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Turf Toe

Turf Toe

What is Turf Toe?

Turf toe is a painful sprain of the first metatarsophalangeal (MTP) joint that most commonly occurs in patients who are athletes. The MTP joint is responsible for connecting the metatarsal of the forefoot to the phalanx bone in your big toe. Turf toe occurs due to a forced hyperflexion—when the toe bends upwards—of the MTP joint due to trauma.

What Are the Causes of Turf Toe?

Turf toe is caused as a result of trauma to the tissues, ligaments, two bones, and tendon that surrounds the MTP joint. This is commonly known as the plantar complex.

Turf toe injuries can be mild and require very little time to heal, or they can be more severe and need complete rest and immobilization of the foot in question. Turf toe injuries are separated into three types, depending on severity:

  • grade 1 toe turf injury: sprain or stretching of the plantar complex
  • grade 2 toe turf injury: partial tears in the plantar complex
  • grade 3 toe turf injury: complete tear of the plantar complex

Turf toe injuries are more common in patients that are athletes, especially those that practice sports on uneven surfaces or artificial turfs that are harder and less absorbing of shock. Wearing improper shoes—those that are too soft and flexible—can also make you more predisposed to getting toe turf.

What Are the Common Symptoms of Turf Toe?

Common symptoms of turf toe include:

  • acute pain
  • swelling of the big toe near the MTP joint
  • weakness felt in the big toe
  • increased pain on hyperextension of the big toe at MTP joint
  • bruising
  • inability to move big toe (grade 3 injury)

What to Expect During Treatment for Turf Toe at the Podiatrist

Diagnosis of turf toe happens at a podiatric appointment after a thorough foot exam. A physical foot exam will usually consist of:

  • inspection of the big toe and MTP joint
  • palpation of the MTP joint to feel for tenderness and swelling
  • muscle strength test
  • range of motion evaluation
  • valgus and varus stress tests to determine the stability of the first MTP joint

Imaging tests such as X-rays and MRIs are commonly required to rule out the possibility of a fracture of the big toe.

Treatment for turf toe at the podiatrist includes:

  • rest and ice therapy
  • NSAIDs to relieve pain and swelling
  • taping of the toe
  • use of custom-fitted stiff shoes and orthotics—to immobilize the leg and take the weight off the injured foot

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