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Turf Toe

Turf toe is a common name given to a sprain of the ligaments of the metatarsal-phalangeal (MTP) joint, the largest joint of the big toe.

Turf Toe Hero Image 2

Turf toe is a common name given to a sprain of the ligaments of the metatarsal-phalangeal (MTP) joint, the largest joint of the big toe.

There are three grades of severity of turf toe:

• Grade 1: The tendons surrounding the MTP joint have been stretched out, causing tenderness and swelling.
• Grade 2: A partial tear of one or more of the tendons surrounding the MTP joint has occurred, causing swelling in addition to limited and painful movement of the toe.
• Grade 3: One or more ligaments of the MTP joint are completely torn, making it very difficult to move the toe. Grade 3 injuries are often accompanied by severe swelling and bruising.

What causes Turf Toe?

Turf toe occurs when repetitive force is placed on the big toe joint in a hyperextension position, like when the foot is in a push-off position — for example when a lineman on a football team is crouched and ready to push off. Football players are at greatest risk for turf toe, but it can also occur in other sports.

Turf toe is common in these sports:

• Football
• Basketball
• Dance
• Gymnastics
• Soccer
• Wrestling

Symptoms

Symptoms accompanying turf toe generally include:

• Tenderness, pain, and/or swelling of the MTP joint of the big toe
• Pain that is often worse with push-off and cutting movements of the foot

When to see a doctor

If you’re having difficulty bending your toe and therefore walking normally, make an appointment to see an orthopedic specialist. During your appointment, your doctor will examine your big toe joint for tenderness and pain when stress is placed on the joint. In order to make a diagnosis, your doctor may order a weight bearing x-ray scan to check for fractures. In some cases, a magnetic resonance imaging (MRI) scan may be used to assess the severity of the tear.

Non-operative treatment

Turf toe is generally treated with conservative methods, including:

• “RICE” — an acronym for rest, ice, compression, and elevation — in order to reduce swelling
• Nonsteroidal anti-inflammatory drugs, like ibuprofen, to relieve swelling and pain
• Stabilizing the foot in a protective shoe or boot to relieve pressure on the big toe joint
• Taping the big toe to the second and/or third toe to restrict motion

Surgical Treatment

Surgery is rarely used to treat turf toe, but if symptoms do not subside with conservative treatments, you may need surgical intervention to repair damaged ligaments and restore range of motion.

Recovery

The time it takes to return to play following a turf toe injury depends on the severity of the injury. Complete tears can take up to six weeks to heal using conservative methods, and up to a few months after surgical intervention. Players can return to normal activities when they have regained full range of motion without any pain. As you return to normal activities, your doctor may suggest that you use taping or orthotics (a special type of shoe insert) to support the big toe joint.

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