- 29 January 2018
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Turf Toe Injury – An Overview
There are a lot of injuries that derive their names from sports – golfer’s elbow, tennis elbow (made popular by Sachin Tendulkar) and the like. While these might not really be sustained by only golfers and tennis players, yet, they are most commonly found in people who play these sports. Another such injury – Turf Toe – is a somewhat rare injury on paper, but in reality is becoming very common, especially among people heavily involved in sporting activities. Turf toe is observed to be a common injury to people involved in playing on artificial turfs.
What is turf toe?
Turf toe is a sprain, which occurs in the ligaments found around the big toe joint. A turf toe injury mainly hinges in permitting up and down motion of the toe joint.
Behind the big toe joint, at the ball of the foot, there are two pea-shaped bones, which are embedded in the tendon that enables the movement to the big toe. Known as sesamoids, they are found just behind the big toe joint, in the ball of the foot, which allows movement of this joint.
The turf toe injury primarily affects this part. These mentioned bones do their work like a pulley for the tendon, providing the leverage needed when the person walks or runs. These muscles also tend to absorb the weight that functions in pressing the ball of the foot.
In a turf toe injury, typically the damage is a sudden occurrence. As mentioned earlier, this is common in people playing on an artificial turf, which is harder than grass and sticks more to cleats. However, this does not mean that the turf toe injury cannot occur on a lawn, as, if the shoe or other technical aspects of the person’s sport does not provide enough support to the big toe area, this injury is entirely a possibility. To give another perspective, shoes like the ones soccer players wear, which are flexible and let the foot bend too far forward, make this injury a possibility.
As with many internal injuries, there is turf toe surgery and non-surgical turf toe treatments recommended for a turf toe injury. The required treatment for this injury, however, depends upon the treating doctor’s recommendations. Let’s look at the various grades of the turf toe injury and the subsequent treatments ideal for curing it.
Grade 1 –
Grade 1 of the turf toe injury might not be an acute stage, but still, it becomes crucial to take it seriously and opt for the right treatment. It is important not to underestimate the injury at any cost and ensure rest and athletic inactivity for the prescribed duration.
For this grade, a non-surgical method is recommended as the ideal turf toe treatment and here are some of the protocols one must follow to cure the turf toe problem of the first degree.
Rest, ice, compression and elevation is the first part or known as the R.I.C.E protocol. In this, the patient is advised to rest entirely for the early 48-72 hours after getting injured. Followed by that, apply ice to the affected region for 20 minutes 2-3 times each day.
Nonsteroidal anti-inflammatory medications: This is part of the turf toe treatment and helps in reducing the turf toe pain and swelling around the area. Depending on the doctor’s recommendation other anti-inflammatory medications could also be taken.
Toe protection: Patients are also advised to wear orthotics or other protective gear post rest days, to avoid complications and reduce strain on the affected area. Different techniques involving immobilisation, where the big toe gets taped to the smaller toes, which is necessary to minimise movements on the injured part. These methods have differing opinions.
A range of motion exercises: It is advised to begin movements after 3-5 days, with mild actions and activities such as cycling.
In the grade 2 type of the turf toe injury, the first phase would be to avoid any sporting activity for 3-15 days. That is the first step to turf toe treatment.
As with the grade 1 injury, in grade 2 as well, it is recommended to adjust footwear or wear protective orthotics to help protect the affected area for turf toe treatment.
AS with the previous grade, in grade 2 as well, there is an immobilisation period. Slow but progressive exercises and movements are recommended while taping the toe would also sound like an option to restrict far too many movements. Other activities in this phase like light running, cycling, jumping and pivoting would help in regaining the movements and precision of the toe as well as ridding of turf toe pain and taking it to the pre-injury phase.
The grade 3 turf toe injury is the acute variety. As part of the turf toe treatment, doctors ideally ask the patient to immobilise the toe using a walking boot or crutches, at least in the initial stages.
Physical therapy is the next stage of turf toe treatment, and it follows the initial immobilisation stage, as early movements are necessary to stabilise the joint and to stretch and support the big toe.
In this grade, athletes are advised to take rest for nearly eight weeks post-injury. Resting and recuperating is a part of Turf Toe Treatment, while the total time estimated with this degree for a full recovery is six months.
The turf toe injury is seemingly rare in the first place and 90% of the time a non-surgical method is the ideal turf toe treatment. However, in cases where the injury is severe and beyond the repairing clutches of the non-surgical methods or any other turf toe treatments, a turf toe surgery process becomes the last turf toe treatment to avoid complications in the future such as turf toe pain.
Who would need a surgical turf toe treatment?
Athletes with significant injuries, grade 3 or acute than that would need a surgical turf toe treatment. Patients with a significant plantan complex tear or a sesamoid fracture are in need of a turf toe surgery. Even in these cases, the non-surgical turf toe treatment is tried first, and when this fails, a surgical plan will be implemented.
After the surgical turf toe treatment, patients need complete rest for 5-8 days post surgery and minimal exercises which causes less or no strain in the following weeks.
Patients need to wear protective toe gear for the next four weeks, keeping the operated downward and immobilised to avoid any turf toe pain. Only after eight weeks of the surgical turf toe treatment can the person apply weight and resume more intense exercises, yet using protective toe gear or taping.
The injury usually heals appropriately with the right treatment, be it non-surgical turf toe treatment or through a turf toe surgery, although it could take up to six months for full recovery from an acute version of the same. From an athletes perspective, it is essential not to ignore even the slightest hint that this sort of injury gets sustained or some turf toe pain, else this problem, which may seem like a minor problem initially could turn into a prolonged process with chances multiple setbacks in the course if not appropriately treated.
About Sunshine Hospitals
A Multi Super Speciality Institution, 500+ bedded Sunshine Hospitals (Paradise Circle, Secunderabad) is promoted by globally reputed Joint Replacement Surgeon Dr. AV Gurava Reddy (Orthopedic Doctor) and like-minded associates who share the objective of making world-standard healthcare available, affordable and accessible to the common man.