Turf toe is a specific injury of the great toe joint of the foot. It can run the gamut from mild sprain to complete dislocation of the joint. The injury got its name from its increase in occurrence with athletic play on artificial turf surfaces. The usual mechanism for this injury occurs when the toe rapidly stops on the ground and the rest of the foot and body keeps moving forward causing a hyperextension of the big toe joint. This results in injury to the ligaments that connect the great toe bones to the first metatarsal bone. Pain and swelling and inability to move the toe are the typical symptoms. Diagnosis is usually made with the history of injury. Clinical findings are typical of soft tissue injuries including swelling and bruising. X-rays are needed to rule out fractures or dislocations. Mild to moderate great toe joint injuries can be treated with initial rest, ice and elevation using a stiff soled shoe for walking. Taping the toe to restrict bending can be helpful. Return to activities can be attempted after 2-4 weeks as symptoms and swelling improve. More severe injuries may require immobilization in a walking boot initially for 4-6 weeks. Dislocations of the great toe joint need to be reduced under anesthesia. If closed reduction is unsuccessful, Surgical reduction may be needed. Long term problems after great toe joint injury are not common, provided there is adequate recovery before return to activity. Post traumatic arthritis of the great toe joint is an occasional long term complication of turf toe injuries. Foot orthotics with a modification to restrict great toe motion is helpful at controlling symptoms in people with chronic pain and stiffness of the great toe joint after injury. If you or anyone you know have a problem with the big toe joint, get in to see me for an evaluation. We’ll keep your toes tapping!
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