Ask the Doctor: How can You Diagnose & Treat Turf Toe?

I’m a high school basketball player. My big toe really swells up and hurts after practice and games. The strange thing is that I can’t remember injuring the toe. What do you think is wrong?

Dr. Bush-Joseph

Dr. Charles A. Bush-Joseph:

I’m sorry to be the bearer of bad news, but it sounds like you have a case of turf toe. Although the condition is usually caused by “jamming” the big toe, it can also be a chronic condition caused by pushing off the toe repeatedly when running or jumping. As the name implies, the turf toe is more common among athletes who play on hard artificial surfaces – typically basketball, football and soccer players.

Although turf toe sounds like a simple “stubbing of the toe,” it’s actually quite serious. The injury involves tearing the capsule that surrounds the joint at the base of the toe, which I’m sure I don’t need to tell you is very painful. Furthermore, this tearing of the joint capsule can lead to instability and even dislocation of the joint at the base of the toe. Long-term damage may lead to accelerated cartilage wear and arthritis of the big toe.

Although turf toe sounds like a simple “stubbing of the toe,” it’s actually quite serious. The injury involves tearing the capsule that surrounds the joint at the base of the toe, which I’m sure I don’t need to tell you is very painful. Furthermore, this tearing of the joint capsule can lead to instability and even dislocation of the joint at the base of the toe. Long-term damage may lead to accelerated cartilage wear and arthritis of the big toe.

Treatment Options:

Although the diagnosis of turf toe is fairly straightforward, it’s a good idea to see a sports medicine orthopaedic physician. He or she will probably order X-rays to rule out a fracture. Treatment of turf toe typically involves the old standby: RICE (rest, ice, compression, elevation). Anti-inflammatory medications may also be recommended by your doctor. To heal properly, you’ll probably need to stay on the sidelines for at least three weeks. When you return to football, your physician may recommend special orthotics used to limit the motion of the big toe and prevent further damage to the joint.

Make sure that you’re 100% before resuming full-scale activity! Turf toe can turn into a long-term, nagging injury. Although surgery is rarely required for treatment of turf toe, if a bone spur forms and severely limits motion of the toe joint, surgery to remove the spur may be necessary.