Ankle and Foot

Turf Toe. Symptoms and Treatment

Details

Published on Monday, 30 January 2012 17:51

Written by David Micca, DPM, FACFAS, CWS, FAACWS

Turf Toe Symptoms and Treatment -by David J. Micca, DPM, FACFAS, CWS, FCCWS

Symptoms of Turf Toe

Symptoms include pain with the onset of activity. Swelling and stiffness of the great toe joint increases with activity. Bruising may occur following the initial injury but is not commonly seen as turf toe progresses.

There may be radiating pain if that extends from the 1st MPJ dorsally (top of foot) towards the ankle. This is usually due to a chronic extensor tendinitis/capsulitis. Transfer of the weight to the lateral side of the foot to aid in propulsion and limit 1st MPJ dorsiflexion. Chronic pain to the outside and ball of the foot may ensue as a result of this compensation.

Treatment of Turf Toe

Most turf toe injuries are treated non-surgically. If surgery is performed for this condition it is usually after years of repetitive jamming and destruction of the joint requiring joint replacement surgery. Prevention by addressing the biomechanical influences for turf toe is the key to treating this condition pallitively.

An initial assessment to rule out fractures or dislocations is made. Once ruled out, treatment is geared at protecting the soft tissues and allowing for functional rehabilitation.

1. RICE protocol: Rest and restricted motion at the 1st MPJ. Rigid soled shoes to limit hyperextension during propulsion. Ice during the first 48 hours of injury. Compressive dressing and elevation
2. NSAIDs as an adjunctive therapy to reduce inflammation of the joint
3. Taping of the hallux with a crossing loop over the top of the proximal phalanx to splint the first MPJ and protect the soft tissues while restricting hyperextension
4. Physical therapy modalities such as whirlpool and ultrasound with cold compression to improve motion by actively reducing edema and prevent scarring.
5. Functional orthotic control, more specifically a kinetic wedge orthotic which plantarflexes the 1st ray allowing less jamming at the MPJ
6. HA padding which preloads the hallux also allowing the 1st metatarsal to drop