Turf Toe: A Therapist’s Personal Experience with Injury

Believe it or not, physical therapists are not immune to injury. At PhysioDC, the therapists have all been through some orthopaedic injury or surgery at some point in their lives. PTs tend to live fairly active lifestyles. The fact of the matter is, while living an active lifestyle is healthy for you in a cardiovascular sense, it makes you more susceptible to injury. The most recent affliction amongst the therapist here is turf toe.

Turf toe is the common term for a metatarsalphalangeal joint sprain. This most commonly occurs in the big toe. It is most commonly associated with football players playing on a hard surface, such as artificial turf, when somebody falls onto their calf, and the toe is planted into the ground being forced into extension.

So let me ask you, have you ever been told you have tennis elbow, and you think, “Impossible! I’ve never played tennis a day in my life?” Guess what? I don’t play football, and I have turf toe. Turf toe is simply a hyperextension sprain injury of the toe.

My injury occurred just 1 week ago when playing soccer. It was an unlucky moment when the ball was being passed from one player to another from the opposing team. I just couldn’t let that pass be completed, so as any dedicated teammate would do, I stuck my left foot out to cut off the pass. Unfortunately, the ball was coming pretty hard, and it hit my big toe at just the right angle to jam and extend the toe all at the same time.

It felt pretty awful right away, but I figured I could walk it off. As the next play was set, I tried to run and realized that I couldn’t even walk. I knew it was time to get home and break out the ice pack. It was apparent that the most pain happened when I tried to push off of the left foot, because that puts my big toe into extension. Luckily for me, I had an orthopaedic boot, from a previous soccer related injury, sitting in my coat closet waiting for me.

Now remember. One should never self diagnose. I made an appointment with an orthopaedic surgeon, where I received an xray of the left foot. Luckily for me, nothing was broken. The best treatment plan when this is acute is to rest, ice and elevate it to decrease inflammation and insult to the toe.

The orthopaedic boot has a rocker bottom and is rigid in the sole so that I cannot extend my big toe when pushing off of the injured foot. If somebody has to wear the boot for an extended period of time (more than a week), it is suggested that they purchase a “evenup” device. This is a device that goes on outside of the shoe of the non-injured foot. This helps to even out the 1-2cm height discrepancy between the orthopaedic boot and a standard shoe. This is the rest component.

The other part of the rest component is that I will not be dancing or playing soccer for a few weeks. I’ve been icing for about 15 minutes at a time, multiple times per day. When I am not at work, I am basically off of my feet as much as I can with my leg elevated above my heart.

Sometimes people come into our office with a variety of injuries and don’t tell us the whole story. We wonder how did this person end up with such chronic ankle weakness or hip weakness or pelvic malalignment? Perhaps it is because they have been using compensatory patterns to avoid pain, which our bodies are so good at doing. People think, “Oh, that old toe injury is not a big deal.” The big toe is so important. We are meant to push off of this toe for power when we walk, run or jump. It helps widen our base of support for stability and gives us better balance. Don’t brush off a toe injury as nothing.

My injury is still fairly new, but in the coming weeks, I will be rehabilitating this toe, by doing a gentle range of motions, within my pain tolerance, by bending it in both directions. I will be trying to strengthen my foot and toes by doing towel scrunches. I will work on strengthening my ankles with use of resistance bands doing inversion and eversion exercises, as well as practicing on walking properly and balancing.

As the soft tissue heals, which just takes time (about 4-6 weeks), I will start to do more difficult activities like pushing up onto my tippy toes from a sitting position, then in standing and then on just the injured side. Finally, I’ll slowly return to more dynamic and ballistic movement patterns that I need for playing soccer and dancing.

Until then, it’s time to rest and live my athletic ambitions vicariously through watching team USA dominate the Rio Olympics. Please feel free to leave questions and comments below regarding this topic. You can also visit our Recommended Products tab to find any balance equipment and the even-up shoe lift. For more interesting PhysioDC news, you can like us on Facebook or follow us on Instagram.