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Causes and Symptoms of Turf Toe Injuries

by MASS4D® Insoles

Turf Toe Injuries

A turf toe injury refers to a ligament sprain of the big toe joint that occurs on turf surfaces. This may cause tenderness and swelling around the big toe joint.

Turf toe injuries occur when the big toe joint bends beyond its normal range of motion, thus spraining the ligaments that support the joint. If the big toe continues to bend uninterruptedly, this injury can become far more severe in nature.

The term turf toe was first coined by Bowers and Martin after they noticed an increase in ligament sprains of the big toe joint amongst college football players following the installation of an artificial turf at West Virginia University.

The authors stated that a combination of flexible football shoes and hard artificial surfaces increased the risk of turf toe injuries.

Types of Turf Toe Injuries

A study categorised turf toe injuries based on history and physical examination:

  • hyperextension injuries - refer to a stretch or tear in the ligament of the big toe joint, causing swelling, tenderness and discolouration. These commonly occur when a player’s leg is injured with the big toe pointed downward.
  • hyperflexion injuries - also known as sand toe, these are less common and typically occur when a player is tackled from behind which pushes the knee forward as the foot is pointed downward.
  • dislocation injuries - refer to dislocation of the small bones that attach to the ligament of the big toe joint and support its function. These injuries could also include a fracture to these bones or dislocation caused by fracture of these bones.

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Impact of Weak Foot Posture

The big toe plays an important part in the push-off phase (when the foot lifts from the ground) of walking or running. With a weak foot posture, such as flat feet, there is more stress on the big toe joint which may increase the risk and ill effects of turf toe injuries.

As the foot arch collapses, it causes improper distribution of weight to the feet. Typically in flat feet, there is more pressure on the forefoot especially the big toe. This explains why most people with bunions have flat feet. In addition to this, a weak foot posture causes the bones and muscles in the foot to move beyond their normal range of motion, which can increase injury risk.

Treatment and Recovery

A thorough examination of the big toe and foot posture, combined with an X-ray of the injured area, can allow a foot specialist to provide a personalised active rehab programme. MASS4D® foot insoles can be recommended to improve treatment outcomes by helping reduce stress on the big toe.

MASS4D® insoles support the feet in their optimal posture to promote proper distribution of weight to the feet and restore normal range of motion. This can help limit stress on the big toe joint and prevent it from excessive bending to avoid turf toe injury.

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Reference: VanPelt D. M., Saxena A., Allen A. M. (2012) Turf Toe Injuries. Sports Medicine and Arthroscopic Surgery of the Foot and Ankle. Springer-Verlag.

Reference: McCormick J. J., Anderson B. R. (2009) The Great Toe: Failed Turf Toe, Chronic Turf Toe, and Complicated Sesamoid Injuries. Foot and ankle clinics: July 2009, DOI: 10.1016/j.fcl.2009.01.001

Reference: Williams E. B. (2008) How To Treat Turf Toe Injuries. Podiatry Today: September 2008, Vol. 21, No. 9, Retrieved from: http://www.podiatrytoday.com/

Reference: Bowers D. K., Martin B. R. (1976) Turf-Toe: a shoe-surface related football injury. Medicine and Science in Sports: February 1976, Vol. 8, No. 2, pp. 81-83

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