Turf Toe

From DeLee JC, Drez D Jr.: Orthopaedic Sports Medicine: Principles and Practice. Philadelphia, WB Saunders, 1994, p. 1860.

Description
Turf toe is an injury to the capsule and ligaments of the joint of the base of the big (first) toe. This injury is usually to the bottom of the joint.

Common Signs and Symptoms

Pain with motion, especially extending (lifting up) the first toe, including when trying to stand on your tiptoes or push off, such as when running or jumping
Tenderness on the bottom of the joint at the base of the great toe
Bruising, redness, swelling, and warmth of the big toe, especially on the bottom of the base of the big toe (occasionally)
Foot pain, stiffness and limping

Treatment Considerations
Initial treatment consists of rest from the offending activity and ice to help reduce inflammation and pain. Elevating the injured foot for the first 24 to 48 hours may also help reduce swelling and pain. Contrast baths (cold and heat treatment) and gentle range-of-motion exercises of the big toe are helpful. Wear stiff-soled shoes with a wide toe area to help reduce bending of the big toe. Stiff shoes may, however, affect athletic activity. Taping of the great toe usually is helpful and may allow for earlier return to sports. Rarely, a short trial of casting or bracing the foot and ankle may be attempted. Treatments such as range-of-motion and strengthening exercises and others, by a physical therapist or athletic trainer, may be recommended. A cortisone injection is usually only recommended for chronic symptoms. If the treatments listed here are not successful, surgery may be necessary.

RICE Principle
With all acute injuries, follow the RICE principle to reduce swelling, pain and inflammation.

Rest- Walk with crutches if you cannot bear weight or it is very painful.
Ice- Use an ice pack for 20 minutes every two to three hours during the first 72 hours.
Compression- Use an ace wrap if needed. Start at the top of the toes and wrap up to the ankle.
Elevation- Keep the injured leg above the level of the heart when you are sitting or lying down