A Turf toe injury or first metatarsal-phalangeal (MTP) joint sprain is a sports injury to the joint capsule and ligaments that connect the big toe to the rest of the foot, causing pain at the ball of the foot. The toe joint consists of nine ligaments, four bones, and three muscular attachments.
What Causes Turf Toe?
It occurs when the big toe gets bent too far upward (hyperextension) or downward (hyperflexion). This can occur during a sports activity by jamming the big toe, pushing off a hard surface, or pushing off repeatedly from the ball of the foot when running or jumping.
The severity of the turf toe injury depends upon the degree of damage that occurs to the ligaments and joint capsule. Injury can range from a mild stretch referred to as a Grade 1 to a complete tear or Grade 3 .
Symptoms
Symptoms of turf toe include:
- Foot pain at the base of the first toe that is worse with sports activity like running and jumping.
- Swelling and stiffness.
- Bruising and limitation of motion in more severe injuries.
Turf toe presents with pain at the base of the big toe, worsened by running and jumping, along with swelling, stiffness, bruising, and limited motion in severe cases. These symptoms are key for prompt diagnosis and treatment.
How is Turf Toe Diagnosed
Turf toe is diagnosed based on your mechanism of injury and physical examination of your foot. X-rays are important to look for fractures, but an MRI may be necessary to evaluate the soft tissue (ligament and capsule) injury at that joint.
Turf Toe Treatment
Treatment begins with rest, elevation, ice, and anti-inflammatory medication. A stiff-soled shoe, walking boot, or cast may be used to limit motion at that joint and allow healing. Physical therapy can be used after the initial treatment to restore motion and strength. Surgical treatment from a sports medicine orthopedic surgeon may be recommended for turf toe if symptoms do not improve after several months of rest and physical therapy if the joint range of motion is severely limited, or if there are associated injuries such as a fracture. Return to sports can be done as early as two to three weeks for low-grade injuries but may take more than three months for high-grade injuries. A stiff-sole shoe insert or shank may be necessary to allow for a return to sports.
When Can You Return to Sports After Turf Toe?
The timeline for returning to sports after turf toe varies based on the injury’s severity. Low-grade injuries may allow for a return in as early as two to three weeks, while high-grade injuries may require more than three months of recovery. Utilizing stiff sole inserts or shanks can aid in the return to sports.
For more information or specific medical advice, please consult with a healthcare professional specialist at Rady Children’s Hospital’s sports medicine program for further consultation regarding turf toe treatment and care.