Turf Toe: Treatment and Prevention
The big toe may seem like a minor contributor to sports performance and overall health, but this tiny area of the body actually provides an essential element of stability, propulsion, and control. And when the big toe is in pain, or its range of motion is limited, this seemingly minor problem can actually cause considerable suffering and can even bring a promising sports career to an end. This often happens in the form of turf toe, or metatarsalphalangeal joint sprain.
What is Turf Toe?
The ligaments that connect the big toe to the ball of the foot are complex, and are essential to the moves involved in walking, running, jumping, and quickly changing direction. When a person takes a forward step, the heel leaves the ground first, and as this happens, the weight of the body shifts forward onto the ball of the foot and the big toe bends in a backward motion. The ligaments involved in turf toe are extended at this point, and as they straighten out, they help push the foot off the ground and allow the body to fluidly shift all of its weight to the other foot.
If this motion happens too suddenly, or if it happens in a forceful way that’s repeated over and over again, the ligaments can become strained, damaged, or inflamed. This is a very common problem for football players, who often stop suddenly while engaged in a forward motion, and who tend to have a large amount of body weight that becomes entirely concentrated on the ball of the foot in this moment. Other sports with high incidents of turf toe include gymnastics, dance, and soccer. Training in cleats can lead to turf toe, since cleats can hold the foot to the ground during the moment of liftoff, which can strain the ligaments. Tackling can also lead to a sudden backward bending motion in the toe area.
While turf toe is caused by constant or sudden hyperextension of the toe ligaments, the likelihood of this happening is increased when athletes train on hard surfaces or artificial turf. Dancers who subject the feet to exaggerated bending and sudden impact with a hard floor sometimes feel no pain in the toe during one moment and severe pain and limited mobility in the next.
What Does Turf Toe Feel Like?
There are two ways turf toe can occur: Through sudden motion and impact, or though repeated chronic strain of the ligaments. In the first case, athletes experience a sudden forceful motion that sometimes includes a sound in the foot, like a pop or a crack. The foot may be painful immediately, but sometimes it takes a short time for the pain to take hold. In most cases, no matter how severe it is at the beginning, the pain tends to get worse during the next 24 hours. Pain is often accompanied by swelling, heat, and a limited range of motion in the toe and foot. When the hyperextension of the ligaments is repeated and chronic, the pain tends to increase slowly and can be severe when the foot is subjected to strain and impact.
How to Cure Turf Toe
Immediately after the injury occurs or becomes noticeable, the athlete should stop running and jumping for the time being. The principles of RICE—rest, ice, compression and elevation—should be applied.
1. Rest the foot. Stop training and sit still. During the next several days, keep weight off of the foot whenever possible and take a break from workout routines that place stress on the ligaments.
2. Ice the tender area around the toe and the ball of the foot. Use a bag of frozen vegetables if possible, like peas, since the bag can be shaped around the area where the ligaments are the most damaged. Keep the ice on the foot for twenty minutes at a time, three to four hours a day.
3. Compression with a brace or bandage can keep fluid from building up in the area, which can ease the pain of swelling and speed the healing process.
4. Elevation can also help drain away fluid, lymph, and excess blood, which can speed healing and reduce pain. Keep the foot propped above the level of the heart.
If the pain is especially severe, or if the foot doesn’t respond to treatment or isn’t completely healed within a few weeks, an MRI scan may reveal a more serious problem, like a ligament that’s completely torn rather than just strained. Athletes should use their judgment and see a doctor sooner rather than later to have the issue resolved. A doctor may prescribe pain medication, and may recommend crutches or a brace to help the toe heal properly. Surgery may also be necessary depending on the severity and nature of the problem. In any case, physical therapy and range of motion exercises will probably be recommended to bring the foot back to its full function.
Preventing Turf Toe
The best way to prevent turf toe from happening in the first place is to pay attention to training conditions and gear. When possible, it’s always better to train on grassy or cushioned surfaces than hard ones. Wooden floors are better than concrete, and real earth is better than fake turf. Shoes are also an important contributor to the health and strength of the foot. Runners should change their shoes every 500 miles, and other athletes and dancers should make sure their shoes are stable and provide adequate support. Training shoes should never been worn out or improperly sized.
It’s also a good idea to maintain strength, balance, and coordination in the muscles of the feet, legs and core. The stronger and more balanced the body, the less subject it will be to sudden strain and injury. Strength training a few times a week using targeted suspension and resistance equipment can help. For more information about working resistance training into your routine using the Kbands and KB Duo, take a look under the products tabs towards the top of the website.