| Turf toe is a condition of pain at
the base of the big toe, located at the ball of the foot. Turf toe is
usually caused from either jamming the toe, or pushing off repeatedly when
running or jumping. The most common complaint is pain at the base of the
toe, but you may also have symptoms of stiffness and swelling.
The name turf toe comes from the fact that this injury is especially
common among athletes who play on artificial turf. The hard surface of
artificial turf, combined with running and jumping in football and soccer,
make this a frequent consequence of Astroturf play.
Swelling and pain at the joint of the big toe and metatarsal bone in the
Pain and tenderness on bending the toe or pulling (stretching) it upwards.
How is it diagnosed?
Your health care provider will ask about your symptoms and examine your
toe. He or she may order an x-ray to be sure you did not break your toe.
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Turf toe can sometimes look like gout, a type of arthritis of the big toe.
Your provider may order tests to be sure you do not have gout.
Footwear: Throughout the past several decades, football shoes have
evolved from the traditional 7-cleat shoe containing a metal plate in the
sole designed for grass surfaces, to a more flexible soccer-style shoe
designed for grass surfaces, and finally to shoes designed for artificial
These changes in shoe type have allowed increased speed at the
expense of stability. The absence of a stiff sole places the forefoot, and
specifically the MTP joints, at much greater risk for stress-type
injuries. Athletes wearing flexible turf shoes are much more prone to
injury than those wearing shoes containing a stiff forefoot.
Synthetic surfaces: Artificial grass contains a higher coefficient of
friction and tends to lose some of its resiliency and shock absorbency
The combination of increased surface friction and a hard
undersurface is believed to play a major role in the natural history of
the injury. A higher coefficient of friction places the forefoot at
greater risk to become fixed to the playing surface. Thus, the forefoot
becomes more prone to an external force that places the hallux MTP joint
in a position of extreme dorsiflexion.
Ankle range of motion: The risk for turf toe appears to be related to the
range of ankle motion in those injured. A greater degree of ankle
dorsiflexion has been correlated with the risk for hyperextension to the
first MTP joint.
How is it treated?
Treatment may include the following:
putting ice packs on your toe for 20 to 30 minutes every 3 to 4 hours for
the first 2 to 3 days or until the pain goes away
elevating your foot on a pillow
taking anti-inflammatory medicines prescribed by your health care
One of the keys to treating turf toe is keeping the toe from moving too
much. Your toe can be taped to restrict how much it moves. You may have a
special insole placed in your shoe that will reduce the movement of your
How long do the effects last?
The length of recovery depends on many factors such as your age, health,
and if you have had a previous toe injury. Recovery time also depends on
the severity of the toe injury. Pain from turf toe may last several weeks
or longer. You need to stop doing the activities that cause pain until
your toe has improved. If you continue doing activities that cause pain,
your symptoms will return and it will take longer to recover.
A doctor needs to examine the athlete who may have turf toe. Treatment
consists of applying ice, heat, and tape or stiff-soled inserts in the
shoe to restrict movement of the great toe. The athlete must follow the
prescribed treatment to alleviate this disabling condition and to return
to his or her normal level of function.