• Turf Toe

    (Metatarsalphalangeal Joint Sprain; Sprain Big Toe)


    Turf toe is a sprain of the base of the big toe where the big toe meets the foot. It is usually a hyperextension sprain of the first joint of the toe. A sprain is stretching or tearing of the ligaments that support a toe. Ligaments are strong bands of tissue that connect bones to each other. The injury is called turf toe because it often occurs in football and soccer players when playing on artificial turf.
    Turf Toe Swelling
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    Turf toe occurs when the big toe is forced to extend beyond its normal range of motion. This can be caused by:
    • Standing on the balls of your feet as another person falls onto you, causing your big toe to hyperextend
    • Stopping suddenly when running, causing your big toe to slide into the end of your shoe and bend up and backward as you go forward

    Risk Factors

    Factors that increase your chances of getting turf toe include:
      Sports such as:
      • Football
      • Soccer
      • Rugby
      • Basketball
      • Running
      • Gymnastics
      • Dancing
    • Poor coordination
    • Increased ankle dorsiflexion
    • Wearing athletic shoes with flexible soles
    • Playing sports on artificial turf


    Symptoms include:
    • Pain and tenderness in the ball of the foot and the big toe
    • Swelling and bruising of the ball of the foot and the big toe
    • Inability to bear weight on the ball of the injured foot
    • Inability to push off on the big toe
    • Reduced range of motion in the big toe


    You will be asked about your symptoms and how you injured your toe. An exam of your toe will be done to assess the stability of the joint and the severity of the injury.
    Your doctor may need images of your foot. This can be done with:


    Treatment includes:

    Supportive Care

    The toe will need time to heal. Supportive care may include:
    • Rest—Activities may need to be restricted at first. Normal activities will be reintroduced gradually as the injury heals.
    • Ice—Ice therapy may help relieve swelling.
    • Compression—Compression bandages can provide gentle pressure to help move fluids out of the area.
    • Elevation—Keeping the affected area elevated can help fluids drain out or prevent fluids from building up.
    • A metatarsal pad may be advised to cushion the area under the toe.
    • Stiff-soled shoes or rigid orthotics may be advised to keep the toe from hyperextending.
    • A walking boot or cast may be needed for more severe injuries.
    Over-the-counter medication may be advised to reduce inflammation and pain.


    Surgery is only needed to repair turf toe if:
    Surgery is only needed to repair turf toe if:
    • A small piece of bone has been broken off by the injury to the ligament
    • A ligament is torn completely


    Often, turf toe cannot be prevented. However, to reduce your risk of getting turf toe, wear stiff-soled athletic shoes when playing sports.


    American Academy of Physical Medicine and Rehabilitation http://www.aapmr.org

    OrthoInfo—American Academy of Orthopaedic Surgeons http://orthoinfo.aaos.org


    British Columbia Podiatric Medical Association http://www.foothealth.ca

    Achilles Foot Health Centre http://www.footdoc.ca


    Turf toe. Foot Health Facts—American College of Foot and Ankle Surgeons website. Available at: http://www.foothealthfacts.org/Content.aspx?id=1479. Accessed February 24, 2016.

    Turf toe. Ortho Info—American Association of Orthopaedic Surgeons website. Available at: http://orthoinfo.aaos.org/topic.cfm?topic=A00645. Updated August 2012. Accessed February 24, 2016.

    Revision Information

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