What Is Turf Toe?

A common athletic injury from field sports

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Turf toe is a painful injury to the base of the big toe that typically occurs in athletes who play field sports, such as football, baseball or soccer.

Turf toe describes an injury in which the big toe forcefully and quickly goes into a dorsiflexion position, meaning it points directly upward. The injury often occurs on a grass or artificial turf playing field which is why the name "turf toe" was adopted.

Causes of Turf Toe
Verywell / Gary Ferster

Symptoms

The type of extreme force that causes turf toe injuries generally results in a bruise at the base of the big toe where the joint capsule and ligaments have stretched or torn. In some cases, an athlete may even dislocate the big toe.

Not only does turf toe result in a great deal of immediate pain, but over time the joint may become stiff, less flexible, and more prone to arthritis. This limited mobility in the joint can increase the likelihood of the big toe being injured again in the future.

If turf toe is not allowed to heal completely, it can become a chronic injury that may limit an athlete's ability to compete fully.

Causes

Turf toe is especially common in athletes who play field sports and even more common in those who play on artificial turf. Experts argue that running, jumping, and cutting movements on the unusually hard artificial field makes jamming or overextending a toe even more likely than on grass fields.

Other experts feel that sports shoes and footwear can contribute to turf toe and that athletes need to wear the correct sports cleats for their sport. Some experts recommend a stiff shoe with less flexibility in the forefoot to prevent overextending the toe joint.

Diagnosis

Turf toe is considered a soft tissue injury and the diagnosis is fairly straight-forward. A physician will typically diagnose turf toe based on an athlete's symptoms, sports history, and a physical examination of the injured toe joint. In some cases, X-rays may be taken to rule out a toe fracture, arthritis or other trauma to the bones.

Treatment

The immediate treatment of turf toe is to control the swelling and inflammation of the affected toe joint. Using RICE treatment (rest, ice, compression, and elevation) along with anti-inflammatory medications is usually helpful. The athlete must also rest the sore toe to allow the joint to heal.

It's often recommended that athletes wear a stiff-soled shoe during healing to prevent too much dorsiflexion in the joint. Pro athletes often wear a shoe with a steel plate or use a custom foot orthotic with a mortons extension (an extension of the hard shell of the custom orthotic). This will reduces the pain and allows the toe to heal. Another way to prevent this harmful motion during healing is to tape the toe so it doesn't ben while the foot is pushing off the ground.

Many pro football players routinely have their toes taped before games to prevent turf toe.

Surgery is rarely recommended as a treatment for turf toe, but if an athlete develops a bone spur, surgery to remove the spur may be warranted.

Healing Time

It can take a long time for turf toe to heal completely, and athletes should expect to take a break from field sports for at least three weeks while the joint capsule heals. Athletes who return too soon or play through pain are often sidelined even longer in the future.

Prognosis

Arthritis of the big toe is quite common in those who suffer repeated turf injuries or trauma to the big toe joint. A way to reduce this probelm from worsening is to wear custom foot orthotics with a mortons extension. Using this orthotic will limit the motion preventing pain at the turf toe injury site and reducing the chance of arthritis from forming at this joint.

Frequently Asked Questions

  • How long does turf toe last?

    Depending on the severity of turf toe, it can take anywhere from several days to weeks to fully heal. During this time, it's especially important to avoid putting pressure on the affected foot. Pressing a cold compress against the toe for 20 minutes at a time can help reduce swelling and alleviate pain.

  • What is turf toe surgery necessary?

    Turf toe usually doesn't call for surgery unless a painful bone spur develops, in which case the bone spur may be removed by a medical professional. A bone spur is a small, bony protrusion that extends from a bone, often in the big toe or heel. After removal, they can grow back, which is why it's important to treat the underlying cause of a bone spur.

5 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Najefi A, Jeyaseelan L, Welck M. Turf toe: A clinical update. EFORT Open Rev. 2018;3(9):501-506. doi:10.1302/2058-5241.3.180012

  2. Aran F, Scott A. National Center For Biotechnology Information. Turf toe.

  3. American Academy Of Orthopaedic Surgeons. Turf toe.

  4. Robertson G, Goffin J, Wood A. Return to sport following stress fractures of the great toe sesamoids: a systematic review. Br Med Bull. 2017;122(1):135-149. doi:10.1093/bmb/ldx010

  5. Cleveland Clinic. Turf toe.

Additional Reading

By Elizabeth Quinn
Elizabeth Quinn is an exercise physiologist, sports medicine writer, and fitness consultant for corporate wellness and rehabilitation clinics.