Turf Toe ( First MTP Joint Sprain)

turf toe




Turf toe is a condition of pain at the base of the big toe, located at the ball of the foot. Turf toe is usually caused from either jamming the toe, or pushing off repeatedly when running or jumping. The most common complaint is pain at the base of the toe, but patients may also have symptoms of stiffness and swelling.


Turf Toe is a sprain of the metatarsophalangeal (MTP) joint of the first toe. That is, the joint of the toe to the foot is sprained. The injury usually results from a hyper flexion mechanism; the toe is bent to far upward. This can result from a hard push off on a rigid surface, having the toe forcibly flexed while being tackled, or by stopping short allowing the toe to jam in the toe box of the shoe. These mechanisms cause damage to the ligaments of the joint and the joint capsule.
The 1st MTP joint is instrumental in all sports that involve foot contact with the ground. The Great Toe is the final structure in contact with the ground on push-off. Due to this, up to 8 X a person’s body weight may be transferred through the 1st MTP joint. Contact sport athletes are at a greater risk of injury of the 1st MTP due to the possibility that during contact, the joint may be forcibly hyper flex.


 Grade  Signs & Symptoms  Tissue Damage
 1  Plantar or medial pain, minimal swelling, negative x-rays   Stretched joint capsule and ligaments
 2   General tenderness, moderate swelling, loss of motion, bruising  Partially torn capsule and ligaments, with no joint surface injury
  3   Severe pain, severe swelling, & bruising, loss of motion   Ruptured ligaments, joint surface injury, possible joint dislocation



Treatment of the injury begins with proper assessment of the extent of the injury. Determining if it is a 1st, 2nd, or 3rd degree sprain is instrumental in returning the athlete to play

The immediate treatment for all grades of sprains is the same, Rest, Ice, Compression, and Elevation. This is the standard for acute care of any athletic injury.


First Degree Sprains
A 1º sprain usually results in very little time loss. The athlete must be able to run and change direction properly prior to return to competition. Application of ice and taping the toe may be enough treatment for return to competition on the day of the injury. Also, spring steel shoe inserts can be of great benefit to reduce the forces applied to the joint.

Second Degree Sprains
This type of injury often leads to time loss. This is due to the greater amount of tissue damage suffered. This athlete may need crutches for walking, and should be seen by a physician to rule out a bony fracture. When the athlete can run and change direction with out pain and loss of mobility, he/she may return to participation with the toe taped and a steel shoe insert.

Third Degree Sprains
These injuries are severe and may be a season ending injury. It must be determined if the joint surfaces have been damaged. If so, early return to participation may result in severe degenerative arthritis, and the loss of a career. Surgery may be required to repair the torn ligaments and tendons.

Degenerative arthritis
Hallux rigidus


At Physioline, all the members of the rehabilitation team work together so as to provide proper care and the therapy in order to:
• Pain relief
• Reduce swelling
• Strengthening of muscle
• Regain full range of motion
• Gait training
• Balance and Proprioceptive training
• Advice to wear spring steel shoe insert for stability
• Prevention of complications

Visit Physioline for further Consultation and treatment