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Turf Toe

“Turf Toe” is a term commonly used to refer to pain, swelling, or joint stiffness at the base of the big toe, caused by a sprain to the ligaments and joint capsule. It has been given a lot of attention as it relates to football players who play on artificial turf, but it is common in sports such as soccer, basketball, and wrestling too.  It can be caused by a traumatic injury such as when the toe is jammed into the playing surface, or when an opponent lands on the back of the foot when the toe is extended. Other injuries can build over time due to the repeated push off forces required for running or jumping. 

What causes turf toe?

Factors contributing to this condition include playing on artificial surfaces which are typically harder than grass. This increases the likelihood of cleats getting stuck and jamming the big toe. Today’s footwear tends to be lighter and more flexible than ever.  Extra mobility in the front part of the shoe can make it more likely that the big toe can go into a hyper-extended position. Make sure to wear the proper footwear for your sport, and consider a shoe with less flexibility in the forefoot to help prevent injuries.

How can I treat turf toe?

Treatment can vary based on the severity of the initial injury. The injury may range from just a mild overstretching of the ligaments to a complete disruption of the ligament/ joint capsule and dislocation of the joint itself. A period of decreased weight bearing or immobilization may be recommended needed initially, but surgery is seldom required.  Taping may be all that is needed for some of the more minor injuries. After clearance from your physician, it is important to consult with a physical therapist or athletic trainer to ensure that full mobility is restored to the joint. Many times the toe is left with decreased mobility which can lead to increased risk of re-injury. A complete biomechanical evaluation and gait analysis can help clean up any altered movement patterns and strength deficits.  Many times a stiff plate is made for the shoe or incorporated into a foot insert to prevent the great toe from going into too much hyper-extension in the future. 

Injuries to the big toe should be taken seriously, since range of motion and stability deficits in the area can impact how well the athlete can push off to jump or accelerate.  Persistent pain, strength loss, and residual stiffness have ended the careers of many prominent athletes.

Chris Gabriel, OCS (Board Certified Orthopedic Specialist), CSCS (Certified Strength and Conditioning Specialist), practices physical therapy with OrthoCarolina Matthews and with D1 Sports. Chris and his team treat a range of patients for orthopedic and sports medicine needs.  He enjoys working with various local high school, college, and professional sports teams. 

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