Turf toe is a condition of pain at the base of the big toe, located at the ball of the foot. The condition is usually caused from either jamming the toe, or pushing off repeatedly when running or jumping. The most common complaint is pain at the base of the toe, but you may also have symptoms of stiffness and swelling.
The name "turf toe" comes from the fact that this injury is especially common among athletes who play on artificial turf. The hard surface of artificial turf, combined with running and jumping in football and soccer, make turf toe a frequent consequence of artificial turf play. There has also been some blame on athletic footwear. Flexible shoes, especially used in competition, provides less support to the forefoot joints, possibly contributing to the prevalence of turf toe.
Effects on the Toe:
When a player sustains a turf toe injury, they are actually tearing the capsule that surrounds the joint at the base of the toe. Tearing this joint capsule can be extremely painful. Furthermore, tears of the joint capsule can lead to instability and even dislocation of the joint at the base of the toe. This can cause accelerated cartilage wear and arthritis of the big toe (hallux rigidus).
Diagnosis of Turf Toe:
Turf toe is diagnosed based primarily on the physical examination of the patient. Making the diagnosis of turf toe is not difficult, but x-rays may be taken to ensure there is no fracture or evidence of arthritis.
Treatment of turf toe consists of controlling the inflammation of the joint capsule. The most important aspect of treatment is to rest the sore toe to allow the inflammation to subside and the joint capsule to heal. In addition to resting the toe, inflammation can be controlled by icing the area, and elevating the foot, and anti-inflammatory medications.
Athletes diagnosed with turf toe should avoid their sport at least three weeks to allow the joint capsule to heal. Without doing so, the injury can progress, and can lead to an even longer recuperation. It is not uncommon for athletes to try to come back too soon, or to try to play through the injury. Unfortunately, this usually leads to a more chronic injury, and ultimately a longer recovery.
Turf toe can return, especially in athletes that try to come back to sports before adequate healing. Once returning to activities, special footwear inserts can be used to limit the motion of the big toe and prevent further damage to the joint capsule. Ask your doctor to evaluate your feet for possible inserts that can control motion of the inflamed joint. Surgery is rarely needed for treatment of turf toe, but in certain cases it may be helpful. If a bone spur forms, and severely limits motion of the toe joint, surgery to remove the spur may be helpful.
Rodeo SA, et al. "Turf-toe: An analysis of metatarsophalangeal joint sprains in professional football players" Am. J. Sports Med., Jun 1990; 18: 280 - 285.