Turf toe. How many of you cringed when you read those words? A simple, yet extremely painful injury, turf toe has destroyed the careers of athletes, both amateur and professional.
Turf toe is a sprain of the ligaments around the big toe. Flexor hallucis longus (FHL) is the ligament that runs underneath the big toe, giving you the ability to flex the toe. The injury is caused when the toe is hyperextended, i.e., when your big toe bends too far up toward the top of your foot, and the ligament is damaged by varying degrees of a sprain or tear. Other surrounding ligaments could be damaged in a turf toe injury, but the FHL ligament is the most commonly affected.
There are three levels of sprain severity used to diagnose turf toe:
1st Degree – A slight sprain with localized swelling, inflammation, and pain, but no damage to the metatarsophalangeal (MTP) joint (Where the metatarsal bone meets the phalange at the ball of the foot). Heals fairly quickly, within 1-5 days.
2nd Degree – A partial tearing of the ligament, and possible damage to the MTP joint and surrounding bones. Pain, swelling, inflammation, reduced range of motion. Healing may take up to two weeks.
3rd Degree – A complete tear of the FHL ligament and possible dislocation of the MTP joint and retraction of the muscle. Significant pain, swelling, inflammation, bruising, and loss of movement. Takes up to 3-6 weeks to heal.
It is fairly easy to develop turf toe, especially if you’re involved in sports like soccer, football, or rugby. Ballet and other dancers, as well as volleyball players, martial artists, and gymnasts are also at risk of developing turf toe, but even the average person can suffer from this problem, although it is less common. Loose fitting shoes worn during practice and games on artificial turf are many times the reason it is developed to begin with. However, in physical contact sports like football, when a player is tackled while running downfield, the weight of the other players will bear down on the runner’s calve while his toes are still flat on the turf. This hyperextends the big toe and damages the ligament.
With an injury like turf toe, always remember to RICE:
Rest – Rest allows the natural healing process to begin. Staying active and continued use only exacerbates the injury.
Ice – Immediately applying ice after injury reduces inflammation and pain, and helps speed up the healing process.
Compression – A compression bandage will provide protection and support for the injured toe, as well as help to manage inflammation. However, you should only apply this for ten minutes at a time to avoid restricting blood flow.
Elevation – Keeping your injured foot resting above your heart will reduce the amount of swelling to the area.
Massage therapy is often incorporated into the healing process in many injuries to help manage pain and improve blood flow to bring nutrients and healing to the area. Increasing circulation not only brings nutrients, but also removes impurities and waste and acid build-up in the tissue. Massage has been, and continues to be, used in reducing recovery time after an injury. What most people don’t realize is if it is incorporated into your health and maintenance routine before an injury, you reduce the risk of hurting yourself to begin with. Utilizing the benefits of massage during the healing process can cut the time almost in half, especially when used in conjunction with the RICE technique. Continuing to receive regular massage after an injury can also lower your risk of reinjuring yourself in the future.
Taping is another way to help heal a turf toe injury if you don’t have the luxury of staying off your feet for 3-6 weeks. Taping helps keep the toe immobilized, which removes an amount of risk if you are back on the field before making a full recovery. Over-the-counter drugs like ibuprofen or aspirin can be used to manage pain and inflammation as well during the healing process.
If you believe you have developed turf toe, you should see your doctor to have it properly diagnosed. He will provide a physical examination of the injury, and may ask to take x-rays or other imaging tests to determine the damage done to the ligament. It is not always possible to get in to see your doctor immediately, so remembering the RICE and taping techniques to deal with the initial injury will get you a head start on healing.