turf toe treatmentBig toe injuries, known as turf toe, result from bending your toe too far or with too much force. This causes the ligaments, tendons, and other soft tissue located in the joint to stretch too much or tear.  It's named for the artificial turf football and soccer players play on. Often it occurs when athletes like soccer players wearing flexible shoes that let the foot bend too far forward. 

Turf toe can have an acute onset from trauma during sports play or it can result from repetitive movements and overuse. Athetes who makes sudden movements and change direction during play are more at risk for this type of injury.

While it's most commonly seen in football and soccer players it can also be found in:

  • dancers
  • basketball players
  • gymnasts

turf toe painSymptoms of Turf Toe

Symptoms of turf toes include:

  • Pain and tenderness - pain can vary; it can be constant or only occur when you apply pressure to the area. The toe can be so painful that it's hard to put weight on it.
  • Swelling and bruising - the base of the big toe can become inflamed, but bruising can occur around the swollen toe and up to the top of the foot.
  • Stiffness - turf toe can cause limited range of motion; inability to move the toe or bend it up or down.
  • Instability of the toe joint - the MTP joint (the primary joint affected in turf toe) may pop out of place or feel unstable.

Athletes who continue to participate in their sport with a turf toe injury can further damage the area around the toe and healing time can increase dramatically. 

turf toe injuryTypes of Turf Toe

Podistrists and other health care providers use a grading system to determine the best treatment for your turf toe injury. The grading system is based on its level of severity and include:

  • Grade 1- the tissue is stretched but not torn; you'll experience slight swelling and tenderness when touched. This grade requires the least limitations to continued sports play.
  • Grade 2 - the soft tissue is partially torn. You'll experience more severe swelling, bruising, and swelling. Toe movement is painful and limited and you'll be more limited in playing sports.
  • Grade 3 - the soft tissues are completely torn. You'll experience severe pain, swelling, and bruising. The MPT joint is often dislocated. It's very difficult to move the toes or play sports. 

Diagnosis of Turf Toe

To diagnose turf toe your podiatrist will:

  • Ask you about your participation in sports and ask you how the injury occurred.
  • Examine your toe to identify swelling and bruising and check for pain and stiffness.
  • X-ray your foot and/or send you out for other imaging such as an MRI; the latter will identify any damage to the ligaments and other tissues.

walking boot to treat turf toeTreatment of Turf Toe

Treatment of turf toe will depend on the grade and severity of your condition. These can include one or more of the following.

  • Rest - your podiatrist will let you know how long you need to stop sports play and rest your toe. You may need a walking boot to take the pressure off of the area, particularly if the injury is more severe.
  • Ice, Elevation, and Compression - if your injury is acute (you injured it suddenly during sports play) it's important to ice, elevate your foot above your heart, and use compression to decrease pain, swelling, and inflammation. 
  • Nonsteroidal anti-inflammatory drugs (NSAIDs) - these may be used for relief of minor pain as well as to decrease the inflammation of the injury. Note: Please consult your physician before taking any medications.
  • MLS Laser Therapy- this non-invasive laser therapy promotes tissue repair
  • Orthotics - your podiatrist may recommend orthotics to control your foot movement and prevent this condition from recurring. 
  • Purchase supportive shoes - to test shoes before you purchase them you can test them to ensure they are stable.
  • Physical therapy - physical therapy can help increase the range of motion of your toe and help it heal.
  • Surgery - fortunately surgery for this injury is rarely needed. It would only be required if all conservative measures fail. 

Turf toe can lead to another condition called Hallux Rigidus or "stiff big toe". That's why it's particularly important to get it treated in the early stages.

Prevention of Turf Toe

To prevent turf toe from occuring or reoccuring, it's important to:

  • Correct any problems with your gait.
  • Wear supportive shoes designed for the sport you play. 
  • Warm up before play. Warm tissues are less likely to get injured.
Dr. Rion Berg
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A podiatrist in North Seattle treating families for over 40 years.