turf toeWhat is Turf Toe?
A sprain in the MPJ (metatarsophalangeal joint) of the big toe is known as Turf Toe. Not to be confused with a ‘strain’, this injury is an actual tear of the ligament that holds bones together.  Turf Toe can occur suddenly with or without an audible ‘pop’ or as a result of repetitive injury to the base of the big toe, and has the potential in the more severe cases, to be a sports ending injury.

What Causes Turf Toe?
Injuries to football players on artificial turf gave the condition its name.   Cleats were getting caught in the harder surface causing hyperextension (bending the big toe backwards) and damaging the joint capsule. Any athlete who frequently pushes off hard, pivots or jumps is susceptible. Soccer, basketball, rugby or track participants as well as dancers (particularly ballerinas) and martial arts practitioners are also at risk.

How is Turf Toe Treated?
Fortunately most patients suffering from Turf Toe are young and otherwise healthy, and with accurate diagnosis and correct treatment return to their careers quickly. However, patients who have suffered a turf toe injury in the past are more vulnerable to similar injuries in the future than those who have not, so it is imperative that the injury be treated appropriately.
R.I.C.E. (Rest, Ice, Compression,Elevation) is the immediate treatment.  If, however, this treatment does not relieve the pain, contact Hampton Roads Orthopaedics & Sports Medicine for an appointment, as more in depth treatment may be necessary.

Treatment is dependent upon the GRADE of the turf toe injury, so correct diagnosis is essential:
Grade 1: mild stretch injury,mild tenderness, minimal swelling, some pain with continued play.
Grade 2: Partial joint capsule tear, tenderness, moderate bruising, swelling, limp and loss of motion.
Grade 3: Complete joint capsule tear, severe pain swelling,can’t bear weight, possible dislocation.

Treatment can range from :
Grade 1: R.I.C.E, NSAIDs for pain, taping, graphite shoe insert to provide stability, may return to play.
Grade 2: As for  grade 1 plus possible walking boot, crutches, 2 days to 2 weeks out of play.
Grade 3: As for grade 1 plus walking boot or cast, physical therapy, up to 6 weeks out of play.

While surgery is not often necessary, the presence of a fracture, a loose body in the joint, or damage to the joint tendon could require surgical repair. One of the primary reasons Turf Toe can become chronic is return to play too soon. Following the treatment plan prescribed promises the best outcome for your athlete.

HROSM has a full team of orthopaedic providers who are ready to diagnose, treat and support your athlete to a full recovery.  If you have need of our orthopaedic or physical therapy services, contact us at 757-873-1554 or request an appointment online.