Turf toe is a common condition with a unique name. This moniker for sprained ligaments in the joint of the big toe gained popularity when athletes began to play sports on artificial turf instead of natural grass.

Turf toe occurs when speed and force are applied to the big toe while it is in the bent or flexed position.

Think of a runner in the starting blocks at the beginning of a race. Note the placement of the foot. Heels are up; toes are bent and braced on the ground. The big toe is in perfect position to suffer a sprain. As the sprinter pushes off the block, the toe absorbs the force and drives into the ground before lifting into the runner’s stride.

The transition between the push and the lift is critical. When the big toe bends too far, or an athlete pushes off of the toe too fast, the force causes injury. The soft tissues and ligaments surrounding the joint between the toes and the foot (metatarsophalangeal joint) can be strained, sprained, or torn. In severe cases, the joint is completely dislocated.

But participation in sports is not the only way people experience turf toe. People are also susceptible to the condition when they wear soft-soled shoes or stub their big toes.

What are the symptoms of turf toe?

The symptoms of turf toe vary depending on the severity of the injury.

  • Tenderness
  • Swelling
  • Bruising
  • Limited movement
  • Pain when moving the toe or walking

If you experience severe pain in your big toe or pain that lasts longer than 48 hours, contact your primary care provider or an orthopedic specialist for diagnosis and treatment.

How do you prevent turf toe?

The best way for most people to avoid turf toe is to wear shoes that offer protection and support for the big toe.

Athletes should talk to their coaches, athletic trainers, or sports medicine specialists and take part in conditioning programs that strengthen the toes, feet, and supporting leg muscles.

Building strength and practicing on soft or cushioned surfaces whenever possible are two fundamental ways athletes can prevent turf toe. When given an option, they should choose the natural grass of a football field instead of concrete covered with artificial turf, a hardwood basketball court rather than an inflexible asphalt driveway, or a rubberized track instead of a hard roadbed.

How is turf toe treated?

As with all joint injuries, early treatment leads to the best range-of-motion in the future.

Treat mild cases of turf toe like other mild sprains or strains; PRICE them.

Protect your toe.
Rest your toe; stay off your feet.
Ice the toe for 20 minutes and then remove the ice for 20 minutes. Repeat as needed.
Compress (apply pressure) and stabilize the injury with an elastic compression bandage.
Elevate your toe above your heart. Use over-the-counter pain relievers as needed.

A grade-2 sprain often requires immobilization. Your healthcare provider may fit your foot and lower leg with a brace or walking boot for a week or more. As your condition improves, you can stabilize your big toe by taping it to your second and third toes.

A grade-3 sprain or fracture takes several weeks to heal in a brace or cast. After the brace is removed, physical therapy may be necessary to regain function, prevent stiffness and preserve future joint movement.

The most severe cases of turf toe require surgery to repair and reposition the torn ligaments.

When should you go to the doctor?

If you stub your toe or experience pain while being active and the pain has not diminished in 48 hours, seek medical attention.

Your healthcare provider will take an X-ray to see what is going on inside your toe.

If you would like to see an orthopedic provider right away, you can visit Bone & Joint’s Walk-In Care center without an appointment.