Foot & Ankle

Turf Toe

Turf toe is a sprain or hyperextension injury to the metatarsophalangeal (MTP) joint, located at the base of the big toe. The MTP joint is essential for stability and movement during walking, running, and jumping.

Understanding Turf Toe

A turf toe injury typically occurs when the big toe is forced into excessive backward motion (hyperextension), often during sports or high-impact activities.

Though turf toe is frequently associated with sports played on artificial turf, it can also occur on any surface that puts stress on the MTP joint. Sports that involve running, jumping, or sudden changes in direction, such as football, basketball, and soccer, often see this injury. While turf toe is often considered a mild injury, it can lead to chronic pain and long-term joint issues if left untreated.


Causes and Risk Factors

Turf toe typically results from high-impact activities or trauma that forces the toe to extend beyond its normal range of motion. Common causes and risk factors include:

  • Sports Injuries: High-impact sports like football, basketball, soccer, and rugby increase the risk due to rapid accelerations and changes in direction.
  • High-Impact Movements: Activities requiring the big toe to push off or bear sudden forces can lead to hyperextension injuries.
  • Improper Footwear: Inadequate shoes or cleats lacking proper arch support or cushioning increase the risk, especially when the shoe provides too much traction.
  • Weak Foot Muscles: Poor foot mechanics or muscle weakness can contribute to an increased risk of injury during high-stress activities.
  • Previous Injuries: Athletes who have had a turf toe injury in the past are at an increased risk of re-injury.


Symptoms of Turf Toe

Symptoms can vary depending on the severity of the injury but commonly include:

  • Pain and Tenderness: The base of the big toe experiences pain, particularly during toe extension or weight-bearing activities.
  • Swelling: Swelling typically occurs around the MTP joint, often visible after the injury.
  • Stiffness: The big toe may feel stiff, and range of motion can be limited, particularly during walking or running.
  • Bruising: In more severe cases, bruising may appear around the MTP joint.
  • Pain during Walking: Difficulty bearing weight or walking may arise due to pain and instability in the toe joint.

Early diagnosis and intervention can help alleviate pain, prevent complications, and improve recovery.


Diagnosis of Turf Toe

Diagnosing turf toe involves a clinical evaluation by Dr. Ryan du Sart, who will assess pain, swelling, tenderness, and range of motion in the affected area. To confirm the diagnosis and rule out other injuries, X-rays are typically performed to evaluate any bone damage. In some cases, an MRI or ultrasound may be ordered to assess the extent of soft tissue damage, particularly ligament or cartilage involvement.


Treatment Options for Turf Toe

Treatment for turf toe depends on the severity of the injury. Dr. du Sart provides both non-surgical and surgical options to restore function, alleviate pain, and promote recovery.


Non-Surgical Treatment

For mild to moderate turf toe injuries, conservative treatment can be highly effective. Common non-surgical approaches include:

  • Rest and Activity Modification: Resting the foot and avoiding high-impact activities are critical for recovery. Continuing to engage in physical activity before the joint heals can worsen the injury.
  • Ice and Elevation: Applying ice and elevating the foot can help reduce swelling and alleviate pain, especially during the acute phase.
  • Buddy Taping: The injured toe may be taped to the adjacent toe to reduce movement and provide support during healing.
  • Medications: NSAIDs (e.g., ibuprofen) can be prescribed to reduce pain and inflammation. In some cases, paracetamol may be recommended.
  • Immobilisation: In more severe cases, a stiff-soled shoe or orthotic insole may be used to immobilise the toe and reduce pressure during recovery.
  • Physical Therapy: Once the acute phase has passed, a physical therapy regimen may be initiated to restore range of motion, strength, and flexibility.


Surgical Treatment

Surgery is typically considered for more severe injuries, particularly if conservative treatments fail to alleviate symptoms. Surgical options may include:

  • Joint Stabilisation: Surgery may be performed to repair or tighten the ligaments in the MTP joint, particularly if the ligaments are torn or overstretched.
  • Tendon Repair or Reconstruction: In cases where ligaments or tendons are severely damaged, Dr. du Sart may recommend tendon repair or reconstruction to restore the function of the joint.


Recovery and Rehabilitation

Recovery from turf toe varies depending on the injury’s severity and the chosen treatment. A typical recovery process includes:

  • Initial Rest and Immobilisation: For 1-2 weeks, patients should rest and use a walking boot or crutches to prevent weight-bearing on the affected toe.
  • Physical Therapy: After the acute phase, physical therapy will focus on regaining strength, range of motion, and flexibility in the joint. This may include stretching exercises, balance training, and strengthening exercises.
  • Gradual Return to Activity: Once the joint has healed, patients can slowly return to activities. High-impact sports or activities should be avoided until full recovery is achieved.

Most patients recover from mild cases of turf toe within 4-6 weeks, but more severe cases can take several months to heal completely.


Preventing Turf Toe

Preventing turf toe injuries involves several strategies to reduce the risk of strain on the MTP joint:

  • Proper Footwear: Ensure that shoes provide adequate support, cushioning, and flexibility to prevent injuries during physical activity.
  • Strengthening Foot Muscles: Perform regular strengthening exercises for the feet and lower legs to improve foot stability and mechanics.
  • Proper Warm-Up: Before engaging in sports, take time to warm up and stretch the muscles to prepare for high-intensity movements.
  • Gradual Increase in Activity: Avoid sudden increases in physical activity intensity or duration to prevent overuse injuries like turf toe.


Why Choose Dr. Ryan du Sart?

Dr. Ryan du Sart is a fellowship-trained orthopaedic surgeon with extensive experience in diagnosing and treating sports-related injuries, including turf toe. His patient-first approach ensures each treatment plan is tailored to the individual, helping athletes and active individuals return to their activities as quickly and safely as possible.


Book a Consultation

If you suspect a turf toe injury or experience persistent pain in your big toe following a high-impact activity, early diagnosis and intervention are crucial for a full recovery. Contact Dr. Ryan du Sart today to schedule a consultation.

Phone: (08) 9779 9767
 Email: admin@ryandusart.com.au

Clinic Locations:

  • 6 Higgins Street, South Bunbury, WA 6230
  • 20 Prince Street, Busselton, WA 6280



References:

  1. Mayo Clinic. (2021). Turf Toe Injury. https://www.mayoclinic.org
  2. American Academy of Orthopaedic Surgeons (AAOS). (2021). Turf Toe: Symptoms and Treatment. https://www.aaos.org
  3. National Institute for Health and Care Excellence (NICE). (2021). Management of Foot Injuries. https://www.nice.org.uk
  4. Cleveland Clinic. (2020). Foot and Ankle Injury: Diagnosis and Treatment. https://my.clevelandclinic.org