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Turf Toe Q & A
Turf Toe Q and A

Turf Toe Is Not Exclusively An American Football Injury

As mentioned in the previous turf toe blog, turf toe injuries happen when the toe is forcibly bent upwards (into hyperextension) a movement that happens when pushing off into a sprint and having the toe get stuck flat on the ground. Hence it can occur in sports or activities where the forefoot is fixed on the ground and the heel is raised off the ground with a force pushing the big toe into hyperextension not just American football but is common in sports including soccer, basketball, wrestling, gymnastics…
Ballet is another common activity for causing turf toe injuries. Standing “on point” is potentially a high risk activity. Looking at what you are asking your body to do when standing on point, you could easily imagine it to be a ballet position invented by podiatrists and foot surgeons to keep them in business. So much so, I would suggest standing on point is probably advisable not to be attempted in the skeletally immature athlete.

What Are The Signs Of Turf Toe?

Typically with turf toe, the injury is sudden and most commonly seen in athletes playing on artificial surfaces. Artificial surfaces are harder than grass surfaces and studs/cleats are more likely to stick during play. Turf toe can also happen on grass, especially if the shoes worn don’t provide adequate support for the foot.

The most common symptoms include:

  • Pain
  • Swelling
  • Limited joint movement at the base of the big toe.

These symptoms may come on slowly gradually worsening over time if caused by repetitive injury or if caused a sudden forceful motion, the injury can be painful immediately. In this situation usually the entire joint is involved, with pain, swelling and restricted toe movement often worsening over the 24hrs immediately following injury.

What Are The Tests For Turf Toe?

Plain X ray and an MRI of the big toe give the best information for investigating turf toe be it an acute traumatic injury or a chronic overuse type injury.

How Long Does Turf Toe Typically Take To Recover?

  • A grade 1 injury (the lowest grade injury) can frequently continue playing with a few modifications like taping of the toe, wearing a stiffened insole to reduce hyperextension at the toe helping to prevent further injury.
  • A grade 2 injury will typically result in a couple of weeks lost playing / training time.
  • A grade 3 injury the most significant injury will often require crutches and “boot” for up to weeks and can take 3-4 months to return to play.

The risk of returning to play too early is that almost always this will end up extending the period of time out, prolonging the disability associated with turf toe.

Preventing Turf Toe

Wearing stiffer shoes can aid in the prevention of turf toe. Often the injury occurs in athletes wearing flexible soccer boots that allow the foot bend too far forward.Wearing shoes with better support and shoes stiffer in the forefoot area help keep the big toe joint from suffering excessive forces and bending too far with pushing off activities when running or jumping.

Disclaimer: Sydney Physio Clinic does not endorse any treatments, procedures, products mentioned. This information is provided as an educational service and is not intended to serve as medical advice. Anyone seeking specific orthopaedic advice or assistance on Turf Toe Q & A should consult his or her general practitioner or physiotherapist or otherwise appropriately skilled practitioner.

Hayden Latimer is the founder of and principle physiotherapist at Sydney Physio Clinic. Since graduating from Otago University, Dunedin, New Zealand he’s gained wide experience practicing across the globe for over 15 years and is now extremely knowledgeable in helping people reduce discomfort and restore function and mobility.


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