Turf Toe

  • Author:
    Jayson Goo, ATC, MA, CKTI

    Jayson Goo, ATC, MA, CKTI, a National Athletic Board Certified Athletic Trainer, graduated from the University of Hawaii and earned his master's degree in human performance with a specialty in corrective therapy from San Jose State University. Jayson also is an active Certified Kinesio Taping Instructor.

  • Medical Editor: William C. Shiel Jr., MD, FACP, FACR
    William C. Shiel Jr., MD, FACP, FACR

    William C. Shiel Jr., MD, FACP, FACR

    Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.

Foot pain is a common symptoms of turf toe.

Turf Toe Symptom

Foot Pain

Injury to the bones and joints of the foot can be caused by a single blow or twist to the foot or also by repetitive trauma that can result in a stress fracture. A blunt-force injury such as someone stepping on your foot may result not only in a bruise (contusion) injury but also damage to the muscles and ligaments of the foot. Direct blows to the foot can cause bruising, breaking of the skin, or even fracturing of bones. Metatarsalgia is from the repetitive irritation of the joints of the ball of the foot. The term "stone bruise" is commonly referred to as a specific localized pain and tenderness of the ball of the foot. "Turf toe" is a common athletic injury in which the tendon under the joint at the base of the big toe is strained. Trauma to the toenail can cause pooling of blood under the nail and the temporary or permanent loss of a toenail. Repetitive trauma to the bones, muscles, and ligaments can result in extra bone growth known as spurs or exostoses.

Quick GuideBurning or Swollen Feet? What Foot Pain Says About Your Health

Burning or Swollen Feet? What Foot Pain Says About Your Health

What is turf toe?

Turf toe is an injury to the underside of the big toe and joint at the base of the big toe. This joint, the first metatarsophalangeal (MTP) joint, is commonly known as the "ball of the foot." Turf toe is specifically a joint sprain of the big toe. The sprain may involve damage to ligaments, tendons, or bone separately or in combination.

The sprain, often is a result of playing on artificial surfaces, was first documented in American football players in 1976. Turf toe was recognized as a common injury soon after the invention of AstroTurf in 1964. There are varying degrees of severity of the sports injury. While sometimes mild, which injured athletes can play through, turf toe is sometimes a more serious health condition and can be career-ending.

The amount of damage to the ligaments, tendons, bones, and surrounding tissues determines the severity of the injury. Though often referred to as a ligamentous injury or sprain of the MTP joint, the tendons may be strained and bones may be fractured. American football players such as Tom Brady and Deion Sanders and soccer great George Best are among the notable athletes to have suffered from this sports injury.

What is the anatomy of the big toe?

The first MTP joint is a hinge joint with sliding and rotational components. There is also a set of paired sesamoid bones underneath the base of the big toe. There are nine ligaments that span the joint, which is covered by a capsular ligamentous balloon-like structure that helps holds the synovial fluid that lubricates the joint. The primary movers or muscles that move the joint of the MTP are the flexor hallicis brevis. Flexor hallicus longus are the muscles that plantar flex or curl the big toe; contraction of the extensor hallicus longus and brevis lift the toe and important muscles in normal foot function.

The primary movements of the joint at the base of the big toe are flexion and extension. The toe is also capable of being moved closer to and away from the foot.

What causes turf toe?

Turf toe commonly occurs as an athlete tries to push off of the ground, causing a stretch or hyperextension injury to the structures on the bottom of the big toe.

In a 1993 survey of 80 National Football League players, 36 players reported that they had incurred a turf toe injury and 83% of those players reported that the injury had occurred on artificial turf. Older players and those with more experience in professional football were more likely to have sustained a turf toe injury.

Turf toe injury does cause a lasting decrease in first MTP motion and increased plantar foot contact pressures in football players.

Turf toe, foot, and/or toe pain (metatarsalgia) may also be caused by plantar fasciitis, arthritis, contusions, blisters, bunions, neuromas, sesamoiditis, hammertoes, fractures, and gout.

Medically Reviewed by a Doctor on 9/7/2016

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