Proper treatment of pedal nail disorders requires a thorough understanding of the underlying etiology. As a class, biomechanical abnormalities constitute an important cause of pedal nail dystrophy. These biomechanical etiologies have been presented with regard to the three body planes. Treatments using biomechanical and orthopedic principles were explored, with an emphasis on counteracting abnormal dynamic and static forces. Additionally, sports that have a high correlation of nail pathologies have been discussed with prevention as the key element to treatment.