How to Treat Turf Toe

Aug 6, 2020

When you mention a sprain, the first place many people will think of is the ankle. Considering how common ankle sprains are, that’s really not surprising.

But sprains can take place in many other joints of the body, too. If you’ve experienced a sudden, wrenching pain and swelling in your big toe, there’s a good chance that a sprain has happened there as well. The common name for it is “turf toe.”

But no, you don’t need to be on turf for it to occur. 

How Does Turf Toe Happen?

Any sprain occurs when one or more of the ligaments that surround and stabilize a joint become overstretched or torn. Turf toe is no different.

The large joint at the base of the big toe – the metatarsophalangeal (MTP) joint – is surrounded by ligaments, a tendon, and other connective soft tissues that help form the plantar complex. A strain or tear in any of these soft tissues may be diagnosed as turf toe.

Typically, turf toe occurs in situations where the forefoot is firmly fixed on the ground but the rest of the foot keeps moving, forcing the big toe into a state of hyperextension.

The “turf” in “turf toe” comes from how often this injury can happen in sports played on turf. The odds of the forefoot getting firmly planted increases while wearing cleats, and the injury can happen when the front of the foot just doesn’t want to keep moving (and someone is running up to slam into you).

However, as we’ve noted, you don’t necessarily have to be playing on turf to be at risk for this type of injury. It can happen in other situations as well. 

Morning jogging with pet: man runs together with his beagle dog

What Are the Symptoms of Turf Toe?

Since there are different parts of the plantar complex that can be injured, and to different degrees, not every case of turf toe may feel exactly the same. Common symptoms include:

  • Pain in the big toe and/or the front of your foot, that is sensitive to touch
  • Swelling
  • Bruising
  • An inability to bed the big toe down or put weight on it

In some cases, the big toe joint may feel “loose,” which often signifies that it has been dislocated.

The severity of the symptoms often depends on the severity of the injury itself. We divide this into three grades of damage:

  • Grade 1 – The plantar complex has been stretched and strained. This often results in some localized tenderness, pain, and mild
  • Grade 2 – Something in the plantar complex has partially torn. Pain and tenderness is more widespread, and swelling and bruising can be more evident. It will probably hurt to move the toe, and your range of motion may be limited.
  • Grade 3 – There is a complete tear within the plantar complex. Pain, swelling, and bruising are often severe. Moving the big toe is difficult and very painful (and you absolutely shouldn’t do it!).

The severity of the injury will certainly have an effect on treatment, but that doesn’t mean you should ignore a potential case of turf toe that is mild!

How To Treat Turf Toe graphic

Treating Turf Toe

If you suspect you have sprained or otherwise injured your big toe in any way, the first action you should always take is stopping what you are doing.

Trying to “walk it off” or play through pain, no matter what you’re playing for, can greatly increase your risk of further injury, which in turn can have more severe and longer lasting consequences. It’s not worth hurting yourself more.

Get off your affected foot as soon as you can and give us a call. We can hear your symptoms and recommend whether you should come in for a closer examination. We can also arrange an appointment via telemedicine so we can get a direct look at your foot without you having to come in.

Whether an upcoming appointment has been scheduled with us or not, follow standard RICE protocol unless we recommend otherwise:

  • Rest – Continue to avoid bearing weight on the foot.
  • Ice – Apply cold packs (or ice wrapped in thin towels) for up to 20 minutes at a time, several times per day. Never apply ice directly to the skin, however, as it could cause damage.
  • Compression – Apply an elastic bandage if you are comfortable doing so. If you are not, it is better to omit this step.
  • Elevation – Keep your foot above the level of your heart. This is as simple as using a recliner or propping your foot up on pillows when you sleep.

If you need to come in for an examination, we may conduct X-rays or other imaging tests to check on the severity of the injury.

Depending on what we find, we might recommend that you wear a brace or walking boot to help keep the joint immobilized and give it a better chance to heal. In more severe cases, even stricter immobilization equipment may be recommended, such as a cast.

If healing and recovery do not proceed as expected, or you have a severe tear in your plantar complex, surgery might be necessary. We will be sure to fully discuss what to expect from such a procedure should the need arise.

Man stretching legs and feet sitting on a track

Don’t Let Sports Injuries Take You Out of the Game

Whether you’ve been hit by turf toe, an ankle sprain, stress fractures, or any of a host of other foot and ankle sports injuries, never hesitate to seek the help you need. The sooner you do, the faster you can get back to the activities you love at full strength and with much less risk of reinjury.

Schedule an appointment with Rainier Foot & Ankle Associates by calling (360) 761-1285 or by filling out our online contact form. We’ll be happy to see you!