Turf Toe: Better Known as Toe Jammed

From the beginning of time, there was grass and they said this was good. Then came the rain and the grass became mud, snow and it became slush, drought and it became concrete separated by deep canyons. Man in his infinite wisdom searched for a better playing surface. What could withstand heat or cold; rain or snow and not loose its consistency or shape. The logical choice was plastic soda straws. They could be cut and bent and withstand all the elements Mother Nature could unleash. We now had the invention of artificial grass. The implications for sports were infinitesimal. Sports could now play anytime of day or night under any conditions. The plastic was manipulated and the traction extreme. Along with the traction came new injuries. The most common injury was "carpet burn". It is akin to taking sandpaper and rubbing off multiple layers of skin to expose meaty flesh driving opportunistic bacteria deep into the epidermis.

A simple miss kick of the ball or a stumbling on the field elicits the famous "TURF TOE". If you don't believe this is a serious injury, just ask Dieon Sanders, former NFL Star. He missed most of one season with this malady. Treatment is difficult, mainly because we walk on our feet not allowing it to heal.

Metatarsalphalangeal joint sprain is the medical term for "turf toe". It is a hyperextension injury of the joint that attaches the big toe to the foot. Shoes that give very little resistance to bending of the foot can predispose you to this injury. The damage is done to the joint capsule and ligaments. The severity of the injury as well as the subsequent treatment will dictate the recovery time. X-rays should be taken to rule out any fractures. Ice, rest and anti-inflammatory medications are standard treatment. Immobilization is important for proper tissue healing and decreased down time. There are three ways to control the joint for optimum healing. The best and most uncomfortable is the fracture boot (picture). This will take much of the stress off the joint and allow you to walk and still have the near natural blood flow to the affected area. The second best method is the metal or plastic innersole for your shoe (picture). This limits the motion of the joint with the plastic having the most give. The last choice is taping. Short term taping is fine, especially if the previous appliances are not readily available. Fitness can be maintained with an exercise bike. When you can walk pain free without the boot or innersole, then they can be discontinued. A progressive running program can begin with pain dictating how fast you return to the field.

When you return to play, you should do two things to protect the joint. The first is a tape job to prevent hyperextension of the joint (see picture). The other is a custom made thermoplastic insert molded to your foot to also prevent any painful hyperextension. Icing after play will help prevent any residual inflammation. The new long grain artificial turf should help cut down on the injury but shoe selection is more difficult on this more "natural feeling" grass fields. Remember when you get toe jammed to let pain be your guide.