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Amelia Bennett

Mr. Adam Freeman

Essentials of Healthcare, 1st

27th April 2022

Turf Toe

Turf toe is the common name for a sprain of the ligaments around the big toe joint. These

joints primarily work as a hinge to allow up and down motion. Behind the big toe, in the ball of

the foot the two pea shaped bones in the tendon that move the big toe called sesamoids. The

bones work like a pully for the tendon and provide leverage when a person runs or walks. They

essentially absorbed weight that presses on the ball of the foot.

When walking or running a person begins each step by raising their heel and resting their

body weight on the ball of the foot. The person then goes forward by “pushing off” of the big toe

and shifting their weight to the other foot. If the toe does not lift off the ground when pushing off

to instead stay flat on the ground a person runs a risk of suddenly injuring the area around the

joint. Or this could also happen if the person is tackled or fall forward and the toe says flat the

effect is equal to if the person was sitting and bending their big toe backward by hand beyond its

normal limit, causing a hyperflexion of the toe. The hyperflexion either repeated or with enough

sudden force can cause the sprain in the ligaments that surround the joint. This condition is

caused by jamming the big toe or taking part in sports that expose the toe to repetitive pushing

off, such as running and jumping. If the injury is caused by a sudden forceful motion, the injury

can cause instant pain and worsen in a 24-hour span of time. Occasionally when the injury

occurs there is a “pop” that can be felt. Usually, the entire joint is involved, and the toes

movement is limited. Typically turf toe injuries are sudden and are most seen in athletes playing
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on artificial surfaces. The artificial surfaces are harder and less shock absorbent than grass and

can cause the athletes cleats to have an increased risk of sticking but, this can also happen on

regular grass especially if the shoes worn do not provide adequate support of the foot. Often the

injury occurs in athletes wearing flexible soccer-style shoes that allow the foot to bend too far

forward. Turf toe can also be caused by direct injury that leads to damage of the bone beneath

the cartilage.

The most common symptoms of turf toe include pain, swelling, burning sensation,

weakness, inflammation, and limited joint movement at the base of the toe. These symptoms

develop slowly and gradually get worse over a period if it is caused by repetitive injury. The pain

goes up the foot and toward the ankle. The signs and symptoms may suddenly get worse during a

24-hour span of time. It will take approximately two to three weeks for the pain to subside even

after being treated.

On the field of the injury or acute care for this injury would be the R.I.C.E. protocol also

known as rest, ice, compression, and elevation. This treatment procedure is to give the injury

ample time to heal which means the foot needs to be rested and the joint to be protected to

prevent further injury. Taping can also alleviate pain; this can be redone by a medical

professional later. The doctor may recommend an over-the-counter oral medication such as

ibuprofen to control pain and inflammation, steroid injections, and Non-Steroidal Anti-

Inflammatory Drugs (NSAIDS). A person should also avoid positions that cause pain to the area.

If toe pain continues after 24 hours, then, immediately reduce activity levels. A physician

may be needed for treatment. The specialist for this type of injury is a Podiatrist, which is Turf

toe is diagnosed by a doctor asking for a person to explain as much as possible about how they

injured the foot. They may also ask about the persons occupation or participation in sports, type
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of shoes worn, and history of foot issues. Then comes the doctor’s examination of the foot,

noting patten and location of swelling and comparing the injured foot and the uninjured one. The

doctor will most likely ask for an X-ray to rule out any other damage or fracture beneath the

skin. In some circumstances a person could be asked for other imaging tests such as a bone scan,

Computed Axial Tomography (CAT) scan, ultrasound, electrical simulator, cold laser, or

Magnetic Resonance Imaging (MRI) by the doctor. The diagnosis will be made based on the

results from the physical examination and the imaging tests.

The doctor may tape or strap the affected toe to the one next to it to relive some of the

stress from it. Another precaution the doctor may take to protect the joint would be immobilizing

the foot in a cast or special walking boot. The patient may be asked to use crutches so that no

weight is placed on the injured joint. In severe cases of Turf toe, an orthopedic surgeon may

suggest a surgical intervention to correct tendon irritation. Even after immobilization of the joint

ends some patients require physical therapy to reestablish previous range of motion, strength,

and conditioning of the injured toe. Examples of physical therapies are Manual Therapeutic

Technique (MTT), Therapeutic Exercises (TE), and Neuromuscular Reduction (NMR).

A major step of treatment is to evaluate how the injury happened and take steps to

prevent it from happening again. Turf toe can be prevented by wearing shoes with more support

to keep the toe joint from excessive bending and the force of pushing off while walking or

running. A person can also consider using specifically designed shoe inserts that are prescribed

by a doctor or physical therapist. A physical therapist or a specialist in sports medicine can help a

person work on correcting problem in gait that can lead to injury or developing training

techniques to assist in reducing the chance of injury.

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Cite

Turf Toe. Cleveland Clinic. https://my.clevelandclinic.org/health/diseases/17590-turf-toe

Saling, Joseph, et al. ""Turf Toe: Symptoms, Causes, and Treatments" Webmd, 27 Jan. 2022,

https://www.webmd.com/fitness-exercise/turf-toe-symptoms-causes-and-treatments.

Accessed 1 Jan. 1970.

Harwood, Ngan (Kim). "What Is A Turf Toe?" Thefootcareclinic, 30 May. 2019,

https://www.thefootcareclinic.com.au/turf-toe-all-about-turf-toe-and-how-to-manage-big-

toe-pain/. Accessed 1 Jan. 1970.

"Turf Toe | Twin Boro Physical Therapy - New Jersey" Twinboro, NaN undefined. NaN,

https://twinboro.com/body/foot/conditions/turf-toe-nj.html#:~:text=Common

%20interventions%20in%20the%20treatment%20of%20Turf%20Toe,range%20of

%20motion%20of%20the%20foot%20and%20tendon. Accessed 1 Jan. 1970.

"Turf Toe - Foot - Conditions - Musculoskeletal - What We Treat - Physio.co.uk" Physio, NaN

undefined. NaN, https://www.physio.co.uk/what-we-treat/musculoskeletal/conditions/

foot/turf-toe.php#:~:text=If%20you%20have%20or%20suspect%20you%20have

%20turf,15%E2%80%9320%20minutes%20over%20the%20toe%20every

%201%E2%80%932%20hours. Accessed 1 Jan. 1970.