Turf Toe: What You Need to Know for Healthy Feet

Turf toe is a painful condition that could prevent you from working, taking care of your family, or enjoying your favorite pastimes. While most people associate turf toe with football, a number of different sports and activities can cause the condition.

In fact, 80 percent of athletes responding to a survey said that they had experienced turf toe in the past.

Fortunately, turf toe is treatable—and it may even be preventable.

What is Turf Toe?

Turf toe affects the main joint of your big toe. The injury happens when you forcibly bend up your big toe into hyperextension, as you might do when pushing off into a sprint.

Anatomy of Your Big Toe

Your big toe has two joints. The metatarsophalangeal joint (MTP) is larger than the other joint, and it is the part affected by turf toe. The MTP is the joint that connects your foot to your big toe.

Several important structures surround the MTP joint; they work to support the joint and prevent it from popping out of place (dislocating). Doctors refer to these structures as the plantar complex.

The plantar complex includes:

• Plantar plate: This is a thick band of tissue that sits under the MTP and prevents your big toe from bending too far upward.
  
  
• Collateral ligaments: Situated on each side of your big toe, these ligaments connect the bone in your big toe to your foot. They stop your big toe from moving too far to either side.
  
  
• Flexor hallucis brevis: This tendon sits at the bottom of your foot, between the ball of your foot and your big toe. It gives strength and stability to the big toe when you push off on your foot.
  
  
• Sesamoids: Located within the tendon that connects your calf muscle to your big toe, the two small sesamoid bones help the tendon and big toe move more easily. The sesamoids also stabilize the MTP joint by helping the front of your foot bear weight.

Turf toe develops as the result of injury to any of the plantar complex structures.

The severity of turf toe can vary widely, from simply stretching the soft tissue to partially tearing it—you can even dislocate your MTP joint.

To help them create personalized treatment plans, bone doctors grade turf toe on a scale of 1 to 3, with 3 being the most severe:

• Grade 1: You’ve stretched the plantar complex, causing slight swelling and pinpoint pain.
  
  
• Grade 2: Partial tearing of the plantar complex has triggered mild swelling, widespread tenderness, and bruising. The movement in your big toe may be limited and painful.
  
  
• Grade 3: A complete tear of the plantar complex has caused severe swelling, tenderness, and bruising. It is difficult and painful to move your big toe.

Treatment for Turf Toe

Treatment for turf toe largely depends on the grade of the injury and the tissues affected. In most cases of grade 1 turf toe, you can treat your sore toe with RICE:

Rest: Avoid extra walking and any activities that stretch your big toe.

Ice: Apply a cold pack to your big toe several times each day.

Compression: An elastic compression bandage can reduce swelling and pain.

Elevation: Prop up your feet so that your toe is above your heart.

Over-the-counter anti-inflammatory medications, such as ibuprofen, can ease swelling and pain. Stretching and strengthening exercises may help treat and even prevent turf toe.

Your bone doctor can also provide treatment and prevention tips. For example, the physician may prescribe a walking boot that keeps your toe pointed downwards. Physical therapy helps strengthen and stretch your big toe. Surgery is only necessary to treat certain severe Grade 3 injuries.

You may be able to prevent turf toe by wearing hard-soled shoes when running or playing sports on hard surfaces, applying athletic tape to your toe for added support, and using proper running mechanics.

For more information on turf toe, consult with your orthopedic doctor at Sweeney Foot & Ankle Specialists. We provide leading-edge medical and surgical management of the foot and ankle.