What is Turf Toe?
Turf Toe is typically a traumatic injury by a football player who lands on and bends his big toe backwards further than it is meant to go. Typically, the injury happens when wearing light flexible shoes on a hard synthetic surface like turf. Hence the term… Turf Toe. On average, football and rugby players lose 10-22 days of playing time because of this injury.
If you don’t play sports, you can still incur this injury acutely if you sprint on concrete barefoot and put excessive weight through the big toe. Or you can have a chronic injury from repetitively bending your toe beyond its limits during walking or running. This repetitive injury may sometimes lead to a bunion, joint degradation/arthritis, or chronic pain.
The place where you will experience pain is called “the metatarsophalangeal joint” or the joint between the ball of your foot and the start of the big toe. Around this joint is a capsule (that holds the joint together), muscles, and ligaments. The hardest part of the capsule, called the plantar plate, is strained when you have a Turf Toe injury. Just like an ankle sprain, you can have a grade 1, 2, or 3 injury. Grade 3 would mean you completely tore that part of the capsule off.
If you have an acute injury to the big toe and there is swelling at the joint, you can’t rise up and down on your toes, and if it hurts to actively flex your toes, then you might have experienced a Turf Toe injury. Follow the RICE method (rest, ice, compress, and elevate). Don’t put too much weight on that foot and get help immediately. It’s best to get an X-ray to rule out a fracture or dislocation of the bone. Your orthopedist or podiatrist will provide you with these guidelines. The most important thing is to quickly immobilize the area and get diagnosed to prevent further injury!
After this, your physical therapist will devise a specialized program for you based on the grade of your injury. Grade 1 injuries typically take 1-2 weeks to heal while grade 3 injuries require up to 6 months and rarely (less than 2% of the time) require surgery. Physical therapy treatment consists of gentle manual release techniques, range of motion and strengthening exercises, taping to prevent further injury, gait training (to help normalize your walking pattern), and potentially a fitting for an orthotic. If you end up needing surgery, PT is a requirement post-operatively to return to sport.
If you have never had a Turf Toe injury, great! But here at Sneha Physical Therapy, we are all about prevention. Whether you play sports or not, you could still be susceptible to an injury to your big toe. And if this happens, it’s hard to walk and move around. Switching to a stiffer, more supportive shoe can help reduce this type of injury off the bat!
As a rule of thumb, it’s a great idea to do gentle stretches for your big toe just like you would to your hamstrings or your back on a regular basis. One great way to stretch the big toe is to simply grab the toe and bend it into extension - meaning the end of the toe is coming closer to your knee. Typically, we should all have 80-90 degrees of great toe extension. Check this by bending your toe backward and noting the angle made by the ball of your foot to the tip of your toe. If you have more than 90 degrees then I would avoid this stretch as you might be hyperflexible already! If you have less than 80 degrees, then make sure the pressure is gentle and sustain the stretch for 30 seconds to 1 minute once a day.
That’s a wrap for our “Head, Shoulder, Knees, and Toes” series. Stay tuned for our next series coming in a week!