A turf toe is a sprain of the main joint of the big toe. The injury occurs when the toe is bent up into hyperextension. These types of injuries became prevalent in American football players after artificial turf was introduced, which led to the name turf toe. Artificial turf is much harder than natural turf and doesn’t have much “give” when the players force their feet into the ground. Turf toe became famous in the football world but is also very common in other sports and activities.

Two joints generate motion in the big toe. The largest is the metatarsophalangeal joint (MTP), and in turf toe, this joint is damaged. The “plantar complex surrounds the joint, ” and these structures hold it in place to prevent it from dislocating.

Doctors often treat turf toe without surgery, and nonsurgical treatments are chosen based on the severity of the injury.

• Grade 1: RICE is beneficial for this degree of injury: Rest, ice, compression, and elevation. Pain isn’t severe and can be tolerated, and most athletes can continue participating in sports using a stiff-soled shoe.
• Grade 2: A walking boot may be recommended for a week to keep the MTP joint stiff and restrict motion. RICE and a taping regimen can help with treatment, and most athletes rest 3 to 14 days before returning to activities.
• Grade 3: These injuries require a walking boot or cast to keep the big toe immobile and in a partially pointed down position. As the damage becomes less intense, treatment will move down to Grade 2 and Grade 1. Physical therapy can be helpful as well.

Surgical treatment is not a common choice for treating this injury. If symptoms persist, surgery may be used to repair the soft tissues and restore the motion in the MTP joint.

Turf toe can heal very well when treatment is started early after the injury. Pain and joint stiffness can last as a complication. Push off strength can also be affected and bunions can persist.