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The agony of the feet: Why turf toe is such a dreaded injury in the NFL

WHILE IT'S CAUSED by a hyperextension of the big toe, the injury itself has very little to do with the toe. We just call it turf toe because dorsiflexion hyperextension to the hallux metatarsophalangeal joint, specifically the flexor hallucis longus tendon and the sesamoid complex, resulting in a plantar capsuloligamentous sprain is a long phrase to type. What all that terminology means is basically a strain of the sesamoid complex of bones, tendons and ligaments under the big toe's large knuckle joint, or the ball of the foot. (Those career-and-Super Bowl-changing sesamoid bones are so small they're named after the sesame seed.) And like all tendon and ligament injuries, turf toe is classified…

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  The Best Turf Toe Remedy

n my method, I take the opposite approach to convention and actually encourage mobilizing the affected joint – and here’s why. The underlying problem with the turf toe is that you have 2 bones that meet at a joint, which is inflamed, possibly calcified and likely damaged. Moving and separating those two bones promotes micro-circulation, which works to flush out excess calcium and reduce swelling, allowing the joint to recover. The joint will only get better with movement.

 The Best Turf Toe Exercises

While most common in footballers, there is also a high incidence of turf toe injuries in rugby and soccer players as well. This article will cover a rehab guideline for getting back on the field after an old turf toe injury.

 Turf toe: A clinical update

Turf toe is a rare and debilitating condition that requires a high index of suspicion on presentation to prevent missed injuries and chronic sequelae. They require accurate diagnosis and early definitive management. Grade 1 and 2 injuries have better outcomes and earlier return to sport.

Articles of Interest

Anatomy of Turf Toe

Sprains of the big toe joint became especially prevalent in American football players after artificial turf became more common on playing fields – hence the term “turf toe.” Artificial turf is a harder surface than grass and does not have much “give” when forces are placed on it.

Six N.F.L. Players Show Football’s Grind on Their Feet and Hands

McKitty has problem digits. He suffers from turf toe on both of his big ones, and he has broken or dislocated both thumbs and every finger on either hand.

The Great Toe: Failed Turf Toe, Chronic Turf Toe, and Complicated Sesamoid Injuries

Turf toe injuries and sesamoid injuries are challenging because of the variety of causes that exist as sources of pain. Through a systematic approach to evaluation, injuries to the hallux metatarsophalangeal joint can be diagnosed properly. Correct diagnosis leads to accurate and efficient treatment. I

Tis the Season for Football Turf Toe: What to Understand About this Injury

A turf toe injury happens when the big toe is bent at a 90-degree angle and pressed forcefully against the ground. Usually, the heel is high off the ground, like a sprinter’s block starting position in track or a three-point stance in football. When you put too much force on the big toe, you can hyperextend the toe (bend it farther than it’s supposed to go). This bending of the toe beyond its natural range of motion can cause injury to the tissues around the big toe joint and tear or sprain the ligaments. It also strains the soft tissues of that foot.

Turf toe

The majority of turf toe injuries occur as a result of contact with the playing surface or contact with another player. This essentially causes an axial load, on a hyperextended MTP joint, with fixed equinus at the ankle. The load drives the hallux MTP joint into hyperextension, which leads to attenuation or disruption of the plantar capsular ligamentous complex supporting the joint.

Turf Toe - Everything You Need To Know

Normal ROM in dorsiflexion of the 1st MTP joint is between 35-and 70 degrees although these numbers can vary up to 90 degrees depending on anatomical structures. Just behind the big toe joint in the ball of your foot are two pea-shaped bones embedded in the tendon that moves your big toe called sesamoids. These bones work like a pulley for the tendon and provide leverage when you walk or run. They also absorb the weight that presses on the ball of the foot. When these structures are put at a mechanical disadvantage turf toe sprains can occur.

Turf Toe vs. Sand Toe

“Turf’s Up, Dude!” is not something you usually hear, unless of course, you have a surfer friend who is experiencing what is commonly known in the chiropractic community as “Turf Toe.” So what is, turf toe, you ask? So what is “Sand Toe”, you ask? A close relative of turf toe, the sand toe can also prevent you from experiencing a full range of mobility as a result of repetitive movement in areas of sand from sports like running, beach volleyball, or even surfing.

What causes Turf Toe?

Turf toe occurs when repetitive force is placed on the big toe joint in a hyperextension position, like when the foot is in a push-off position — for example when a lineman on a football team is crouched and ready to push off. Football players are at greatest risk for turf toe, but it can also occur in other sports.

Resources

Turf Toe Bracing Sleeve

The OS1st TT3 Turf Toe Bracing Sleeve Splint creates a dynamic springboard action under the big toe joint or first metatarsal using the tension band concept to distribute force across the length of the entire metatarsal instead of directly on the joint during the toe-off segment of walking or running

FootCareMD

The metatarsophalangeal (MTP) joint is the largest joint in the big toe and is where the long bone of your foot (metatarsal) connects with the smaller bone of your toe (phalanx). Ligaments, tendons and two tiny bones called the sesamoids surround this joint and hold the toe in place. An important ligament on the bottom forms the "plantar plate." All these structures together form the "plantar plate complex," which keep the toe stable when pushing off, such as when walking or running. Turf toe injuries involve damage to one or more parts of the plantar plate complex. Treatment depends on the severity of the injury.

OrthoInfo

The simplest definition of turf toe is that it is a sprain of the main joint of the big toe. The injury happens when the toe is forcibly bent up into hyperextension, such as when pushing off into a sprint and having the toe get stuck flat on the ground. Although often associated with American football, turf toe occurs in a wide range of sports and activities.

Physiopedia

Turf toe is an injury of the first metatarsophalangeal(MTP) articulation, due to hyperextension of the big toe, which leads to damage of the plantar capsuloligamentous complex. It may cause tearing or complete disruption of these structures.

Radiopaedia

The mechanism in typical turf toe injuries is one of extreme traumatic dorsiflexion (hyperextension), often with superimposed varus or valgus angulation, which causes disruption of the plantar plate capsuloligamentous complex and allows unrestricted range of motion of the first MTP joint. Occasionally, fracture of the sesamoids or separation of bipartite sesamoids can be seen.

StatPearls

Bowers initially described the term turf toe in 1976 as a sprain of the plantar capsule ligament of the great toe metatarsophalangeal (MTP) joint. It occurs secondary to forceful hyperextension of the first MTP joint. Injury to the plantar plate of the great toe leads to pain with push-off and reduced agility. It can be a devastating injury in the elite athlete and a nuisance in the general population.