Turf Toe

Turf toe is an injury that affects the base of the big toe. It is a painful injury that occurs in athletes who play turf or field sports, such as soccer, baseball, or football. It is a condition that is caused by pushing off the big toe forcefully over and over again, such as while jumping or running, or by jamming the big toe. It is an injury to the joint at the base of the big toe. The most common symptoms of turf toe include swelling, pain, and limited joint movement. Symptoms generally develop slowly and get worse over time. If the injury is caused by a sudden forceful motion, however, it can be immediately painful and worsen rapidly. It is divided into 3 grades: grade 1 causes slight swelling, grade 2 causes moderate swelling and bruising with tenderness and limited toe movement, and grade 3 causes severe bruising and swelling, severe tenderness, and makes it very painful and difficult to move your big toe.


Turf toe can happen in any activity or sport when the heel is raised, the forefoot is fixed on the ground, and a force causes the big toe to hyperextend. Turf toe commonly occurs among athletes who play football on artificial grass. Artificial surfaces are less shock absorbent and harder than grass surfaces. Athletic shoes made for artificial surfaces are more flexible and softer than those shoes designed for grass surfaces. While this provides the athlete with greater agility, it offers less stability in the forefoot, which can lead to turf toe. Turf toe usually occurs when someone falls on the back of the calf while the tips of the toes and knee of that same leg are touching the ground. This results in a hyperextension of the toe, resulting in an injury to the joint. In rare cases, turf toe can be caused by improperly cutting toenails. Toenails can become long enough that they rub on the shoes. When the person engages in a physical activity like running, the metatarsal can become hyperextended.


The RICE protocol is an effective way to treat many sports-related injuries, and turf toe is no different. It is important to rest the injured toe. Take a break from the exercise or activity that caused the injury. You should also avoid putting weight on your foot or walking. You should also ice the injured toe. Ice for approximately 20 minutes at a time, several times throughout the day. Make sure the ice is wrapped in a thin towel or cloths to prevent causing skin damage, like frostbite. You should also use an elastic bandage to help compress the area. Lastly, be sure to keep your toe and foot elevated above the level of your heart to help reduce swelling. Over-the-counter medications can be used to help provide pain relief. For grade 2 injuries, your doctor may suggest a walking boot for approximately a week. For a grade 3 turf toe injury, you may be immobilized in a cast or walking boot for several weeks to help stabilize the toe.


The length of recovery time depends on the severity of the injury. A grade 1 injury shouldn’t limit an athlete too much. They may need only a couple of days off, and should be able to play through it if they have too. A grade 2 injury may take a week or two to heal. A grade 3 injury may last over a month. Once you begin exercising again, try to limit the overall movement of your  toe. You should wrap it or brace it with an elastic wrap or possibly tape it to try to restrict movement and bending. You may also want to wear shoes that feature a stiff insole. This will limit how much the toe is able to bend when you walk or run. It is important that your exercise and rehab program improves flexibility and enhances strength so you can get back to the level you were at before the injury. To help prevent turf toe, avoid practicing or playing on poorly maintained playing fields if possible. Make sure to wear proper footwear, and avoid jamming your big toe into a hard surface. The American Academy of Orthopaedic Surgeons has more information on turf toe and rehab details.