Turf toe is a sprain of the main joint in the big toe. This injury is a metatarsophalangeal (MTP) joint sprain. Turf toe happens when you bend your big toe up toward the top of your foot too far.
Turf toe is a common injury to the joints in the big toe and is often the result of sporting activity. Treatment options and recovery time for turf toe depend on its severity, but the overall outlook is good in most cases.
Turf toe happens when you bend your big toe up toward the top of your foot too far. This can cause you to sprain or injure your toe and the ligaments surrounding it.
This injury is a metatarsophalangeal (MTP) joint sprain. This injury affects the tissue and one or more of the joints that connect the toes to the rest of the foot.
Turf toe gets its name from the hard, artificial turf surfaces many American football teams use. As many as 45 percent of NFL players experience turf toe.
Repeated striking of hard surfaces with the feet can cause turf toe. More than 80 percent of these injuries have happened on artificial turf.
Turf toe can also affect soccer and basketball players, martial artists, and ballet dancers because they constantly use their feet on hard surfaces.
Read on to learn how to treat turf toe and what to do if the pain won’t disappear.
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
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.
Learn more about the differences between ligaments and tendons here.
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 walk, run, play sports, or continue using your foot for everyday activities.
Tell your doctor about the situation where 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 examine your big toe 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 its 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 an X-ray, which allows your doctor to see the bone structure around your toe to check for abnormalities, and an MRI scan, which can help your doctor see detailed images of the area around your toe.
There are three grades of turf toe injuries. Treatment will depend on the injury’s grade.
A 2020 study of 24 people diagnosed with various grades of turf toe from 1999 to 2016 found that more than 70 percent of them had significant improvement 4.5 years after treatment.
According to some researchers, there are currently no evidence-based guidelines for treating turf toe. More studies are needed to develop optimal treatment guidelines.
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 your foot and toes. Keeping your big toe taped to your other toes can prevent 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 if it causes a bone break, a ligament tear, or severe joint damage.
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 the injury causes a bone break, 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 for 2 or more weeks.
Grade 3 injuries can take months to heal. You may need to wear a cast for 6 or more weeks and have several follow-up appointments before your doctor allows you to play sports or exercise again.
A study of 15 football players with grade 3 injuries found they missed an average of 16.5 weeks of playing time while recovering from surgery.
In rare cases, turf toe can cause long-term stiffness, damage, or decreased ability to run or jump using the injured foot. This typically occurs if you experience repeated injury or do not properly treat the turf toe.
Minor turf toe injuries can be treated at home and won’t keep you from physical activities for very long.
A more serious turf toe injury 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.
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.