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Close up of a soccer player's legs on astroturf

Turf Toe: Seek Treatment Early

By: Lauren Crockett, MS, ATC, VATL

Joint pain. Stiffness. Swelling.

If your child plays sports and experiences these symptoms in their big toe, they may have a condition that’s commonly called “turf toe.”

Despite its name, turf toe can affect athletes whether they play on artificial turf or natural grass. The condition is technically a sprain of the metatarsophalangeal joint, which connects the bones of the foot to the bones of toe, and usually occurs when athletes have their heel raised with their forefoot planted on the ground. Pushing off into a sprint, for example, can force the big toe to flex more than it should.

It is most commonly seen in football players, linemen in particular, but also occurs among athletes who play soccer, basketball, field hockey, and rugby.

Fortunately, most turf toe injuries do not require surgery to get better. However, it is important to seek treatment early for your child so more serious complications do not develop.

Left untreated, turf toe can become a debilitating injury. During normal walking, the big toe bears 40 to 60 percent of a person’s body weight. That load can increase up to eight times during running and jumping. Athletes can miss significant playing time due to persistent symptoms. If addressed correctly and quickly, athletes can usually get back onto the field at a pre-injury level.

Your child’s treatment plan will depend on the severity of their joint injury. Rest and applying ice are often the first steps to reduce pain and swelling. Additionally, your child’s doctor may recommend a non-steroidal anti-inflammatory drug, rehabilitation, and taping or bracing to promote healing. Turf toe injuries are staged into three categories:

  • Grade 1: These injuries are typically considered mild. At this stage, your child may need to rest for a few days.
  • Grade 2: These injuries may require up to two weeks of rest before your child can begin easing back into activity.
  • Grade 3: These injuries typically require several weeks of immobilization and rest. It may take up to six months for turf toe symptoms to resolve.

If your child’s symptoms persistently cause a decrease in athletic performance or extended loss of playing time, surgery may be necessary to correct the problem.

No matter how mild or serious an athlete’s turf toe symptoms may be, many benefit from wearing proper footwear. Flexible cleats can predispose athletes to toe injuries because of their limited support. It’s imperative to add a rigid material to the shoe or cleat of an athlete who may be showing signs of turf toe. Additionally, orthotics with a Morton’s extension can help support the injured toe.

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About CHKD Sports Medicine

About CHKD Sports Medicine  CHKD's sports medicine program offers the most comprehensive care for your young athlete. From diagnosis and treatment to customized rehabilitation plans, we specialize in physical therapy and injury prevention programs for active children and teens. Our team is composed of pediatric orthopedic surgeons, sports medicine specialists, physician assistants, certified athletic trainers and pediatric sports medicine physical therapists.