Tag Archives: Foot

Turf Toe!

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Turf toe is not a term you want to use when talking to a head football coach about his star running back or the ballerina before her diva debut. “Turf toe” is the common term used to describe a sprain of the ligaments around the big toe joint. Although it’s commonly associated with football players who play on artificial turf, it affects athletes in other sports including soccer, basketball, wrestling, gymnastics, and dance. It’s a condition that’s caused by jamming the big toe or repeatedly pushing off the big toe forcefully as in running and jumping.

Here is information about turf toe — what causes it, how to prevent it, and how it’s treated — to help you stay in the game.

What Causes Turf Toe?
Turf toe is a sprain to the ligaments around the big toe joint, which works primarily as a hinge to permit up and down motion. 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 you are walking or running, you start each subsequent step by raising your heel and letting your body weight come forward onto the ball of your foot. At a certain point you propel yourself forward by “pushing off” of your big toe and allowing your weight to shift to the other foot. If the toe for some reason stays flat on the ground and doesn’t lift to push off, you run the risk of suddenly injuring the area around the joint. Or if you are tackled or fall forward and the toe stays flat, the effect is the same as if you were sitting and bending your big toe back by hand beyond its normal limit, causing hyperextension of the toe. That hyperextension, repeated over time or with enough sudden force, can — cause a sprain in the ligaments that surround the joint.

Typically with turf toe, the injury is sudden. It is most commonly seen in athletes playing on artificial surfaces, which are harder than grass surfaces and to which cleats are more likely to stick. It can also happen on a grass surface, especially if the shoe being worn doesn’t provide adequate support for the foot. Often the injury occurs in athletes wearing flexible soccer-style shoes that let the foot bend too far forward.

What Are the Symptoms of Turf Toe?
The most common symptoms of turf toe include pain, swelling, and limited joint movement at the base of one big toe. The symptoms develop slowly and gradually get worse over time if it’s caused by repetitive injury. If it’s caused by a sudden forceful motion, the injury can be painful immediately and worsen within 24 hours. Sometimes when the injury occurs, a “pop” can be felt. Usually the entire joint is involved, and toe movement is limited.

How Is Turf Toe Diagnosed?
To diagnose turf toe, the doctor will ask you to explain as much as you can about how you injured your foot and may ask you about your occupation, your participation in sports, the type of shoes you wear, and your history of foot problems. The doctor will then examine your foot, noting the pattern and location of any swelling and comparing the injured foot to the uninjured one. The doctor will likely ask for an X-ray to rule out any other damage or fracture. In certain circumstances, the doctor may ask for other imaging tests such as a bone scan, CT scan, or MRI.

How Is Turf Toe Treated?
The basic treatment for treating turf toe, initially, is a combination of rest, ice, compression, and elevation (remember the acronym R.I.C.E).This basic treatment approach is to give the injury ample time to heal, which means the foot will need to be rested and the joint protected from further injury. To rest the toe, the doctor may tape or strap it to the toe next to it to relieve the stress on it. Another way to protect the joint is to immobilize the foot in a cast or special walking boot that keeps it from moving. The doctor may also ask you to use crutches so that no weight is placed on the injured joint. In severe cases, an orthopaedic surgeon may suggest a surgical intervention.

It typically takes two to three weeks for the pain to subside. After the immobilization of the joint ends, some patients require physical therapy in order to re-establish range of motion, strength, and conditioning of the injured toe.

Orthotic or not to Orthotic…..

Orthotic shoe devices are molded pieces of rubber, leather, metal, plastic, or other synthetic material that are inserted into a shoe. They balance the foot in a neutral position and cushion the foot from too much pounding. A wide range of orthotics are available for different foot problems. Doctors do not always agree about the usefulness or specific type of orthotics.

Custom-made orthotic devices may control pain if you have a specific problem, such as an unusual-shaped foot, or your foot rolls toward the arch (pronation). Custom-made orthotics are available by prescription. Insurance companies differ in how much of the cost they cover.

Before investing in an expensive pair of custom-made orthotics, consider trying good-quality nonprescription orthotics. They can usually be found at drugstores, supermarkets, and sporting goods stores. You can test the effectiveness of several different devices without great expense, which may help you decide whether a more durable custom-made device would be helpful.

You may also choose to buy well-made athletic shoes to support your feet and cushion your heels. Soft arch supports and heel cups can help cushion your feet and absorb shock.

My Feet Hurt SOOOO Much!

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Plantar fasciitis is the most common cause of heel pain. The plantar fascia is the flat band of tissue (ligament) that connects your heel bone to your toes. It supports the arch of your foot. If you strain your plantar fascia, it gets weak, swollen, and irritated (inflamed). Then your heel or the bottom of your foot hurts when you stand or walk.

Plantar fasciitis is common in middle-aged people. It also occurs in younger people who are on their feet a lot, like athletes or soldiers. It can happen in one foot or both feet. Repeated strain can cause tiny tears in the ligament. These can lead to pain and swelling.

No single treatment works best for everyone with plantar fasciitis. But there are many things you can try to help your foot get better:
Give your feet a rest. Cut back on activities that make your foot hurt. Try not to walk or run on hard surfaces.
To reduce pain and swelling, try putting ice on your heel.
Do toe stretches, calf stretches and towel stretches several times a day, especially when you first get up in the morning. (For towel stretches, you pull on both ends of a rolled towel that you place under the ball of your foot.)
Get a new pair of shoes. Pick shoes with good arch support and a cushioned sole. Or try heel cups or shoe inserts. Use them in both shoes, even if only one foot hurts.

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