The effects of turf toe can be painful and long-lasting. Treatment is fairly straightforward, and most athletes make full recoveries.

Published: December 9, 2019

Turf toe is a sprain of the big toe joint where it meets your foot (the metatarsophalangeal or MTP joint). While the injury often is associated with sports played on artificial turf, especially football, it also can be caused by soccer, basketball, dance, ballet and gymnastics.

The injury can be painful and long-lasting, but treatment is fairly straightforward. Most athletes make a full recovery.

Artificial turf gets much of the blame for turf toe because it is less forgiving than grass and makes for less flexibility when athletes attempt to push off with their feet.

Turf Toe Symptoms

Symptoms include pain, swelling, bruising, and limited range of movement. Turf toe injuries are categorized in one of three types.

• Grade 1. A mild stretching of the big toe joint. This type typically causes a relatively low amount of pain and discomfort.
• Grade 2. Partial tear of the MTP joint. Symptoms will be significantly more noticeable and last longer.
• Grade 3. A dislocation of the big toe joint. Motion will be extremely limited, pain and swelling will be severe, and symptoms will persist for up to several weeks in most instances.

Turf Toe Treatment

Treatment will vary depending on the grade of the injury.

• Grade 1. Rest, ice, compression, elevation (RICE) should be applied as soon as possible, with periodic icing continuing afterward. Further medical treatment often is not required for Grade 1 sprains, and over-the-counter pain and anti-inflammatory medicines can help.
• Grade 2. Same RICE approach as Grade 1 with the likely addition of a walking boot to protect the joint as it heals. Most midlevel sprains require about a week of immobility for the injured toe. When the joint has been dislocated, the toe typically needs to be immobilized for several weeks.
• Grade 3. Surgical repair of the joint may be required. RICE can help relieve symptoms at this stage, but additional medical action is required to treat the injury.

Physical therapy exercises are often helpful to increase range of motion and rebuild strength in the injured toe. Athletes should always treat these injuries with caution, as it is possible for mild cases to worsen if left untreated.

You can reduce your risk of a turf toe injury by wearing athletic shoes with more support and less flexibility. A prescription insert for athletic shoes also can reduce the probability of suffering a sprain.