The curious case of turf toe


Toe injuries are not often associated with the need to remove an athlete from a contest. Turf toe is a painful foot injury that has pushed athletes to the sideline for extended recovery periods.

The human foot is divided into three basic sections: the hindfoot (heel), the midfoot (arch), and the forefoot (toes).  Turf toe affects the forefoot.

Turf toe involves the first metatarsalphalangeal joint.  This joint is the connection between the great toe and the bone that anchors it to the foot.  Like other sprains, it consists of damage to the connective tissues that stabilize the moving parts.

The mechanism of injury consists of the sudden, extreme dorsiflexion (upward bending) of the great toe.  The force results in stretching and tearing ligaments beyond their normal range of motion.  Cartilage can also be injured in more severe trauma.

Inflammation follows with swelling and pain.  Initial treatment includes rest, ice, compression and elevation.

This type of injury usually involves an activity on a firm surface.  Turf toe is most common in football.  The recent popularity of artificial turf over natural turf is part of the reason for the rise in cases.  A force applied to the calf muscle while the knee is flexed is another cause of turf toe.

“The injury is primarily mechanical in nature and so is the treatment.  Putting the foot in a more rigid shoe or an orthotic device will avoid further injury,” said Dr. Joseph DiFrancesca, a Norwich podiatrist who treats many athletes with turf toe.  He also believes that careful selection of athletic shoes with a rigid shank will reduce injury rates.

The healing process for turf toe can take several weeks.  Unfortunately, an early return to activity without sufficient healing can lead to a chronic debilitating injury

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