It’s that season again when kids and adults are getting into the competitive spirit with the start of the school year and playing football, soccer, volleyball, and even rugby. With the increased activity, as foot and ankle specialists we will have patients coming in with concerns of an excruciatingly painful injury to the big toe, often called “turf toe”. Despite the name, this injury can occur on any surface, and while this injury is not all that common, it can be an injury that can linger all season long and can even have a long-term impact.
A turf toe injury generally occurs in contact sports, such as football, and can be caused by a specific mechanism where the big toe is fixed to the ground in a hyper-extended position and a load is applied to the back of the foot (think big toe pointed up and the ball of the foot pointed down so that the area on the bottom of the big toe joint is overstretched). This can be seen when a running back is tackled or when a lineman is blocking. In either situation, a load to the back of the foot causes an axial load on a hyperextended big toe joint causing stretching and/or tearing of the plantar-capsule ligament complex or “sprain” of the joint ligaments. This injury can also be caused by running, cutting, or jumping without adequate shoe gear, causing repetitive excessive hyperextension of the big toe joint. This injury mechanism can also be associated with injuries such as stress fractures, sesamoid fractures, or cartilage injury of the joint surface.
These injuries can be debilitating for an athlete in a high-impact sport such as football and soccer. The injury typically presents as acute pain, stiffness, and swelling of the big toe joint, resulting in the inability to push off. This reduces the overall speed and agility of the player. Due to the function of the big toe joint in sports, this injury is painful with nearly every step, jump, or cut on the field.
General treatments for turf toe vary based on the severity of the injury. Low-grade injuries can be treated more conservatively with rest, ice, NSAIDs, stabilization of the joint, and physical therapy. However, more severe injuries generally require more rest and time away from the sport to heal appropriately. More severe injuries may require complete offloading of the foot, enhanced soft tissue recovery techniques such as laser therapy, and even surgery. Long-term support may include custom orthotics and specific shoes.
If you have experienced this type of injury and symptoms, it is best to quickly be evaluated by our expert podiatrists at Foot and Ankle Center of Iowa. We will perform x-rays and a thorough evaluation to determine the extent of your injury and recommend the appropriate treatment protocol. An expert in foot and ankle care is essential to ensure accurate diagnosis and start the healing process. This injury can be detrimental to a young athlete’s sports season and can also linger and/or progress into the next sports season, especially if not recognized right away and the right treatment protocol is not instituted.
At the Foot and Ankle Center of Iowa, we are driven by research-based treatment protocols and can provide comprehensive care for a turf toe injury or any other sports injuries. We have many treatment modalities to offer you in the office and now even offer our new MLS Laser Therapy to help reduce pain and inflammation to provide an excellent adjunct for the treatment protocol of injuries such as turf toe.