Turf Toe Injuries/MTP Sprain

What are Turf Toe Injuries? 
Commonly reported as a sports-related injury, turf toe refers to a condition where there is damage to structures around the big toe caused by hyperextension (bending the toe back too far) (McCormick & Anderson, 2010). Pushing forcefully off the big toe, as people do when they begin to run or jump, places repeated stress on the metatarsophalangeal joints (MTP) around this area. Sports that involve frequent stopping, starting, and sudden changes of direction (e.g. basketball, soccer, etc.) can be a main cause of turf toe. 

Symptoms of turf toe include pain when extending the big toe, or bearing weight upon it, a “popping” feeling in the foot when the injury occurs, swelling and inflammation, as well as instability and limited movement of the big toe. According to a report by McCormick & Anderson (2010), most turf toe injuries are mild and do not require surgical treatment, however in more severe cases, surgical procedures may be necessary. 

Doctors grade turf toe injuries from 1 to 3 depending on the extent of damage to the MTP joint, sesamoids, and surrounding tissues, ligaments, and tendons (McCormick & Anderson, 2010). 

Grade 1: Plantar complex is stretched, leading to tenderness and swelling 

Grade 2: Partial tearing of the plantar complex, resulting in tenderness, swelling, and bruising. Movement is restricted

Grade 3: Plantar complex is torn, leading to severe tenderness, swelling and bruising. The toe is very painful and difficult to move. 

Prevention?

  • Wearing flexible footwear while running on artificial turf, or other hard surfaces
  • Wearing shoes with better support, to stop the toe from bending excessively when a person pushes off of it
  • A physical or sport therapist can work with individuals to correct an problems with their gait, which could enhance their techniques while playing sports
  • Performing exercises and stretches such as the following, to improve body alignment (Jenn, 2016):
    • Shin Dorsiflexor Release
      • Find a stable, firm surface roughly at knee height
      • Place a tennis ball under the front of the shin and kneel onto it
      • Move the ball along the sore spots to target the entire muscle
      • Perform on each leg for 3-5 minutes
    • Soleus Release
      • Sit on the ground with your lower calf on top of a tennis ball or foam roller
      • Place the other leg over the one being released to add pressure
      • Roll yourself up and down over the ball, focusing on the tender spots
    • Big toe mobilization with movement 
      • Stand with one foot in front of you, and one behind, with the weight on the front foot
      • Anchor a resistance band attached to your front foot to a chair behind you
      • Rock your front knee forward as far as you can without raising your heel, pushing your knee outward
      • Repeat for 3 sets of 10

If you have any pain during exercises, or are unsure about what you are doing, please consult your local physiotherapist before continuing.

Jenn, F. (2016). Podiatrist-recommended turf toe exercises for athletes. Retrieved from https://healingfeet.com/sports-injury-2/podiatrist-recommended-turf-toe-exercises-athletes

McCormick, J., & Anderson, R.B. (2010). Rehabilitation following turf toe injury and plantar plate repair. Clinical Sports Medicine. 29(2). doi:10.1017/j.csm.2009.12.010