Don’t Let Turf Toe Slow You Down

A few years ago when Stephen Jackson, a forward of the Golden Warriors, would be out for the rest of the NBA season due to a left toe injury. He would have to undergo surgery to remove bone fragments from his big toe.

This type of injury, commonly called “turf toe”, involves the ligaments to the metatarsalphalangeal joint (MPJ) at the base of the big toe (ball of the foot). They can be torn when the toe is either hyper-extended or hyper-flexed as a person stops short to jump or turn, which is why it is a common occurrence in athletes. Another contributing factor is artificial surfaces and or shoes that are too flexible.

The MPJ is a synovial joint between the head of the metatarsal bone and the base of the proximal phalanges enclosed in a capsule. Collateral and plantar ligaments support the joint. It is responsible for flexion (toe down), extension (toe up), adduction (movement of toe away from the midline), and some abduction (movement of toe towards the midline).

Normally, the treatment is non-surgical consisting of controlling inflammation with NSAIDS, ice, and restriction of the toe’s range of motion. Proper healing can take weeks or at least a month depending on the extent of the injury, which is graded according to severity on a scale of I to III. Grade I is more like a sprain, when the ligaments and capsule are stretched. There is an incomplete tear in the ligaments and capsule in Grade II and Grade III is a complete tear of the ligaments and capsule. Regrettably, there can be a recurrence with the formation of bone spurs. At this point, surgery becomes the next option.