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Turf Toe: Treatment, Surgery, and Recovery

Your big toes play a big role in your life. They allow you to walk and run faster, help maintain your overall balance, and can bear twice as much weight as all your other toes combined. So when a big toe is injured, you’ll know it. That’s what makes turf toe, an injury common among many athletes, so painful and problematic.

What is Turf Toe?

Turf toe is a sprain of the big toe joint that usually occurs when playing sports (indeed, the name itself comes from the fact that most of these sports are played on grass or artificial turfs, such as football and soccer, although basketball players, wrestlers, gymnasts, and dancers are also at risk). The injury is the result of excessive upward bending of the big toe joint, caused by running, jumping, or jamming the toe against the ground or an object.

What are the Symptoms of Turf Toe?

Because turf toe is caused by repetitive activities, signs and symptoms usually come on gradually, starting with dull pain and slight swelling and eventually leading to limited joint movement. Of course, a direct injury that damages the bone beneath the cartilage can also occur, with these same symptoms manifesting over a brief 24-hour period.

To determine whether you are suffering from turf toe, a podiatrist (a foot and ankle doctor or surgeon) will examine your foot and take X-rays to rule out any broken bones. If turf toe is confirmed, nonsurgical and surgical treatment options are available.

Nonsurgical Treatment of Turf Toe

Turf toe injuries are classed by grade depending on severity, as follows.

Grade 1 Turf Toe

The least severe of turf toe injury, physicians will usually recommend the RICE protocol of Rest, Ice, Compression, and Elevation for 48-72 hours. Anti-inflammatory medications may also be used to reduce pain and swelling, and better toe protection will be recommended. This may be in the form of supportive shoes concealing a turf toe insert—a hard, carbon graphite plate—which helps restrict the movement of the big toe.

But being labeled grade one shouldn’t be taken lightly. Individuals with grade one turf toe should still limit their athletic activities to ensure the toe properly heals and the injury doesn’t progress. You may want to speak with your physician about immobilization (taping the big toe to a smaller one to reduce movement) or about wearing a walking boot to ensure healing happens.

Grade 2 Turf Toe

The highly active athlete isn’t going to like it, but grade two turf toe generally requires a few weeks of rest to ensure proper healing. Toe-taping and a walking boot will usually be strongly suggested, and the purchase of more protective footwear will be recommended.

Grade 3 Turf Toe

Often requiring up to eight weeks off from athletic activity with symptoms persisting for as many as six months, this is the most severe form of turf toe. Your physician will want to immobilize you through the use of a walking boot or crutches. Because you’ll be off your foot for a while, physical therapy will likely be recommended to limit stiffness of the joint and to get the big toe properly stretched from time to time.  

Surgical Treatment of Turf Toe

Though uncommon, if turf toe symptoms reoccur frequently and athletic performance is being compromised, you may want to consider surgery. Surgery is generally only needed for serious grade three injuries, and are performed if there is a major plantar complex tear or a sesamoid fracture (a hairline break caused by repetitive stress or overuse) to one of the two small bones found below the metatarsophalangeal (MTP) joint. Following surgery, it will be recommended that you do not put pressure on the affected foot for up to a month; you may also be directed to wear a toe spica, a type of splint, during this period. Following this, you will likely be directed to wear a boot for another month. At eight weeks, you should be able to apply weight with supportive shoes that include a turf toe plate.

If you’re suffering from serious turf toe pain and feel surgery is your only option, you may consider asking your physician or surgeon about BandGrip for wound closure following surgery. Completely non-invasive, BandGrip bandages are an alternative to sutures, staples, and tapes, using patented micro-anchors to grip the skin and pull surgical incisions together so the natural healing process can take place with minimal scarring.

Advanced Wound Closure