Most people have heard of turf toe, but few know much about this painful condition. Turf toe is a sprain of the joint at the base of the big toe, or the metatarsophalangeal (MTP) joint.
This injury can occur when the toe is jammed or forcefully bent backward. Turf toe can involve damage to the ligaments, tendons and bone at the ball of the foot, and in some cases, the big toe can become dislocated.
Athletes, particularly those who compete in field sports such as football, baseball and soccer, are most at risk for this condition, as a large number of MTP sprains have been associated with playing on artificial turf. This condition also commonly affects basketball players, wrestlers, gymnasts and dancers.
What Causes Turf Toe?
If the foot bends too far forward or if the big toe is jammed as the foot tries to push off, hyperextension occurs. In other words, the toe is bent beyond its normal limit, causing a sprain.
In most cases, turf toe happens as a result of running, jumping or making quick or sudden movements while engaging in an athletic activity. Though injuries can occur on natural grass, especially if improperly supportive shoes are worn, more MTP sprains occur on artificial turf, as the surface is harder and less shock-absorbent than grass.
Diagnosing an MTP Sprain
To diagnose this condition, the doctor first will take a medical history. This typically includes information about how the injury occurred as well as the patient’s athletic activity, occupation and past history of foot problems.
A physical examination is next, during which the doctor will determine the extent and location of the pain, swelling and bruising by comparing the affected joint with the uninjured joint on the other foot. The joint movement will also be tested. An X-ray, and in some cases, a CT scan or MRI will be ordered to rule out a toe fracture, arthritis or other bone trauma.
Treatment and Rehabilitation
The initial course of treatment for turf toe involves the R.I.C.E. technique — rest, ice, compression and elevation — as this allows the injury to heal without further stress to the joint. Over-the-counter non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, can be used to manage pain and reduce swelling. The patient may need to bind the toe to keep it immobilized, and the doctor may recommend using crutches and wearing a stiff-soled shoe to prevent too much movement during healing.
Some patients may require physical therapy to restore range of motion and strength. Wearing appropriately supportive shoes can help prevent turf toe, and many athletes may need to work with a therapist to develop training techniques or to correct problems in gait.
At Steward Health Care: Centers of Orthopedic and Sports Medicine, we are committed to getting you back on the field and back to participating in the sports you love. Our experienced orthopedic and sports medicine physicians are athletes and sports enthusiasts themselves, so they understand the importance of a quick and effective course of treatment. Contact us today to schedule an appointment if you suspect you may have turf toe.