The first big toe joint is a complicated structure. Not only does it take most of the weight and torque while running, but also while bending down and walking on hard floors.
Like the other metatarsal-phalangeal joints, the big toe joint has a smooth cartilage interface and large range of motion, but this joint also has two bones underneath it called ‘sesamoids’.
The true “turf toe” definition is the rupture of the ligaments at the bottom of this joint that hold these bones in place. Once ruptured, the treatment ranges from 4 weeks in a walking boot to 8 to 12 weeks after surgical repair.
Pain ranges from dull to sharp, depending upon the level damage or injury to the joint.
A firmer shoe can relieve the direct or indirect pressure and minimize the movement of the big toe joint. Make sure that the shoe has enough room at the end (the toebox), about the width of your thumb, and that front of the shoe is high enough to allow your toes to move freely.
Temporary arch supports and supportive athletic shoes will reduce pressure and pain at the big toe joint. Custom molded orthotics are the best solution for immediate and long term turf toe treatment.
Over-the-counter padding can be bought and placed on top or around the big toe joint to prevent pain with restrictive shoes.
Anti-inflammatories both topical and oral may help for chronic pain. Injection therapy is most effective for the acute pain associated with turf toe.
Surgical treatment options for a severe or chronic painful turf toe can vary. A simple soft tissue capsule or ligament tear requires a non-weight bearing status for 3 to 4 weeks, partial weight bearing in a walking cast boot with support 4 to 6 weeks and full weight bearing with physical therapy 6 to 8 weeks.
Sesamoid bone involvement can require fixation or removal of the bone(s). full recovery can take up to 12 weeks.
Yes, turf toe is a serious injury if the plantar plate or sesamoids are injured. The big toe joint handles most of the pressure, including the ‘push off’ propulsion force of the foot during normal walking, and the exponential force during running.
You should see a doctor for turf toe for persistent pain, swelling and to rule out serious injuries like a sesamoid fracture.
You should stretch a turf toe if it is either healed or close to being healed. The fibrous tissue that is either injured or torn at the bottom of the big toe joint can contract during or after healing. Stretching the big toe upwards (dorsiflexion) to the point of tension or mild discomfort 4 to 6 weeks after injury can help maintain the range of motion and even prevent reinjury.
It takes 4 to 6 weeks for a big toe injury to heal if the patient remains partial or non-weight bearing in a walking boot.
The fastest way to cure a turf toe is to stay non-weight bearing with crutches 3 to 4 weeks or until there is no pain with weight bearing activities.
“I have never been to any kind of doctor that has been as thorough and seemed to truly care about my well being. My injury was 6 months ago and Dr. Moore has seen me at a minimum of every 3 weeks to check on it and find different ways to relieve my pain and try to help me gain my mobility back. This is a workman’s comp case that has been a heck of a struggle for me and Dr. Moore and his staff have been so helpful in pushing to help me get approval for everything I may need. Sam is so kind and genuine, she is always gentle and caring when she is taking care of me. I would 100% recommend Dr. Moore and his team to anybody.”
Contact Moore Ankle and Foot Specialists today to go over your options for turf toe treatment and start healing.
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