Turf Toe: Overview
The injury is called turf toe because it often occurs in football and soccer
players when playing on artificial turf.
Turf toe occurs when the big toe is forced to extend beyond its normal range
of motion. This hyperextension can be caused by:
Risk factors that increase your chances of getting turf toe include:
Diagnosis
Symptoms of turf toe include:
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.
Tests may include:
Treatment Options
Treatment includes:Avoid using the injured toe.
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.
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.
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.
Take one of the following drugs to help reduce inflammation and pain:
ibuprofen (Motrin, Advil)
naproxen (Aleve, Naprosyn)
acetaminophen (Tylenol)
aspirin
Wear a shoe with a stiff sole to help protect the injured 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.
Tests may include:
Prevention
Often, turf toe cannot be prevented. However, to reduce your risk of getting turf toe, wear stiff-soled athletic shoes when playing sports.
How can I prevent turf toe?
Turf toe 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 turf toe:
Improving sports performance
The key to improving sports performance after recovering from turf toe 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:
Turf toe 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 turf toe often includes the following:
Do not participate in sports until your toe is fully healed.
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.
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.
Use anti-inflammatory medications such as ibuprofen to reduce inflammation and speed up recovery.
Rehabilitation exercises
The main purposes of rehabilitation of turf toe are to restore painless full range of motion of the big toe and to increase the strength and integrity of the joints of the injured foot. The following exercises help increase range of motion and enhance the strength and integrity of the big toe and foot joint.
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.
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.
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.
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. The sequence 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 help prevent toe fractures. 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 turf toe 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?
If the injury is a simple bruise, with rest, ice, elevation, and anti-inflammatory drug treatment, significant pain and swelling may disappear and full range of motion return within 24 to 48 hours. Serious conditions may last 7 to 10 days, and even more acute forms of turf toe accompanied by pain, swelling, and loss of range of motion may last weeks or even months.
