Category: Orthopedics
Posted: 11/22/2025 by Brian Corwell, MD
(Updated: 12/4/2025)
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Turf Toe:
Increased recent attention due to injuries in high profile athletes
Sprain of the first MTP joint
Mechanism: Forced hyperextension of the great toe (most common)
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Causes injury to the MTP joint capsule and surrounding ligaments
Presents as pain, swelling, discoloration, tenderness to palpation, possible joint laxity
Pain with active and passive ROM (both flexion and extension)
Graded 1-3 (Sprain, partial rupture, significant/complete rupture)
Most commonly seen in athletes who compete on artificial turf.
More rigid than natural grass
Synthetic surfaces do not release cleats as easily as natural grass
Improved synthetic surfaces perform more similar to natural grass
Much higher incidence in games vs practices.
In football, quarterbacks and running backs at highest risk
Between 30 and 45% of professional football players claim that they have experienced a turf toe injury, with over 80% of those injuries occurring on artificial turf
The combination of more rigid synthetic surfaces and lighter, more flexible shoes, increase risk of hyperextension injuries
Treatment: usually non operative
Rest/ice/taping after acute swelling decreased/stiff sole shoe/crutches/NSAIDs.
Consider walking boot or short leg splint for severe injuries
Less than 2% of injuries require surgery