You’re an athlete, playing on grass fields, clay courts or artificial turf. And your sport involves running, jumping, cutting and pushing off on hard surfaces. (That sport could be whether its football, tennis, soccer or track.) The action doesn't matter. But what does is that, now, you’ve noticed pain or discomfort at the base of your big toe joint.

Of course, that pain could just mean you’ve been wearing the wrong shoes, or overdoing it on the field. But, for athletes, pain, stiffness and bruising is often a sign of turf toe. So, if you even suspect a turf toe injury, make an appointment with our Houston podiatrist. Because, if left untreated, a turf toe injury can become a chronic problem. And that could limit your mobility, permanently sidelining you from your game.

What is Turf Toe? Football players have a high turf toe risk because of their training fields

Turf toe describes an injury to the ligaments at the base of your big toe. As such, turf toe is a type of sprain, which we also call a soft tissue injury. What separates turf toe from other sprains is its location. As we mentioned, this injury happens at the joint at the bottom of your big toe. At first, turf toe is an athletic injury. The sprain happens when you jam your toe against the hard ground. Or when you bend it backwards. And, at that point, you experience the sharp pain of turf toe.

Now, as I’ve said, turf toe is an acute sports injury. But, because it affects your toe joint, it can also become a chronic problem if you don’t quickly treat the sprain. Because turf toe attacks your joint. Which makes your toe stiff and reduces your flexibility. Plus, it increases your risk for reinjury and arthritis in the future.

What Causes Turf Toe?

Turf toe injuries are almost always athletic injuries. But any motion that makes your toe forcefully connect with hard surfaces can lead to turf toe. So, anyone can get a turf toe injury, but athletes who play on artificial surfaces have the highest risk. Because turf has a lot less give than grass. Which means your toe absorbs the full force of your motion, often leading to injury. And it explains why turf toe is most common in football players.

Your shoe choice can also contribute to turf toe injuries. If you don’t wear cleats when you play on turf, your toes can get hurt. So it’s important to wear sport specific cleats. Or to look for stiff shoes. Because limited flexibility at the front of the shoe can prevent hyperextending toes.

Symptoms of Turf Toe

With a turf toe injury, you’ll notice pain right away. Soon, you will likely see a bruise at the base of your big toe. That’s a sign that your toe ligaments have stretched too far, or even torn. With a severe turf toe injury, your big toe may even dislocate.

After the initial injury, your toe may feel stiff. Walking may be uncomfortable, because turf toe limits your joint mobility. Then, if left untreated, turf toe can make you more vulnerable to future injuries.

Diagnosing Turf Toe

I can usually diagnose turf toe with an exam in my Houston podiatry office. Because it’s so related to athletics, I often pinpoint the injury after taking your history. In some cases, I may need to order x-rays. That way, I can rule out other injuries, like fractures. With an x-ray, I can also check to see if arthritis has set in around your joint.

Turf Toe Treatment

In most cases, we can treat turf toe injuries without surgery. But the treatment we recommend for your sprained toe will depend on how soon we see you. It will also depend on the severity of your injury.

Non-Surgical Treatment for Turf Toe

RICE 

Right after your injury, RICE (rest, ice, compression and elevation) is critical. This will take the pressure off your injured toe. And it will help reduce inflammation and swelling around your big toe joint.

Anti-Inflammatory Medication

Right after your injury, we may also prescribe anti-inflammatory medications. For some patients, we can recommend over-the-counter NSAIDs. (These are non-steroidal anti-inflammatory drugs, such as Advil or Motrin.)

Immobilization

While your turf toe heals, we want to prevent movement in your big toe joint. To do that, we may buddy tape your big toe. (That means taping it to the neighboring toe to prevent movement.) For some athletes, we may recommend shoes with stiff soles, so that your shoe doesn’t bend and move your toe. Some athletes choose shoes with steel plates to remove all fear of flexion in their toes.

Surgery for Turf Toe

Surgery for turf toe is rare. But sometimes, damage to your big toe ligaments extends to other parts of your foot. And that can threaten the stability of your foot bones. (This is especially true when your plantar plate is involved in your injury. The plantar plate involves the ligaments and two bones that stabilize your big toe. Plantar plate injuries sent Kansas City Chiefs’ quarterback Patrick Mahomes into turf toe surgery. Right after his loss in the 2021 big game.) If you need turf toe surgery, we’ll discuss the procedure and what to expect during your recovery period.

Remember, when we treat turf toe—with or without surgery—it will take time for your toe to heal. And, during that time, you’ll need to rest your toe and avoid athletics. Because, if you don’t, you’ll delay your recovery and increase your risk for complications.

What does that mean for you? If you’ve noticed your big toe is stiff or sore, don’t ignore the problem. Or, worse yet, keep playing through the pain. Instead, request an immediate appointment at our office. Because the sooner we treat your injury, the sooner you can get back in the game. Without compromising your performance, or your health!

Dr. Andrew Schneider
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A podiatrist and foot surgeon in Houston, TX.