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Martin Foot & Ankle

Turf Toe

Turf toe is not the most serious of names to give a painful big toe injury. In fact, it almost sounds as if it could be a compliment, like, “Look at that running back juke! He’s sure got turf toes!” Still, the term is an easier mouthful than “metatarsophalangeal joint sprain,” so we let semantics slide.

Metatawhat now?

The metatarsophalangeal (MTP) joints connect the metatarsals—or long bones in the forefoot—with the bases of the toes. Like the majority of other joints in the body, the MTP joints have connected ligaments and other soft tissues that help aid movement and hold the bones in their proper positions.

When a sprain occurs, these tissues are forced beyond their normal limits. The big toe can be particularly vulnerable to this form of injury given its position, and the severity of the sprain is often graded by severity:

  • A Grade 1 sprain is mostly an overstretching of the tissue, causing tenderness and mild swelling.
  • A Grade 2 sprain includes a partial tearing of the tissue. Pain is more widespread, with swelling and bruising, and movement of the toe can become limited.
  • A Grade 3 sprain involves a full rupture of the ligaments or tissues, causing severe pain and discoloration. It becomes difficult to move the big toe in the least.

So why call it “turf toe”? This form of injury often occurs in sports and activities where front of the foot is fixed on the ground and the heel is raised high, producing a great amount of force onto the big toe. In this position, it’s similar to grabbing the big toe and pulling back on it hard. Sports that are played on artificial turf, such as American football, tend to see this form of sprain more often. The surface is not only harder and less adept at absorbing shock than plain grass, but shoes made for turf are also more flexible and provide less stability. Good for agility; not-so-good for preventing injury.

Time Out for Treatment

An MTP joint sprain is not something to try and walk off. Damage to the joint can become worse the more it is used without care, and sprains that don’t heal properly can lead to chronic pain and joint instability in the future. As soon as a sprain happens, get off the affected foot and apply the RICE method: Rest, Ice, Compression, and Elevation of the area. That’s the best way to reduce swelling and pain when the injury happens.

Next, you should call us at Martin Foot and Ankle. Even if it the injury feels manageable on your own at first, we’ll want to make sure no part of the joint has been majorly affected. Depending on the severity of the sprain, we might recommend the use of either taping in mild sprains, or a walking boot for more serious cases. In the most severe injuries, a cast may first be needed, then downgraded to a boot and finally taping.

Surgery is often not required for turf toe, but if the injury is causing long-term consequences or affecting performance, surgical repair of the soft tissues might be considered.

If a big toe sprain has benched you, our doctors in Hanover, York, and Lancaster are here to help you get back into playing shape as quickly yet safely as possible. Call us at (717) 757-3537 to schedule an appointment.

Dr. Jennifer Mulhern
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