What do Rhamondre Stevenson and Joe Burrow have in common; other than playing in the NFL? They have both missed time this season due to turf toe! Turf toe is a sprain of the ligaments on base of the big toe at the metatarsophalangeal joint (MTP joint) and is caused by excessive hyperextension. It is common for athletes who play sports on artificial turf and can occur when their cleat gets stuck as they try to push off. Symptoms include pain, tenderness, swelling around the big toe, decreased range of motion, and difficulty walking. There also may have been a possible “pop” heard or felt at the time of injury. Treatment of turf toe is often based on the severity of the injury. There are 3 grades of severity with ligament sprains: mild, moderate and severe. These can range from minimal damage with slight pain to severe pain, inability to walk and possible need for surgery to repair the ligament.
Conservative management, or non-surgical management of turf toe is based on the severity of the injury. In mild cases, limiting sport participation, taping and icing may be all that is needed. However, in more severe cases, it may require being in a walking boot or non weight bearing in addition to physical therapy in order to address the limitations in range of motion, soft tissue mobility and strength of the surrounding tissue while the injured ligaments heal. The timeline for return to sports can be anywhere from 1-2 weeks to greater than 1-2 months depending on the severity of the injury. When they do return, a firm plastic or kevlar insert can be used to help prevent the toe from hyperextending again.
It does not only affect athletes, so be careful in the summer when wearing unsupportive shoes like flip flops! Without the support of good shoes, the increased stress on your big toe joint, especially after walking a lot on vacation, can also result in turf toe. Wear supportive footwear when playing sports or doing more than your usual activity level.