The turf toe is a sprain of the big toe joint which results from injury during sports activities. The injury usually comes from excessive upward bending of the big toe joint. This condition can be caused by either jamming the toe or from repetitive injury when one pushes off repeatedly from jumping or running.
With turf toe, the injury is quick. It is most commonly seen in athletes playing on artificial surfaces, which is harder than grass and cleats easily. The term “Turf Toe” came from athletes who play on artificial turf. Playing sports on artificial turf can cause the foot to stick to the hard surface. This results in the big toe joint becoming jammed. There has been some proof that less-supportive flexible shoes worn on artificial turf can also cause this injury. The injury often occurs in athletes who wear flexible soccer-style shoes that allow the foot to bend too much. It can also happen on a grass surface, especially if the worn shoes do not provide adequate support for the foot. Activities, i.e., football, basketball, soccer, field hockey, and lacrosse, show the highest degree of injury to the great toe joint on artificial surfaces. Other non-sporting causes include shoe gear changes, limited motion of the great toe joint, and flat foot conditions.
When walking or running, each step begins with raising the heel and letting the body’s weight come forward onto the ball of the foot. At a certain point, an individual propels themselves forward by “pushing off” with the big toe and allows the weight to shift to the other foot. For some reason, if the toe stays flat on the ground and doesn’t lift to push off, there is the risk of quickly injuring the area around the joint. Another scenario is if being tackled or falling forward and the big toe stays flat, the effect is the same as sitting and bending the big toe back beyond its normal limit. This causes hyperextension of the toe. That hyperextension, repeated over time or with enough force, can cause a sprain in the ligaments around the joint.
The most common causes:
Symptoms of acute injury include
There is usually a sudden onset of pain in the pushing-off phase when running. This, in turn, causes further damage to the big toe and dramatically increases healing time. However, there is not enough pain to keep an athlete from doing physical activity or finishing a game.
Grade 1: This type of turf toe injury is considered mild as the supporting soft tissue structure for the big toe is only sprained or overstretched. This is the most common type of injury. There is minimal swelling with mild tenderness and usually no black and blue bruising.
Grade 2: This type of turf toe injury is considered moderate in severity. It presents more diffuse tenderness, swelling, a restricted range of motion, and mildly black and blue bruising. Often there is a partial tear of the supporting ligaments but no articular cartilage damage.
Grade 3: This type of turf toe injury is considered severe because of the:
Treatment centers on an individual basis and the severity of the injury. The following are general guidelines for turf toe injuries.
An example, using a much stiffer athletic shoe that will resist the motion of the big toe. And/or the insertion of an orthotic to increase support of the big toe.
Additionally, strapping the big toe to limit motion can allow an athlete to return to play quicker. Non-steroidal anti-inflammatory drugs (NSAIDs) may be utilized for the relief of minor pain, as well as to decrease inflammation.
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