Toe Sprain: Overview
Toe sprains may be caused by:
stubbing your toe into something when walking barefoot
stopping suddenly when running, causing a toe to jam into the end of
your shoe
landing awkwardly from a jump, causing a toe to jam into the end
of your shoe
Risk factors that increase your chances of spraining your toe include:
sports such as football, soccer, rugby, basketball, or running
dancing
poor coordination
rough ground
Diagnosis
Symptoms of toe sprains include:
pain and tenderness in the toe
pain when moving the toe
swelling and bruising of the toe
The doctor will ask about your symptoms and how you injured your toe. The
doctor will examine your toe to assess the stability of the joint and the
severity of the injury.
Treatment Options
Treatment includes:
rest
Avoid using the injured toe.
ice
Apply ice or a cold pack to your toe for 15-20 minutes, 4 times a day for
2 to 3 days or until the pain goes away. Wrap the ice or cold pack in a
towel. Do not apply the ice directly to your skin.
compression
If the injured toe is the big toe, wrap a 2-inch elastic compression bandage
around it. Put several wraps around the big toe and then include the rest
of the forefoot within the bandage. This will limit swelling of your big
toe. Other toes cannot be effectively compressed with a bandage.
elevation
Keep the injured foot raised above the level of your heart for 48 hours
(such as up on a pillow). This will help drain fluid and reduce swelling.
medication
Take one of the following drugs to help reduce inflammation and pain:
- ibuprofen (Motrin, Advil)
- naproxen (Aleve, Naprosyn)
- acetaminophen (Tylenol)
- aspirin
protection
Wear a shoe with a stiff sole to help protect the injured toe.
Prevention
Toe sprains generally cannot be prevented.
How can I prevent a toe sprain?
A toe sprain is a result of a traumatic event as opposed to overuse, so
it cannot be prevented. However, below are some ways to reduce your risk
of getting a toe sprain:
use tape to prevent extension of the toe beyond its normal range
of motion, or hyperextension
insert a stiff insole into the shoe and wear firm rather than extremely
flexible shoes
perform the exercises in the rehabilitation section to help prevent
toe injuries
such precautions are especially important if you have a history
of foot and toe injuries
Improving sports performance
The key to improving sports performance after recovering from a toe sprain
is a proper rehabilitation program, and adhering to some of those same principles
after the injury is gone.
Also remember that the single most important aspect of improving performance
is stretching before and after you step onto the field, court, ice, or golf
course.
Benefits derived from stretching include:
increased physical efficiency and performance
decreased risk of injury
increased blood supply and nutrients to joint structures
increased coordination
improved muscular balance and postural awareness
reduced stress
enhanced enjoyment
Toe sprain rehabilitation
As an athlete, your number one concern is getting back to full strength
as soon as possible so that you can return to training and competition.
That is why appropriate rehabilitation is extremely important. Rehabilitation
for a toe sprain often includes the following:
Rest
Avoid using the inured toe.
Ice
Apply ice or a cold pack to your toe for 15-20 minutes, 4 times a day
for several days. This helps reduce pain and swelling. Wrap the ice or
cold pack in a towel. Do not apply the ice directly to your skin.
Compression
If the injured toe is the big toe, wrap a 2-inch elastic compression bandage
around it. Put several wraps around the big toe and then include the rest
of the forefoot within the bandage. This will limit swelling of your big
toe. Other toes cannot be effectively compressed with a bandage.
Elevation
Keep the injured foot raised above the level of your heart for 48 hours
(such as up on a pillow). This will help drain fluid and reduce swelling.
Medication
Use anti-inflammatory medications such as ibuprofen to reduce inflammation
and speed up recovery.
Rehabilitation exercises
The main purpose of rehabilitating a toe sprain is to restore painless
full range of motion of the sprained toe and to increase the strength
and integrity of the joints of the injured foot. The following exercises
may help get you back in the game a little faster:
Toe extension
Stand with the injured foot a few inches in front of the other. Slightly
bend the injured side knee, raise up on the toe, and place both hands
on the injured side thigh. With weight on the injured toe, press down
with both hands to the point of significant pain and hold this position
for 5 seconds. Stand straight with body erect, feet flat on the floor,
and hands at sides. Relax for 10 seconds. Perform this sequence 5 times,
3 times daily.
Toe flexion
Stand with the injured foot a few inches in front of the other. Slightly
bend the injured-side knee and turn the injured toes under so that the
top of the toes face or are in contact with the floor. Put both hands
on the injured-side thigh. Place weight on the injured toe and press down
on the thigh with both hands to the point of significant pain. Hold this
position for 5 seconds. Stand straight with the body erect, hands at the
sides, and soles of the feet flat on the floor. Relax for 10 seconds.
Perform this sequence 5 times, 3 times daily.
All fours toe extension
Kneel on all fours with toes underneath the buttocks. Slowly lower the
buttocks over the toes to the point of significant pain and hold this
position for 5 seconds. Return to the starting position and relax for
10 seconds. Perform this sequence 5 times, 3 times daily.
Toe raises
Stand with the injured side next to a chair or other supporting structure
and place the injured-side hand on the support. Lift the uninjured-side
foot from the floor, placing body weight on the injured foot. Raise upward
on the injured foot to the point of significant pain and hold this position
for 5 seconds. Return to the starting position and relax for 10 seconds.
Perform this sequence 10 times, 3 times daily.
When you can perform toe raises without pain, modify the exercise by removing
the supporting structure, placing 5-pound weights in each hand, raising
up on the toes fully, and holding for five seconds. Relax in the starting
position for 10 seconds. This should be performed 10 times, 3 times daily.
As strength increases, the hand-held weights may be increased by increments
of as much as 2 pounds.
These exercises rehabilitate and may decrease your chances of spraining
a toe. We suggest that the exercises be part of your daily warm-up routine.
Both sides should be exercised, especially when your sport is played on
an artificial surface.
When can I return to my sport or activity?
The goal of rehabilitation is to return you to your sport or activity
as soon as is safely possible. If you return too soon you may worsen your
injury, which could lead to permanent damage. Return to your activity
is determined by how soon your toe sprain recovers and full range of motion
is restored, not by how many days or weeks it has been since your injury
occurred.
How long will the effects of the injury last?
A simple toe sprain can be treated with rest, ice, elevation, and anti-inflammatory
drugs. Pain and swelling can disappear and full range of motion return
within 24 to 48 hours.
More serious toe sprains or a toe fracture may last 7 to 10 days. An acute
form of toe sprain - turf toe - is accompanied by pain, swelling, and
loss of range of motion that can last weeks or even months.