Turf Toe is a general term for inflammation or damage to the metatarsophalangeal joint (MTP joint). This is the joint between the metatarsal bones of the foot and the proximal phalangeal bones. Simply, this is referring to the first joint of the toes.
Turf Toe typically affects the Hallux or big toe. This is also referred to as the "ball of the foot"
This can be a devastating injury simply because it is an area of the body that experiences massive relative forces and can be very difficult to rehab and treat.
Turf Toe can be an acute injury, but also a chronic condition due to overuse and in many cases, improper mechanics of the joint and foot.
The injury can occur when a large amount of force is placed on the heel, driving the foot downwards with the big toe dorsiflexed which can hyperextend and damage the joint.
More common however are overuse injuries and improper mechanics. Drastic increases in training volume or intensity can lead to turf toe as can restricted range of motion of the big toe, which is often due to weakness. Modern lifestyle and footwear are often the culprit! Also, bunions are often a precursor for issues and pain.
I have dealt with severe turf toe in the past. It is not fun and takes a very patient and intentional approach to mitigate and rehab to full strength. However, I am happy to say that it can be not only treated and managed but eventually eliminated.
This is contrary to common knowledge that you might get from your physician or online where it is common to find solutions such as surgery, immobilization through various braces, pain medications and even barbaric treatments such as fusion of the joint! Craziness... Often the solution given is simply to rest and ice, which we know does not work either.
So, what can you do about it?
First, lets try a couple assessments and see if you are at risk or need to address imbalances.
Try this test and solution for range of motion
Next lets check how well you can move your toes!
If you feel pain or if these two exercises are very difficult for you then this protocol will help you prevent turf toe or other things like plantarfasciitis. This protocol is also fantastic to manage turf toe and rehabilitate it. Ask your coach if you would like to have it assignd to you and if you are experiencing turn toe please reach out so we can get to work.
Turf Toe Protocol
A) Toe Curls or Walking in Sand - 3 sets of 20 reps or 5 mins walking in sand. (Walking in sand might be the best tool to fight turf toe! Find indoor volleyball courts or sand pits if you don't live near outdoor sand)
B) Toe Typing - 3 sets of 10 reps per movement
C) Sled Drives - 100 meters (Work up to doing these barefoot, start light)
D1) STL Calf Raise - 2 sets of 10 reps per leg (be careful of stressing your MTP joint)
D2) Tibialis Raise - 2 sets of 20 reps
E1) Plantarfascia Stretch - 2 sets of 45 seconds (don't work through pain)
E2) Tibialis Stretch - 2 sets of 45 seconds (don't work through pain)
F) Myofascial Release - 2 minutes
Tip: The best advice I can give is to take this process very slowly. Because you are walking on your feet daily, the rehab will take longer. Focus on reducing the stress that the joint experiences at first and then slowly build up capacity. If you push too hard it will actually get worse. If any of these movements aggrivate the area then leave them out until you begin to improve.
If you have questions, comments or concerns reach out!
-Matt
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