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Turf Toe, Sports Medicine

Holly J. Benjamin, MD, FAAP, FACSM and Abdullah Hasan-Pratt, MD Reviewed 04/2019
 


BASICS

1st metatarsophalangeal (MTP) joint sprain 

DESCRIPTION

  • Forced hyperextension of the 1st MTP, resulting in sprain of the plantar capsuloligamentous complex (PLC) as well as chondral and osseous i...

DIAGNOSIS

HISTORY

  • Acute forced hyperextension of MTP joint resulting in painful weight-bearing, pain with ROM, and especially pain with applied pressure to MTP during running or jumping (toeing off)

  • Swe...

TREATMENT

GENERAL MEASURES

  • Grade 1 sprain:

    • Ice, elevation, and nonsteroidal anti-inflammatory drugs (NSAIDs)

    • Toe spica taping with activity, which restricts excessive dorsiflexion

    • Gentle ROM exercises can...

ONGOING CARE

More severe or recurrent cases may require a rigid-soled shoe or rigid forefoot orthotic when participating in sports. 

PROGNOSIS

The prognosis for full return to preinjury performance leve...

REFERENCES

1
George E, Harris AH, Dragoo J, et al. Incidence and risk factors for turf toe injuries in intercollegiate football: data from the National Collegiate Athletic Association Injury Surveillan...

ADDITIONAL READING

  • Clanton TO, Ford JJ. Turf toe injury. Clin Sports Med.  1994;13(4):731–741.

  • Crain JM, Phancao JP, Stidham K. MR imaging of turf toe. Magn Reson Imaging Clin N Am.  2008;16(...

CLINICAL PEARLS

  • Common injury; clinical diagnosis with adjunctive radiographs typical; MRI is not often needed.

  • Return to play and progression of all three grades of sprains depending on severity of sy...

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