Turf Toe

Turf toe refers to a common sports-related big toe injury, resulting from excessive upward bending of the toe.

Excessive bending traumatizes the big toe joint called the first metatarso-phalangeal joint. The extent of the damage depends upon the extent to which the joint was hyper flexed and may range from only stretching of the joint ligaments to their complete tearing (ligaments are the fibrous attachments joining the toe bone with that of the foot called the first metatarsal bone). The toe may get dislocated if the injury ruptures the joint ligaments severely.

In some cases, the toenail is pushed into the cuticle, causing pain and swelling at the site.

Cause:

Such injuries are common among athletes, especially those playing on artificial turf, hence the name.

The injury typically occurs when the toes are bent, force/pressure on the heel or calf presses the foot into the ground, bending the toe (or toes) excessively, damaging the toe joint.

Athletic shoes usually have very flexible soles that provide minimum support against excessive bending of the toe joint; moreover, cleats in the shoes engage in the turf, fixing the foot in place to receive all the pressure.

It is a common injury seen in American football players, rugby players and karate practitioners.

Symptoms:

  • Pain and swelling in the toe joint
  • Sometimes bruising
  • Walking becomes difficult (as the toe joint is unable to bear pressure)
  • Running, jumping and kicking is out of question.

Treatment:

The first step is RICE that is rest, ice application, compressing the injured toe using bandages and elevating the injured foot. The RICE protocol helps to control pain and swelling initially. Consult a physician as soon as possible. Treatment includes use of:

– Anti-inflammatory drugs for pain and swelling

– Tapes or braces to support the joint

– Stiff-soled shoes and orthotic insoles to restrict bending of the toes

– Surgery may be required to correct/fix the dislocated joint

Complete rest is essential for recovery, which may take a month or more. Turf toe makes an athlete significantly disabled. Even after 5 years, almost 50% of individuals are reported to have persistent symptoms.