Turf Toe

What is turf toe?

Turf toe is a sprain of the joint where the big toe attaches to the rest of the foot.  The ligaments and soft-tissue that connects that toe to the foot are stretched or torn.

How does it occur?

Turf toe can result from excessive pushing off of the big toe when an athlete runs or jumps. It can also occur by jamming the toe into a hard surface such as artifical turf.

What are the symptoms?

The athlete will have pain and swelling where the big toe attaches to the foot.  He will have difficulty bending and straightening his toe.  There may also be brusing around the joint. 

How is it diagnosed?

The medical staff will review the injury and symptoms with the athlete and examine the toe.  Xrays will help determine if a fracture is present.  A MRI scan can further evaluate the soft tissue, including ligaments and tendons, around the big toe joint.  The degree of the injury has been classified as grade 1, grade 2 or grade 3 depending on the amount of symptoms and tissue damage.

How is it treated?

Turf toe is treated with ice, elevation, anti-inflammatories, and activity modification.  Keeping the toe from bending will speed recovery and reduce symptoms.  Therefore, the toe is often taped and a hard plate is placed in the athlete’s shoe to prevent bending of the toe.  With a grade 3 injury, an athlete may require surgery to repair the torn tissue.

When can the athlete return to sport?

The goal of rehabilitation is to return the athlete to activity as soon as is safely possible. Everyone recovers from this injury at a different rate.  Returning to sport before symptoms have resolved may lengthen recovering time and cause permenant damage to the toe joint.  Grade 1 turf toe can generally continue playing with stiff sole shoes.  An athlete with a grade 2 injury can be expected to lose 1 to 14 days of playing time.  The athlete with a  grade 3 injury will lose 3 to 6 weeks of sport possibly longer if surgery is required.

How can an athlete prevent turf toe?

Turf toe is best prevented by wearing good shoes that fit properly and by avoiding jamming the big toe into a hard surface.