What is a Turf Toe?

Injury in sport is common and this can be a significant problem especially in professional sports as it affects the ability to play. One reasonable common injury is what is called turf toe. This is an acute injury to the big toe joint in the foot. This injury is more likely in football and field sports associated with the artificial playing surfaces. This is how it got its name of ‘turf toe’. The actual injury is one of a sprain or tear of the ligaments under the big toe joint with a compression injury to cartilage in the joint. This is commonly due to a hyperextension of joint with the foot in a slightly dorsiflexed position. This is often a position that players find themselves in a tackling situation in the foot ball sports. As this is an acute injury that symptoms of turf toe are an immediate onset. The initial acute symptoms of turf toe include pain at the big toe joint with swelling and bruising. There will be a limited range of motion of the big toe and it will be painful to move. The pain will be a lot worse with when walking and other weight-bearing activities. The diagnosis of a turf toe is typically based on a physical examination by the attending doctor with an assessment of the symptoms. Usually, the way that the injury occurred is also likely to. Imaging by X-rays or MRI scans may be used to rule out other potential causes and or to evaluate the extent of the ligament damage from the injury.

Turf toe is usually given a grade depending on the severity of the injury and this can be used to guide treatment. A grade 1 injury is just a sprain of the plantar plate under the joint. A grade 2 is a partial tear of the plantar plate and a grade 3 turf toe injury is a complete tear of the plantar plate. The treatment of turf toe will depend on the extend of the tissue damage based on that grading. All cases will need an initial rest with ice and elevation along with anti-inflammatory drugs. Immobilization is important and just how much will depend on the grading. If it is a minor grade 1 then a rigid soled shoe. A carbon fiber plate inset may be used to make the shoe even more rigid. If the injury is more severe, a cast or walking boot may be required for up to a month or more to provide the immobilization. When the symptoms start to improve slow progressive movement and exercises can be started with the amount and intensity gradually increased over time. Tape may be needed to restrict the movement of the joint during the early stages of the return to sport. Footwear with a more rigid sole or with a rigid carbon fiber insert can be used. Sometimes a cortisone shot is given. If the initial injury was a severe grade 3 or the injury is not getting better, then there are several surgical approaches that can be used.

Craig Payne is a University lecturer, runner, cynic, researcher, skeptic, forum admin, woo basher, clinician, rabble-rouser, blogger and a dad.