Orthotics Care – What is Turf Toe? (Sprain)

Turf toe is not a word you want to use when communicating with a head football coach about his lead running back or the ballerina before her performance debut. “Turf toe” is the popular term used to describe a sprain of the ligaments around the big toe joint. Although it’s regularly affiliated with football players who play on synthetic turf, it impacts athletes in other athletics including soccer, basketball, gymnastics, wrestling, and dancing. It’s an ailment that’s caused by compressing the big toe or frequently pushing off the big toe forcibly as in jumping and running.

Here in this article, we discuss turf toe — what causes it, how to prevent it, and how it’s treated — to assist you to stay active.

What Creates Turf Toe?
Turf toe is a twist or strain to the muscle’s ligaments surrounding the big toe joint, which serves primarily as a hook to allow up and down motion. Just behind the big toe joint in the ball of your foot are two pebble-shaped bones inserted in the tendon that moves your big toe named sesamoids. These bones form a pulley system for the tendon and produce leverage when you run or walk. They also absorb the weight that pushes on the ball of the foot.

When you are walking or running, you begin each subsequent step by raising your heel and making your body weight come forward onto the ball of your foot. At a certain period, you thrust yourself forward by “pushing off” of your big toe and allowing your weight to move and transfer to the other foot. If the toe for some reason stays flat on the ground and does not lift to push off, you run the risk of quickly injuring the area throughout the joint. Or if you are tackled or fall forward, and the toe stays flat, the effect is the equivalent as if you were sitting and bending your big toe back by hand beyond its reasonable limit, causing hyperextension of the toe. That hyperextension, repeated over time or with enough sudden force, can — cause a sprain in the ligaments that surround the joint.In most cases with turf toe, the injury is sudden. It regularly occurs in athletes engaging on artificial surfaces, which are more difficult than grass surfaces and to which cleats are more prone to stick. It can also appear on a grass surface, particularly if the shoe being worn doesn’t afford adequate support for the foot. Usually, the injury transpires in athletes wearing flexible soccer-style shoes that let the foot bend too far forward.

What Are the Indications and Traits Turf Toe?
The most frequent symptoms of turf toe involve swelling, pain, and confined joint mobility at the base of one big toe. The symptoms develop slowly and steadily get worse over time if it’s triggered by repeated injury. If it’s caused by an instant forceful shift, the injury can be painful immediately and worsen within 24 hours. Sometimes when the injury occurs, a “pop” can be felt. Usually, the whole joint is affected, and toe movement is restricted.

What Foot & Ankle (Over or Under)Pronation

How Is Turf Toe Determined?
To diagnose turf toe, the physician will request for you to explain as much as you can about how you injured your foot and may ask you about your profession, your activeness in sports, the type of shoes you dress in, and your history of foot problems. The doctor will then examine your foot, noting the pattern and position of any swelling and examining the injured foot to the uninjured one. The doctor will likely ask for an X-ray to rule out any other injury or fracture. In particular situations, the doctor may ask for other imaging tests such as a CT scan, bone scan, or MRI.

The diagnosis will then be delivered based on the completion of the physical exam and imaging tests.

How Is Turf Toe Treated?
The basic treatment for nursing turf toe, initially, is a mixture of rest, ice, compression, and elevation (memorize the acronym R.I.C.E).This essential treatment approach is to give the injury adequate time to heal, which indicates the foot will require being rested and the joint protected from further injury. The physician may recommend an over-the-counter oral medication such as ibuprofen to control pain and reduce inflammation. To rest the toe, the doctor may tape or strap it to the toe next to it to relieve the stress on it. Another way to guard the joint is to debilitate the foot in a cast or special walking boot that keeps it from moving. The physician may also ask you to use crutches so that no weight is located on the injured joint. In severe cases, an orthopedic surgeon may advise a surgical intervention.

It typically takes 14 to 21 days for the pain to recede. After the immobilization of the joint ends, some patients require physical therapy to re-establish strength, the range of motion, and conditioning of the injured toe.


Can Turf Toe Be Prevented?
One objective of treatment should be to decide why the injury happened and to take measures to keep it from reoccurring.

One way to limit turf toe is to wear shoes with better support to help keep the toe joint from extreme bending and force with pushing off. You may also want to examine using specifically designed inserts that your doctor or physical therapist can guide for you.

A physical therapist or a professional in sports medication can also work with you on correcting any problems in your gait that can lead to injury and on developing training techniques to help reduce the chance of injury.