Turf toe can occur after a very vigorous upward bending of the big toe causing a sprain to the ligaments under base of the big or great toe.
Turf toe symptoms
Symptoms include swelling and pain at the joint of the big toe and metatarsal bone in the foot. Pain and tenderness will be felt on bending the toe or pulling it upwards. Play assessment and diagnosis video for more detailed information on how a professional podiatrist would diagnose turf toe.
The ball of the foot is usually very tender (always compare one foot to the other for pain on movement and palpation). A full diagnosis is not possible without a scan such as an MRI, although this is not usually necessary, unless appropriate treatment is unsuccessful.
What is turf toe?
Turf toe is simply a sprain to the ligament at the base of the big toe or great toe. It can be caused as the shoe grips hard on the surface and sticks causing bodyweight to go forward and so bending the toe up. It is also common in martial arts. You are more at risk if you have increased range of motion in the ankle and / or wear soft flexible shoes.
When the toe is bent upwards this causes damage to the ligaments under the toe which can become stretched. In addition the surfaces of the bones at the joint can become damaged. An X-ray is usually recommended to check that there is no fracture present.
If pain in the joint at the base of the big toe (called the MTP joint) comes and goes, lasting for around at a week at a time, with no obvious cause then consider gout as a possible cause of the toe pain.
What can the athlete do?
Ice the injury immediately. Applying cold therapy or ice to the injured joint will reduce pain and inflammation speeding up the healing process. Apply a compression bandage.This will help support and protect the toe as well as reduce swelling. The sooner a compression bandage is applied the earlier it will prevent swelling although a compression bandage should only be applied for 10 minutes at a time or it may restrict blood flow to tissues and cause further damage.
Rest, which might include crutches to take the weight off the toe. it is difficult to rest the foot when you need to walk on it but without rest it will take much longer to heal. Use a brace to protect the toe or at the very least wear a shoe that has a firm sole that will not allow bending. A turf toe taping technique will support and protect the toe preventing it from bending in the direction that will stress the toe ligament causing pain.
See a sports injury professional for advice - watch our expert interview podiatrist on toe pain. This is especially important if the injury is severe or doesnt heal as expected.
What can a sports injury professional do?
A doctor may X-ray the toe to check for a fracture. A broken toe may have similar symptoms to a severe turf toe injury. They may apply ultrasound or other electrotherapy treatment to help reduce pain and swelling and encourage the heeling process. After 2 to 4 days the athlete may be able to weight bear again.
A physical therapist or similar will advise on a rehabilitation and strengthening program. General foot and toe exercises may be required to strengthen the injured foot.
Recovery of this injury can take three to four weeks depending on how bad the sprain is. If the athlete does not look after this injury then it may develop into hallux limitus or hallux rigidus! This is a decreased range of motion due to arthritis around the joint. This can cause problems in the rest of the foot or lower limb due to changes to your walking cycle (gait).
Turf toe taping
What is required?
- 2.5cm (1 inch) non stretch zinc oxide tape.
- 3.8cm (1.5 inch) non stretch zinc oxide tape.
- Apply a strip of 2.5cm tape around the big toe as an anchor. Use two strips if the big toe is long.
- Using 3.8cm tape apply two overlapping strips around the middle of the foot.
- When applying the anchors to the middle of the foot, spread the toes apart to simulate load bearing on the foot. This will help prevent the tape being uncomfortable when the athlete stands up.
- Apply a strip of 2.5cm tape from the middle of the foot directly up to the big toe. Ensure the toe is in the desired position before fixing the tape.
- Some therapists prefer to tape from the toe downwards.
- Apply a second support strip from the middle of the foot upwards but slightly to the side and overlapping the first.
- Then a third strip from the other side.
- You should have an 'X' of tape with the cross passing over the joint of the big toe.
- Secure the support strips with two strips over the top at the big toe and the middle of the foot with 2.5cm and 3.8cm tape respectively - like the original anchor strips.
- Assess the taping to ensure the big toe cannot be bent back and the tape is secure.