What Is Turf Toe?

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.

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.

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.

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.