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Turf Toe

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Notice a sudden pain in your toe at the joint that comes on during sports, while running, during a fall, or after an on-field collision? You may have turf toe.

What Is Turf Toe?

Turf toe is a sprained big toe, meaning the ligaments and soft tissues around the big toe have become damaged, and hence painful and inflamed. The specific joint that is sprained is the one at the ball of the foot called the first metatarsophalangeal joint, leading to significant pain anytime the joint is bent upwards from this region - which is typically what naturally happens when we walk.

What Causes Turf Toe?

Turf toe most occurs when your big toe is hyperextended or jammed upwards, which forcefully pushes the supporting tissues and ligaments past the point that they are designed to handle, leading to their injury and the pain and inflammation that follows. In some cases, turf toe can develop over time, such as repetitive stress on the big toe joint when pushing off for sprints, with one final event pushing the tissues past their limits. We also see this repetitive loading in dance sports.

In most cases of turf toe that our podiatrists see and treat, the injury is associated with sports like netball, soccer and basketball due to their rapid accelerations and decelerations, pivots and quick changes in direction. You’re more likely to get turf toe when playing on artificial turf or hard surfaces, where the foot can get stuck and the toe can be forced upward. Turf toe can also occur outside of sports, such as from a slip or fall, or from wearing shoes that do not provide enough support or cushioning for the foot.

Factors that can increase the risk of turf toe include having a previous toe or foot injury, wearing shoes that do not fit properly or provide enough support, and playing sports on particularly firm surfaces.

What Are The Risk Factors Of Leaving Turf Toe Untreated?

With some injuries, like an elbow injury, you can leave your arm in a sling and avoid using it for a notable time, allowing it to heal and repair. With turf toe, however, in many cases it’s difficult to just leave the toe to get better on its own because the bending of the forefoot is a natural and necessary part of the gait cycle, as it powers the foot to take off the ground and take the next step. Hence, your big toe is bent with every step - something that can be very painful and even risks causing further damage when you have a turf toe injury.

What Are The Symptoms Of Turf Toe?

The most common symptoms we see include pain at the big toe, which can range from mild to severe depending on the extent of the injury, initial swelling or bruising at the big toe, stiffness and limited mobility at the big toe joint which can make it difficult to walk and participate in physical activity, and general weakness at the big toe joint and forefoot region.

Turf Toe Diagnosis

Our Brisbane City and Newmarket podiatrists can confidently diagnose turf toe from a physical examination paired with learning both your personal circumstances surrounding the occurrence of the injury.

Turf Toe Treatment Options

If you suspect you’ve sustained a turf toe injury, before you can get in to see a podiatrist, start by resting your foot and avoiding bearing weight on the forefoot and big toe as much as possible. You can apply ice to the area for up to 20 minutes at a time through a tea towel or other protective layer, up to four times per day. Keeping the foot elevated may help ease the swelling, as can wrapping your forefoot with a compression bandage that keeps the big toe straight and in line with the other toes. Non-steroidal anti inflammatory medications (NSAIDs) can also be used to temporarily ease your pain and inflammation.

When you get in to see our podiatry team, we’ll discuss the best treatment options for you based on the severity of your injury. This may include:

• Using strapping (such as buddy strapping) to help immobilise the big toe and prevent further hyperextension of the joint, which could cause further damage and pain
  
• In severe cases of turf toe, immobilisation may need to be achieved with a walker (boot) for several weeks
  
• Using in-shoe padding to temporarily alleviate pressure away from the big toe joint
  
• Using custom foot orthotics to deflect pressure away from the big toe joint
  
• Recommending certain types of supportive footwear that has greater forefoot stiffness to offer your toes greater protection during sports, or making modifications to your existing footwear
  
• Once sufficient repair and healing has occurred, physical therapy may be used to help rehabilitate the strength and flexibility of the joint, with the goal of preventing imbalances that can lead to joint weakness or instability
  
• Joint mobilisation therapy to aid in the return of joint range of motion.
  
• MLS laser to alleviate pain, reduce inflammation and promote healing. 
  

Is There Anything I Can Do To Prevent Turf Toe?

In many cases, turf toe cannot be prevented. However, you may be able to reduce your injury risk by wearing good, supportive and sport-appropriate footwear, wearing your foot orthotics (if you have them) during exercise, having a good warm up and stretching routine prior to physical activity, maintaining good technique and form during sports, and managing any existing forefoot problems that may otherwise lead to joint weakness or imbalances.

FAQs

How long does turf toe take to heal?

This greatly depends on the severity of your turf toe, with mild cases often taking just a few weeks, and more severe cases taking several months to resolve. Your podiatrist will advise you of the likely recovery time given your unique circumstances and injury severity at your appointment.

Does turf toe ever go away?

With the right rehabilitation, you can completely recover from turf toe. If you leave turf toe untreated, however, it is more likely that you will have ongoing pain or other problems, including a higher risk of subsequent forefoot injuries.

Is it okay to walk on turf toe?

To optimise your recovery, aim to avoid weight-bearing on your injured toe or performing any movements that cause you pain or discomfort. If you only have a mild case of turf toe and experience no pain or other symptoms when walking, then you can continue to walk, given that you remain asymptomatic.