the player has diabetes.

It is because this style of sock can provide considerably more cushioning and volume than a conventional thin sports sock.

This additional volume helps occupy some of the space inside the larger shoe while still allowing appropriate length and room around the toes.

Think of it as filling the shoe with cushioning rather than filling it with toes.

Instead of buying a smaller shoe and squeezing the toes into the available space to achieve that reassuring firm feeling, we can potentially create the same secure sensation using the correct shoe size combined with a thicker cushioned sock.

The toes have more room.

The shoe still feels secure.

And the foot has an additional layer of cushioning against the repeated forces generated during play.

Cushioning Is Particularly Valuable in Padel

A well-chosen cushioned sports sock can also help with shock absorption, friction management and comfort.

This does not mean that calluses will disappear completely.

Callus is partly the body’s protective response to repeated pressure, friction and shearing forces. Someone playing padel intensively may therefore continue to develop some hard skin simply because of the mechanical demands being placed upon the feet.

Our aim is not necessarily to eliminate every callus.

Our aim is to reduce the unnecessary trauma created when the toes are repeatedly being driven into the end or sides of a shoe that is too small.

That distinction is important.

Don’t Choose Your Padel Shoe Size by the Number Alone

Shoe sizing varies considerably between manufacturers and even between different models made by the same brand.

A player should therefore not simply decide: “I normally wear a size 39, so I’ll buy a size 40.”

The foot should be assessed inside the actual shoe.

At Dubai Podiatry Centre, when we assess sports footwear, we consider the length and width of the foot, toe position, the space available at the front of the shoe, the shape of the toe box and, importantly, the sock that will be worn while playing.

The shoe and sock should be considered together as one system.

A Simple Rule for Padel Players

If your padel shoes have to be painfully tight to make your feet feel secure, the answer may not necessarily be an even tighter shoe.

You may need:

more appropriate space for the toes + the correct cushioned sock + secure footwear around the rest of the foot.

That combination can allow the toes to sit more naturally while maintaining the secure feeling required for rapid lateral and stop-start movements.

Look at Your Feet After You Play

Your feet often tell us whether your footwear is working.

If you regularly play padel, look for:

  • thickening or discolouration of the toenails
  • recurring bruising beneath the nails
  • pain at the end of the big or little toes
  • curling or retracting of the toes
  • large calluses along the big toes
  • thickened skin around the fifth toes
  • redness immediately after removing your shoes
  • pain that increases the longer you play

These are not simply cosmetic changes. They can be useful clues about what is happening between your foot, sock and shoe during movement.

Better Space Doesn’t Have to Mean Less Stability

One of the biggest misconceptions in sports footwear is that more room for the toes automatically means a loose shoe.

It shouldn’t.

The goal is to provide appropriate space where the foot needs space and appropriate security where the foot needs stability.

For avid padel players, getting that balance right can make an enormous difference.

You may still develop some callus because padel is a demanding multidirectional sport. But your toenails and toes should not have to be repeatedly battered against the end and sides of your shoes every time you play.

And when someone wants to spend several hours on the padel court every week, comfortable feet are not simply about avoiding pain.

They are part of being able to continue playing the sport you love.

At Dubai Podiatry Centre, we assess the foot, toenails, callus pattern, sports shoe and sock together to understand where pressure and movement are occurring and how footwear can be adjusted without unnecessarily compromising stability.

Footwear requirements vary according to the individual, their sport, playing intensity and any previous foot or ankle problems. A larger shoe should not be chosen automatically where it results in excessive movement or instability inside the footwear.

 

For more information or to book an appointment please call our clinic +971 4 3435390 or WhatsApp +971 50 3553024



A patient recently attended Dubai Podiatry Centre with an interesting story that led to a much wider discussion about menopause, movement, muscle strength and the importance of keeping our bodies active as we age.

She had completed menopause and described how, during the previous year, she had gained weight and noticed a significant change in her muscle tone and the way her body felt. She felt that she had lost some of the strength, firmness and resilience that she previously had.

More recently, however, she had become very proactive about her health. Under professional guidance, she had been exploring treatments aimed at supporting her health after menopause, while also paying closer attention to her vitamin D and calcium intake. Most importantly from our perspective, she had started walking every morning and was feeling considerably better.

She also mentioned feeling particularly motivated after listening to Mel Robbins’ podcast discussions about longevity and maintaining strength and health as we get older.

This prompted a fascinating conversation in the clinic about something we often discuss with our patients:

When it comes to movement, we really do have to use it or lose it.

Think of Your Fascia Like a Springy Spider’s Web

Fascia is the connective tissue network that runs throughout the body, surrounding and connecting muscles, bones and other structures.

I often describe it to patients as being a little like a three-dimensional spider’s web running throughout the body.

When we are young and active, our bodies tend to have a wonderful natural springiness. We run, skip, jump, change direction, climb stairs and step over obstacles without giving these movements much thought.

As we get older, particularly if our activity levels reduce, we can gradually stop performing many of these movements.

We may still walk, but perhaps we no longer skip.

We may climb stairs, but rarely jump.

We may exercise, but always in straight, predictable movements.

Gradually, we can lose some of our strength, agility, balance and natural rebound.

The answer is not necessarily extreme exercise. It is about continuing to give our bodies a variety of movements.

Walking and Our “Second Heart”

One of the best forms of exercise remains one of the simplest: walking.

The calf muscles are sometimes referred to as our “second heart” because their contractions help pump venous blood from the lower legs back towards the heart.

Every time we walk and activate our calf muscles, we are helping this natural pumping mechanism.

Regular walking is therefore wonderful for maintaining calf muscle activity, circulation, cardiovascular fitness, mobility and general wellbeing.

But walking does not have to be the only movement we practise.

Bring Back a Little Agility

I am delighted to see movements similar to traditional step aerobics becoming popular again.

Step exercises require us to lift our feet, judge the height of a step, transfer our weight, turn, coordinate our legs and maintain our balance.

These are valuable skills.

As we age, maintaining the ability to change direction, step sideways, lift our feet over an obstacle and react to an irregular surface becomes increasingly important.

Simple activities can include:

  • Walking regularly
  • Stepping up and down from a low exercise step
  • Side stepping
  • Gentle direction changes
  • Appropriate strength exercises
  • Balance exercises
  • Practising safely stepping over small obstacles
  • Maintaining the ability to get up and down from the floor

The exercises chosen should, of course, be appropriate for the individual’s health, balance, strength and medical history.

But What Happens When Walking Hurts?

Our patient’s motivation was excellent, but there was another part of the story.

She was experiencing plantar fascia discomfort as well as lower back and shoulder blade pain, particularly on one side.

Her chiropractor had also identified significant asymmetry and felt that her alignment could be contributing to her symptoms when walking.

This is an important point.

We frequently encourage patients to walk more, but if somebody is significantly mechanically misaligned, repeatedly walking with that imbalance can sometimes continue to aggravate certain tissues.

We therefore assessed her using our 3D scanning system.

The scan demonstrated an apparent leg length discrepancy of approximately 3.1 cm, with the left side measuring longer. For somebody approximately 5 feet 4 inches tall, this represented a considerable asymmetry.

Rather than simply treating the painful plantar fascia, we needed to look at what was happening throughout the body.

The Feet Can Affect What Happens Above Them

The feet are the foundation of the body when we stand and walk.

If one side functions differently from the other, compensation can occur through the legs, pelvis and higher into the body.

I sometimes describe this as a Z-shaped compensation pattern.

The body does not necessarily remain neatly vertical when trying to accommodate an imbalance. Soft tissues tighten, joints adapt and the pelvis and upper body may compensate in different directions.

For this patient, we therefore made the left and right orthotics quite differently.

The angles and thicknesses were individually designed to improve her overall alignment rather than simply giving her two identical insoles.

An Immediate Change From 3.1 cm to 1.3 cm

We then repeated her 3D assessment while she was standing on her new orthotics.

The apparent leg length discrepancy reduced immediately from approximately 3.1 cm to 1.3 cm.

That was an excellent initial change.

Importantly, however, our aim was not to make both sides completely equal on the first day.

The body has been compensating for its existing position for a long time. Muscles, fascia and other soft tissues have adapted to that position too.

Changing everything immediately can therefore be too much.

Instead, we make an initial correction and allow the body time to adapt.

Why We Review Again After 6–12 Weeks

We will review this patient again after approximately 6–12 weeks.

During this period, the muscles and soft tissues have time to respond to the altered skeletal alignment.

An apparent leg length discrepancy can sometimes look greater during the initial assessment because the measurement is influenced not only by the bones themselves but also by rotation and compensation occurring throughout the body.

As these compensatory patterns reduce, the apparent discrepancy may also change.

At the review appointment, we can repeat the assessment and adjust the orthotics according to how her body has responded.

This gradual approach allows us to work with the body rather than trying to force an immediate correction.

Healthy Ageing Starts From the Ground Up

One of the most positive things about this patient’s story was her motivation.

She wanted to walk.

She wanted to become stronger.

She wanted to maintain her mobility and enjoy her body as she moved into the next stage of her life.

That is exactly what we want to encourage.

Menopause and ageing can bring changes in muscle mass, bone health and body composition, but becoming older should not mean accepting that we can no longer move freely.

Walk.

Maintain your strength.

Challenge your balance.

Practise changing direction.

Lift your feet.

Use stairs and steps when appropriate.

And, if you used to skip, perhaps don’t completely forget how to skip.

Our bodies are designed for movement.

Use your movement, maintain your strength, and look after the foundations carrying you through life: your feet.

 

For more information or to book an appointment please call our clinic +971 4 3435390 or WhatsApp +971 50 3553024



At Dubai Podiatry Centre, we sometimes see teenagers whose toenails look damaged, rough or uneven, but when we examine the nail closely, there is actually nothing wrong with the health of the nail itself.

Recently, a mother brought her teenager to see us because they were repeatedly peeling both their fingernails and toenails. The toenails had been peeled so frequently that they had developed sharp and rough edges, with some edges beginning to irritate the surrounding skin and contribute to ingrown toenails.

However, when we examined the feet, the underlying picture was very reassuring.

The nails were growing extremely well from the nail root and nail bed. The skin underneath was healthy and pink, and the circulation and capillary refill were excellent.

The problem was not that the toenails were unhealthy.

The problem was the repeated picking and peeling of perfectly healthy nails.

 

Teenager’s left foot with peeling toenails caused by repeated nail picking, assessed at Dubai Podiatry Centre

 

Why Do Some Teenagers Pick Their Nails Without Realising It?

The teenager’s mother explained that the picking was almost constant, particularly while studying, concentrating or thinking.

Interestingly, the teenager was often not consciously aware that they were doing it.

This is an important distinction. Sometimes repetitive nail picking is less about the nail itself and more about giving the hands something to do while the brain is concentrating.

Some children and teenagers naturally seek movement or tactile stimulation when focusing. Their fingers want to touch, roll, pick or manipulate something while their attention is occupied elsewhere.

If there is nothing else available, the fingernails, skin or toenails can become the target.

 

 

Nail Polish Isn’t Necessarily the Answer

Parents understandably ask whether we can put something onto the nail to stop the behaviour.

  • Would a special nail polish help?
  • Would a strengthening lacquer help?
  • Does the nail need a treatment?

If the nail itself is healthy, coating it does not necessarily address the reason the picking is happening.

From a podiatry perspective, our priority is to examine the nail carefully and establish whether there is an underlying nail or skin condition. We can also safely smooth or treat damaged edges and manage an ingrown toenail if repeated peeling has created a sharp nail spike.

But when the nail is healthy and the damage is being caused by repeated picking, it is also important to address the habit itself.

Give the Fingers Something Else to Do

One of the simplest strategies can be to redirect the hands towards something harmless.

A small piece of therapy putty, reusable putty, Blu Tack or Play-Doh can be surprisingly useful.

While studying, reading, watching television or concentrating, the teenager can gently roll and manipulate the putty between their fingers.

The objective isn’t simply to say: “Stop picking your nails.”

Instead, we are giving the fingers an alternative activity.

This can be particularly useful because it is quiet and discreet. The teenager can manipulate a small piece of putty underneath a desk or while reading without disturbing the people around them.

Fidget spinners and other sensory devices can also be helpful for some people. However, they can sometimes become visually or audibly distracting to classmates, siblings or other people nearby. A small piece of putty can provide tactile stimulation much more discreetly.

 

Keeping Busy Hands Away From Healthy Nails

Some teenagers who enjoy using their hands are wonderful at detailed activities. They may enjoy drawing, crafts, model making, painting miniatures or other projects requiring very delicate hand movements.

Those activities are excellent when there is time to concentrate on the activity itself.

The difficulty comes when the teenager needs their attention elsewhere, particularly during studying.

That is when a very simple tactile object can be useful. The hands can remain gently occupied while the brain concentrates on the information being learned.

Protecting the Toenails While the Habit Changes

While working on reducing the picking habit, it is important to protect the toenails from secondary problems.

Repeatedly peeling a toenail can leave:

  • Sharp or jagged nail edges
  • Very short nails
  • Irritated skin around the nail
  • Nail edges that begin to grow into the surrounding skin
  • Tenderness or inflammation
  • Increased risk of breaking the skin

If an edge has become sharp, painful or ingrown, a podiatrist can examine and manage it appropriately.

It is also important not to assume that every damaged-looking nail is caused by picking. Fungal infections, trauma, skin conditions and other nail disorders can alter the appearance of toenails, so an examination can be helpful when the cause isn’t clear.

 

When Should Parents Seek Further Advice?

Occasional nail picking can simply be a habit. However, if the behaviour is frequent, difficult for the young person to control, causes bleeding or significant tissue damage, causes distress, or begins to interfere with everyday life, parents may wish to discuss it with their GP, paediatrician or an appropriate behavioural or mental-health professional.

The important thing is not to shame the teenager for doing something they may barely realise they are doing.

Sometimes the first useful question isn’t: “How do we make them stop?”

It is: “What can we give their hands to do instead?”

 

At Dubai Podiatry Centre, we can assess toenails that have become painful, rough or ingrown as a result of repeated picking and determine whether the nail itself is healthy or whether another nail condition requires treatment.

Dubai Podiatry Centre
Helping to keep growing feet and toenails healthy.

 

For more information or to book an appointment please call our clinic +971 4 3435390 or WhatsApp +971 50 3553024



Many people assume that when a toenail starts lifting away from the skin underneath, it must be a fungal infection. Surprisingly, this is often not the case.

A detached toenail, known medically as onycholysis, can occur for many different reasons. While fungal infections can sometimes cause nail separation, many patients have repeated fungal tests that come back completely clear. In these cases, the cause is often mechanical rather than infectious.

What Does Toenail Separation Look Like?

The nail may begin separating from:

  • The inside (medial) border of the nail
  • The outside (lateral) border of the nail
  • The tip of the nail (distal edge)
  • Multiple borders at the same time

 

Clinical photographs showing separation of both big toenails from the nail bed (onycholysis), with top and front views illustrating nail detachment caused by repetitive trauma and biomechanical foot abnormalities

 

In severe cases, the entire nail plate may become detached from the nail bed, leaving the nail attached only at the nail root.

Cause #1 – Repetitive Pressure From Footwear

One of the most common causes of nail separation is repeated pressure from footwear.

This can occur when:

  • Shoes are too short or too narrow
  • The toe repeatedly hits the front of the shoe
  • The toe hyperextends upward and strikes the roof of the shoe

When the toenail is repeatedly compressed, the tissues beneath the nail become irritated and swollen. As the swelling settles, the connection between the nail plate and the nail bed can weaken, causing the nail to lift away from the skin.

A useful clue is the appearance of horizontal ridges across the toenail. These ridges run from side to side and often indicate repetitive trauma from the toe repeatedly striking the shoe.

 

Cause #2 – Aggressive Cleaning Under The Nail

Many people regularly clean underneath their toenails using nail files, scissors, metal instruments, or other sharp tools.

Unfortunately, this can gradually separate the nail from the skin underneath.

In fact, when podiatrists remove a toenail surgically, one of the techniques involves releasing the nail from the nail bed using specialised instruments. Excessive cleaning under the nail can unintentionally create the same process over time.

The more the nail is lifted and cleaned underneath, the easier it becomes for the separation to progress.

Cause #3 – Abnormal Toe Position and Foot Mechanics

Perhaps the most surprising cause of toenail separation is abnormal toe movement during standing and walking.

This is often the most overlooked cause and, in many cases, the most common.

When the foot collapses inward, the arch flattens, or a bunion develops, the toe is no longer functioning in a neutral position.

The toe may:

  • Rotate inward or outward
  • Drift sideways
  • Move excessively forward
  • Twist during walking

When this happens, the soft tissue beneath the nail is repeatedly pulled and stretched.

Rather than the nail being pushed away by pressure from above, the skin underneath is gradually pulled away from the nail by repetitive micro-trauma.

Over thousands of steps each day, the tissues can slowly detach from the nail plate.

For example:

  • If the ankles lean inward and the big toe rotates, separation commonly develops along the outer border of the big toenail
  • If a bunion causes the toe to drift sideways, tension can develop on one side of the nail bed
  • If the toes spread excessively due to arch collapse, the tissues beneath the nail can be repeatedly stretched and irritated

The result can look very similar to a fungal nail infection, even when no fungus is present.

 

Why Standing Examination Matters

Many nail problems are missed because the feet are examined only while the patient is sitting.

The position of the toes can change dramatically once a person stands and begins walking.

A proper assessment should include:

  • Standing examination
  • Walking analysis
  • Heel raise testing
  • Observation of toe-off during gait
  • Assessment of foot posture and ankle alignment

Only then can the true cause of the nail separation be identified.

 

Examining The Shoes

The footwear often provides valuable clues.

We frequently examine:

  • The original insoles
  • Wear patterns inside the shoe
  • Pressure marks from the toes
  • Areas where the toes slide forward

Older shoes are often more useful because they clearly show where pressure has been occurring over time.

One particularly revealing finding is damage to the inner roof of the toe box. In some cases, the fabric lining has been worn away by the toenail repeatedly striking the ceiling of the shoe during walking.

This provides clear evidence that the nail is being traumatised from above.

 

The Importance Of Finding The Real Cause

Treating a detached toenail successfully requires identifying why the nail is separating in the first place.

If the cause is fungal, antifungal treatment may be required.

However, if the cause is mechanical, treatment should focus on correcting the underlying problem, such as:

  • Footwear modification
  • Orthotic therapy
  • Correction of abnormal foot posture
  • Management of bunions
  • Reduction of excessive toe movement
  • Protection of the nail from repetitive trauma

 

Without addressing the underlying cause, the nail may continue to separate regardless of how many creams, sprays, or antifungal treatments are used.

At Dubai Podiatry Centre, we assess not only the nail itself but also the biomechanics of the foot and the forces acting on the toe during standing and walking. Understanding these forces is often the key to solving long-standing nail problems that have been mistakenly attributed to fungal infection.

 

For more information or to book an appointment please call our clinic +971 4 3435390 or WhatsApp +971 50 3553024


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