What Is Turf Toe?

A ‘turf toe’ injury is a common injury that we see at the clinic and is a sprain of the ligaments around the big toe joint. It most commonly happens in those playing sports like soccer, AFL, rugby, netball, basketball and dancing. Sports that are played on artificial turf such as futsal and American football also see a high number of turf toe injuries. These sports are played on hard surfaces and require explosive movements and change of direction. 

How does it happen?

Turf toe injuries occur when the big toe undergoes ‘hyperextension’ – that is, when the foot is pointing towards the ground and the toe is bent upwards towards the sky. The big toe stays on the ground and the rest of the body moves forward over the top of it, hence why it is referred to as a ‘hyperextension’ injury. The hyperextension of the big toe joint can occur when you push off from the ground, change direction rapidly, or are under contact such as in a tackle where the toe is caught underneath an opposing force. 

What does it feel like?

In most cases, patients also describe feeling a ‘pop’ or a ‘crunch’ at the time of injury, with pain typically coming on immediately and being at its worst when trying to push off the ground using the big toe, otherwise known as the toe off phase. This is when the big toe naturally goes through plantar flexion. Pain, swelling, bruising and limited mobility are also telltale signs of a turf toe injury. The pain can usually be described as being localized to the big toe joint and it can be throbbing, aching or sharp in nature and the severity of pain will depend on the extent of the injury. If the pain is severe, your podiatrist may send you for an X-ray, ultrasound or MRI to determine the extent of the injury. 

How is it treated?

The initial treatment for turf toe is similar regardless of the extent of the injury. Rest, ice, compression and elevation are recommended in the early stages following injury. Taping or the use of a carbon fibre plate in your shoes are also used. If you are really struggling to walk, we may sometimes recommend using either a moon boot or a Darco shoe, which aims to limit motion through the feet and allows the inflammation to settle. Laser therapy may also be used to assist with healing. 

Following this, the aim is to continue to reduce pain, but to also encourage movement through the big toe joint. A strength and conditioning program will be provided which aims to promote this mobility and increase the strength of not just the toe, but the whole foot and lower leg in general. We will also review your footwear and make recommendations on this, as well as look at the possibility of orthotics to improve your overall foot function if required. 

How can I prevent turf toe injuries?

The main way to prevent turf toe injuries in the future is to make sure that you are wearing appropriate shoes for the sport that you are playing. Specific sports shoes are designed to support the foot and withstand the forces of the movements that are particular to that sport. As with most injuries, it is important to make sure that you warm up and cool down properly to help to reduce your overall risk of injury. Ensuring that you maintain good overall foot health is also very important! 

 

If you have injured your big toe and need help reducing your pain and getting back to your activities, don’t hesitate to contact us so that one of our podiatrists can help you out!

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