(Metatarsalphalangeal Joint Sprain; Sprain Big Toe)
DefinitionTurf toe is a sprain of the base of the big toe where the big toe meets the foot. It is usually a hyperextension sprain of the first joint of the toe. A sprain is stretching or tearing of the ligaments that support a toe. Ligaments are strong bands of tissue that connect bones to each other. The injury is called turf toe because it often occurs in football and soccer players when playing on artificial turf.
|Turf Toe Swelling|
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CausesTurf toe occurs when the big toe is forced to extend beyond its normal range of motion. This can be caused by:
- Standing on the balls of your feet as another person falls onto you, causing your big toe to hyperextend
- Stopping suddenly when running, causing your big toe to slide into the end of your shoe and bend up and backward as you go forward
Risk FactorsFactors that increase your chances of getting turf toe include:
- Sports such as:
- Poor coordination
- Increased ankle dorsiflexion
- Wearing athletic shoes with flexible soles
- Playing sports on artificial turf
- Pain and tenderness in the ball of the foot and the big toe
- Swelling and bruising of the ball of the foot and the big toe
- Inability to bear weight on the ball of the injured foot
- Inability to push off on the big toe
- Reduced range of motion in the big toe
DiagnosisYou will be asked about your symptoms and how you injured your toe. An exam of your toe will be done to assess the stability of the joint and the severity of the injury.Your doctor may need pictures of your foot. This can be done with:
Supportive CareThe toe will need time to heal. Supportive care may include:
- Rest—Activities may need to be restricted at first. Normal activities will be reintroduced gradually as the injury heals.
- Ice—Ice therapy may help relieve swelling.
- Compression—Compression bandages can provide gentle pressure to help move fluids out of the area.
- Elevation—Keeping the affected area elevated can help fluids drain out or prevent fluids from building up.
- A metatarsal pad may be advised to cushion the area under the toe.
- Stiff-soled shoes or rigid orthotics may be advised to keep the toe from hyperextending.
- A walking boot or cast may be needed for more severe injuries.
SurgerySurgery is only needed to repair turf toe if:Surgery is only needed to repair turf toe if:
- A small piece of bone has been broken off by the injury to the ligament
- A ligament is torn completely
PreventionOften, turf toe cannot be prevented. However, to reduce your risk of getting turf toe, wear stiff-soled athletic shoes when playing sports.Proper treatment of turf toe can help prevent long-term complications or problems with the toe joint such as misalignment and immobility.
American Academy of Physical Medicine and Rehabilitation
OrthoInfo—American Academy of Orthopaedic Surgeons
British Columbia Podiatric Medical Association
Achilles Foot Health Centre
Chou LB. Disorders of the first metatarsophalangeal joint. Phys Sportsmed. 2000;28:32-45.
Churchill SR, Donley BG. Managing injuries of the great toe. Phys Sportsmed; 1998.
Foot sprain. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated January 30, 2015. Accessed March 2, 2015.
Mullen JE, O'Malley MJ. Sprains—residual instability of subtalar, Lisfranc joints, and turf toe. Clinics in Sports Medicine. 2004;23(1):97-121.
Pommering TL. Ankle and foot injuries in pediatric and adult athletes. Prim Care. 2005;32(1):133-161.
- Reviewer: Michael Woods, MD
- Review Date: 02/2014
- Update Date: 02/19/2014
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