What is turf toe?
Turf toe happens when you bend your big toe up toward the top of your foot too far. It’s also called hyperextension. This can cause you to sprain or injure your toe and the ligaments that surround it.
Turf toe got its name from American football. Artificial turf has become more common than real grass on many football fields because it’s much cheaper to take care. Turf is much firmer than grass because there’s no soil underneath. In rain or snow, turf can be more slippery than grass.
This makes it easier for football players to slip and hurt their toes or get injured when their feet slam down on the turf. Ballet dancers, basketball players, and wrestlers can also get turf toe because they’re constantly using their feet on hard surfaces.
This injury is a type of metatarsophalangeal (MTP) joint sprain. This means that the tissue and one or more of the joints that connect the toes to the rest of the foot have been injured.
Read on to learn how to treat turf toe and what to do if the pain won’t go away.
What are the symptoms of turf toe?
The most noticeable symptom of turf toe is pain around the big toe area, including the joint that goes up your foot toward your ankle. You might feel the pain right away if your toe bends suddenly and quickly.
The pain can start to come on gradually if you’ve hyperextended your toe over and over. You may also notice a popping sound when you first bend the toe too far and feel the pain.
Other symptoms include:
- tenderness or sensitivity around the toe and nearby joint
- swelling around the big toe and the joint
- not being able to move the toe around normally
- stiffness in the toe joint
What causes turf toe?
Turf toe is caused by bending the big toe too far back toward your foot. When this happens, the big toe area and the MTP joint, known as the plantar complex, can get injured. Areas that may be affected with turf toe include:
- sesamoids: two small bones that help absorb weight on the front of your foot
- flexor hallucis brevis: a tendon that helps the big toe when you put your weight on it when running or jumping
- collateral ligaments: bands of tissue that connect your toe bones and keep the big toe from bending too much to either side of your foot
- plantar plate: a structure that keeps your big toe from being bent too far up
You can get this type of injury doing any activity that involves putting a lot of weight on your big toe. Professional athletes are most prone to turf toe because they’re constantly running, jumping, and generally putting weight on their feet for long periods of time.
When do I need to see a doctor?
See your doctor if you find it difficult or impossible to walk on your foot after getting this kind of injury. If treating the injury at home isn’t helping, you may need physical therapy or surgery to be able to walk, run, play sports, or continue using your foot for everyday activities.
How is it diagnosed?
Tell your doctor about the situation in which you believe you first got the injury. This helps your doctor know to examine your big toe for any pain, swelling, or other abnormalities that may indicate turf toe is the cause of toe pain and stiffness. Your doctor may also do a full physical examination to check your overall health.
Your doctor will look for any abnormal swelling or redness. They’ll also push on your toe to see where the pain is coming from and move your toe around to test your toe’s range of motion. Let your doctor know if this causes a lot of pain. They may be able to inject a substance into your toe to numb it.
Your doctor may also recommend imaging tests to look more closely at the tissues and bones around the toe. The two most common tests are:
- X-ray, which allows your doctor to see the bone structure around your toe to check for abnormalities
- MRI scan, which can be used to help your doctor see detailed images of the area around your foot
How is it treated?
There are three grades of turf toe injuries. Treatment will depend on the injury’s grade.
Grade 1 injuries, the least serious of the three, can be treated at home using the RICE method:
- Rest: Stop doing activities that can make your injury worse and give your toe a break so the sprain can heal.
- Ice: Apply a cold pack or ice in a plastic bag to the area to keep the swelling and inflammation down.
- Compression: Wrap a bandage around the foot and toes. Keeping the big toe taped to your other toes can keep it from moving too much and making the injury worse.
- Elevation: Lie down with your foot up to help drain fluid and keep swelling down.
Taking nonsteroidal anti-inflammatory drugs (NSAIDs) can help manage your pain until the injury heals. Wearing shoes that don’t bend easily can help keep you from bending your toe too far again.
Grade 2 injuries are a little more serious and may require you to use crutches or a walking boot to protect your foot as your injury heals.
You may need surgery to treat a grade 3 injury because a bone is broken, a ligament is completely torn, or the joint is damaged.
The type of surgery you’ll need depends on what part of your plantar complex needs treatment. If soft tissue like a ligament or the joint capsule is damaged, your doctor may use sutures to repair the tissue.
Sutures are stitches for body tissue. If a bone is broken, your doctor will need to repair the bone. You may need to wear a cast to protect the toe until it fully heals.
You’ll usually recover from a grade 1 injury in a few days to a week.
Grade 2 injuries usually take a few weeks to fully heal. You may not be allowed to play sports or do any exercise after a grade 2 injury for two or more weeks.
Grade 3 injuries can take months to heal. You may need to wear a cast for six or more weeks and have several follow-up appointments before your doctor allows you to play sports or exercise again.
What’s the outlook?
In rare cases, turf toe can cause long-term stiffness, damage, or decreased ability to run or jump using the injured foot if it happens repeatedly or isn’t treated properly or quickly.
Minor turf toe injuries can be treated at home and won’t keep you from physical activities for very long. More serious turf toe may take a month or more to heal, but won’t have any serious long-term damage if you take care of your toe during the healing process.
Preventing turf toe
Wear stiff shoes when you’re playing sports to keep your toe from bending too far. A metal plate on the sole of your shoe can help keep the shoe from bending at all.
Before you play sports or exercise with your feet, bend your toes up slowly to stretch the muscles, joints, and ligaments in the foot.