If you’re an active person who likes to play a lot of heavy-impact sports (like football, soccer, basketball, wrestling, gymnastics, or dancing), then you know how much strain these sports put on your feet.
This strain is only worsened if you often play on artificial grass surfaces like AstroTurf. These surfaces place greater friction on your foot and ligaments than natural grass surfaces do, which makes you more susceptible to all kinds of different foot injuries.
Of course, getting the odd sprain or the occasional twist of the ankle can be expected if you play these sports often enough.
However, this continuous strain on your feet might eventually leave you with turf toe. What does turf toe feel like? The short answer: It’s a very painful sprain of the big toe, which can require a few weeks to completely heal.
If you want a more detailed explanation on what turf toe is, what causes it, and how to heal turf toe, then read on!
What Is Turf Toe?
Turf toe is typically classified as a sprain of the ligaments around the main joint of the big toe.
It is a common sports injury that usually results from constant, excessive upward bending (otherwise known as hyperextension) of your big toe joint.
Again, any person who plays a high-impact sport is susceptible to getting turf toe, but American football players tend to report this type of sprain more than other kinds of athletes.
The name “turf toe” actually lends itself from the fact that American football players often play on artificial turf. The turf may be cheaper for stadiums to maintain and keep, but, as stated above, it can cause your feet to stick to more to it or even slide around on its glassy surface when it’s raining.
Turf Toe Symptoms
If you have turf toe, you may feel pain around your big toe, including in the joint that connects your big toe to your foot. This joint, called the metatarsophalangeal (or MTP) joint, is the largest of the two joints that make up your big toe.
You might feel a mild pain right away if you bend your big toe too quickly, or it can gradually build up over time. Repetitive bending motions will only worsen the pain even further.
You may also feel a sort of popping sensation in your foot as soon as the injury occurs. For those whose turf toe builds up gradually, you may still feel the area around your big toe pop without there being much pain at first. The area can also feel a bit tender or sensitive when you touch it.
Your big toe may also swell up, making it difficult to stretch it, extend it, move it around, or bear any weight on it. Your toe’s joints may also become stiff and immovable.
What Causes Turf Toe?
Having your toes flat on the ground, while the rest of your foot is curled upward, can jam your big toe’s joints and nearby ligaments.
Unfortunately, this is the position that most athletes take when they push off into a sprint or a jump. A turf toe injury can occur as soon as you get in this position if done too quickly, or from steady repetitions of this movement on the field.
You may also get turf toe from a direct injury that also damages the bone beneath the cartilage. If your foot is directly injured, the signs and symptoms listed above may appear suddenly and only get worse over the next 24 hours.
Artificial turf’s added friction creates a torque force that can twist your feet or toes into unnatural and uncomfortable angles. When enough pressure is applied, they will eventually break.
Basically, while you may have skidded your feet to a halt on the turf, the rest of your momentum is putting a terrible strain on your toes as your body continues to move.
The MTP joint is usually protected by other important structures in your foot, which hold it in place and prevent it from dislocating. This collection of structures is known as the plantar complex, and is composed of:
- The sesamoids, which are two small bones that help you absorb the weight you put on the front portion of your foot.
- The flexor hallucis brevis, which is a tendon that gives your big toe the strength and stability it needs to push off any surface.
- The collateral ligaments, which are bands of tissue that connect your toe bones together and keep your big toe from bending too far – either to the left or right.
- The plantar plate, which keeps your big toe from bending too far upwards.
If you injure any of these structures that make up the plantar complex, along with jamming your big toe, the injury is still considered to be a part of turf toe.
Turf toe injuries can range anywhere from straining the soft tissue, to partially tearing the tissue, to even a total dislocation of the MTP joint. These injuries are typically graded on a scale of 1 to 3, with 1 being the mildest and 3 being severe.
A turf toe injury is typically classed as Grade 1 when some part of the plantar complex is stretched, which can create some light swelling and make your toe feel tender.
A turf toe injury is classed as Grade 2 if you partially tear any portion of the plantar complex. This can cause more moderate swelling, bruising, limited or painful movement of the big toe, and tenderness in the affected area.
A turf toe injury is classed as Grade 3 when the plantar complex is completely torn. This will cause severe tenderness, severe swelling and bruising, and extremely limited and painful movement of your big toe.
This video goes into a deeper explanation on turf toe.
How to Treat Turf Toe
Remember that early detection is key to a successful (and faster) treatment. If you think you may have turf toe, you should schedule an appointment with your doctor or physical therapist to make sure.
Before your doctor diagnoses you, they will ask you how you first injured your foot. You should go into as much detail as you can.
They may also ask what your occupation is, what sports you play, what kind of shoes you wear and if you use support, and if you have any previous history of foot injuries similar to turf toe.
Your doctor will then compare your injured foot to the uninjured one to note if there is any swelling around your big toe. They may also ask you to try and move your big toe around as best you can or they may test out your toe’s mobility for themselves.
Even if you’re showing clear turf toe symptoms, your doctor may still order an X-ray to rule out any other possible injuries you could have obtained.
They may also ask for image testing such as a bone scan, CT scan, or MRI if your pain or symptoms seem especially severe. This is to ensure the best treatment plan is created, rather than proceeding with an incorrect plan.
If you do indeed suffer from turf toe, your doctor will typically advise you to follow the R.I.C.E. healing protocol.
The acronym R.I.C.E. stands for rest, ice, compression, and elevation.
Rest is important to any treatment, and continued athletic activity will only worsen your pain.
You should take a break from any sports you play in for at least a couple days and avoid putting any sort of weight on your foot whatsoever.
You also need to use cold packs for 20 minutes at a time, several times a day.
Do not apply the ice packs directly to your foot. Instead, wrap them up in a towel before pressing it to your foot.
You should wear an elastic compression bandage to prevent your toe from swelling up any further.
While you rest, you should prop your leg up higher than your heart to reduce the swelling.
Of course, there is no one turf toe treatment method. On top of practicing the R.I.C.E. method, you can also take nonsteroidal anti-inflammatory medications (or NSAIDs) to help reduce any pain and swelling.
While immobilization can be a helpful treatment method, many people are divided on how to go about it.
Some doctors may advise you to tape your big toe to your smaller toes to reduce its movement, but this also limits its circulation due to swelling after a severe injury.
Use of a walking boot to limit your foot’s movement for one to two weeks after the injury can be a good alternative to this.
Is Surgery Required?
Oftentimes, surgery is not required to treat turf toe. It is a mild sprain that will heal in just a couple of weeks if you follow any of the above treatment methods.
However, if you have a grade 3 injury, then you may need surgery to correct it. Severe grade 3 turf toe can have a long-term impact on your ability to walk or play sports, so it’s best to treat it quickly.
If your turf toe is classed as a grade 1 injury, then you should heal within just a few days to a week, at the most.
If your turf toe is classed as a grade 2 injury, then it will take a few weeks to completely heal.
Grade 3 injuries, on the other hand, can take several months to heal. You may need to wear a cast for six weeks or more, though a 2018 study found that the American football players they studied missed an average of 16.5 weeks of playing time after their surgeries.
Your healing time will depend on how severe your turf toe is and on how fast you usually take to heal injuries of this nature.
You can take several preventive measures to reduce the chance of getting turf toe again. However, the measure you choose will depend on how you first obtained your injury.
Of course, you should never just throw yourself back into sports right away, or you risk becoming injured all over again. Instead, you should start with some light motion exercises to test out your mobility after 3 to 5 days of rest.
Of course, you should still protect your toe using medical tape or a prescribed walking boot while trying out these exercises. You may be able to run, cycle, or practice push-off activities like jumping or pivoting with the proper foot support.
When you are able to handle those activities without issue, then you can start playing some high-impact sports again. You should wear shoes with better support or put inserts into your other shoes to prevent your toe from bending excessively when you push off from it.
Prescribed orthotics, in particular, can reduce the strain you put on the plantar complex and on your big toe.
Supportive shoes that have a turf toe plate, which is a rigid carbon graphite insert, restricts the movement of the big toe, which can prevent any more turf toe injuries on the field.
You may also wear individualized orthotics with Morton’s extension, which is a rigid carbon graphite orthotic that extends under the MTP joint.
Physical therapy is only recommended for those who suffer from grade 2 or 3 injuries. It can help to correct any problems with the way you walk and run. It may even help you to develop different techniques for training or playing sports that could prevent you from getting more turf toe injuries.
This video shows some turf toe stretches and exercises.
Playing high impact sports can be really fun, but there’s no denying they’re also killer on your feet.
Turf toe is just one of many orthopedic conditions seasoned athletes may get in their life, but you do not have to let this injury stop you from doing what you love!
If you follow the home treatment methods given above (or follow your doctor’s instructions), then you should be out playing again in no time.
Have you dealt with turf toe?