Large-scale study examining the effects of nail fungus on athletic performance

Large-scale study examining the effects of nail fungus on athletic performance

According to a study in the World Health Organization, the risk of developing nail fungus is 2.5 times higher in athletes than in the general populationJournal of the American Academy of Dermatology.A condition that can disrupt training, impair performance and end careers. However, there has not yet been a comprehensive study that has examined how nail fungus affects different sports.

Today, Case Western Reserve University and University Hospitals announced the launch of the first large-scale collaborative study focused on onychomycosis, a chronic fungal infection of the nails, in athletes.

While fans focus on visible injuries, nail fungus is quietly undermining athletic performance in ways most people never consider.

When athletes struggle with pain, nail damage, or recurrent infections, it can alter gait, reduce training consistency, and ultimately affect competitive results. This condition isn't just about looks; It’s about protecting the athletes’ performance.”

James Voos, chairman of orthopedic surgery and the Jack and Mary Herrick Distinguished Chair at University Hospitals

The warm, humid environments created by intense exercise, restrictive footwear and shared facilities create perfect breeding grounds for fungal infections.

"There is very little data showing how common nail fungal infections occur in different sports, despite the high risk among athletes," said the study's lead researcher Mahmoud Ghannoum, director of the Center for Medical Mycology at Case Western Reserve. “Our goal with this research is to better understand the epidemiology and general findings that will inform improved prevention, diagnosis and treatment strategies.”

The six-month study also includes the UH Drusinsky Sports Medicine Institute – the healthcare partner of the Cleveland Ballet, Cleveland Browns and Cleveland Monsters – and Ortho Dermatologics, a division of Bausch Health.

These partners will help identify and recruit 100 to 200 collegiate and professional athletes, allowing researchers to collect data from multiple sports. They will also raise awareness, facilitate survey distribution, and assist with athlete screening and optional nail sampling for follow-up studies.

“This research represents a critical step in keeping athletes healthy, competitive and current,” Ghannoum said. “Every athlete deserves to compete without any avoidable circumstances stopping them.”

The study begins this month and initial results are expected in June.Athletes are interviewed using an electronic questionnaire that asks about nail appearance, discomfort during training or competition, impact on performance and previous treatments. The anonymous survey captures how toenail fungal infections impact daily activities, self-confidence and athletic function.

Future phases of the study will focus on advanced diagnostic tools and improved treatment protocols with applications extending beyond professional sports. The research could particularly benefit military personnel and other groups facing similar risks from repeated foot trauma, shared equipment and demanding physical environments.

Case Western Reserve and the City of Cleveland are uniquely positioned for this research, combining a high-volume sports medicine environment, a leading medical mycology center and direct access to professional, collegiate and youth sports organizations. This combination allows researchers to study onychomycosis in athletes at a scale and with a level of clinical detail rarely available elsewhere.

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