(Metatarsalphalangeal Joint Sprain; Sprain Big Toe)
Turf toe – Definition
Turf toe is a sprain of the base of the big toe, where the big toe meets the foot. It is usually a hyperextension sprain of the first metatarsophalangeal joint. A sprain is stretching or tearing of the ligaments that support a toe. Ligaments are strong bands of tissue that connect bones to each other. The injury is called turf toe because it often occurs in football and soccer players when playing on artificial turf.
Turf toe – Causes
Turf toe occurs when the big toe is forced to extend beyond its normal range of motion. This hyperextension can be caused by:
- Standing on the balls of your feet as another person falls onto you, causing your big toe to hyperextend
- Stopping suddenly when running, causing your big toe to slide into the end of your shoe and bends up and backward as you go forward
Turf toe – Risk Factors
A risk factor is something that increases your chance of getting a disease, condition, or injury.
- Sports such as:
- Football
- Soccer
- Rugby
- Basketball
- Running
- Dancing
- Poor coordination
- Increased ankle dorsiflexion
- Wearing athletic shoes with flexible soles
- Playing sports on artificial turf
Turf toe – Symptoms
Symptoms include:
- Pain and tenderness in the ball of the foot and the big toe
- Swelling and bruising of the ball of the foot and the big toe
- Inability to bear weight on the ball of the injured foot
- Inability to push off on the big toe
- Reduced range of motion in the big toe
Turf toe – Diagnosis
The doctor will ask about your symptoms and how you injured your toe. The doctor will examine your toe to assess the stability of the joint and the severity of the injury.
Tests may include:
- X-rays — a test that uses radiation to take a picture of structures inside the body, to make sure that no bones are broken
- MRI scan — a test that uses magnetic waves to make pictures of structures inside the body, to determine if a ligament has torn completely (rarely needed)
Turf toe – Treatment
Treatment includes:
Turf toe – Self-care
- Rest — Do not try to run or play sports until you can walk without pain. Do not return to your sport until you can run, jump, and push off from your injured foot without pain.
- Ice — Apply ice or cold pack to your toe for 15 to 20 minutes, 4 times a day for 2 to 3 days or until the pain goes away. Wrap the ice or cold pack in a towel. Do not apply ice directly to your skin.
- Compression — Wrap an elastic compression bandage around your big toe. It is important not to cut off blood circulation to your toe or any body part when using such wraps, do not make them very tight. Put several wraps around the big toe and then include the rest of the forefoot within the bandage. This will limit swelling and support your toe.
- Elevation — Keep the injured foot raised above the level of your heart for 48 hours (such as up on a pillow). This will help drain fluid and reduce swelling.
- Stiff-soled shoes or rigid orthotics — Wear stiff-soled shoes or rigid orthotic inserts in your shoes to keep your toe from hyperextending.
Medication
The following drugs may help reduce inflammation and pain:
- Ibuprofen (eg, Motrin, Advil)
- Naproxen (eg, Aleve, Naprosyn)
- Acetaminophen (eg, Tylenol)
- Aspirin (eg, Bayer)
Surgery
Surgery is only needed to repair turf toe if:
A small piece of bone has been broken off by the injury to the ligament
A ligament is torn completely
Turf toe – Prevention
Often, turf toe cannot be prevented. However, to reduce your risk of getting turf toe, wear stiff-soled athletic shoes when playing sports.
Proper treatment of turf toe can help prevent long-term complications or problems with the toe joint such as misalignment and immobility.
