Turf Toes

Turf toe injuries should be diagnosed by a health professional. For a professional diagnosis your podiatrist, doctor, sports medicine doctor, or physical therapist.

Diagnosis for turf toe injuries will often start with a physical examination of the injured foot. The health professional will likely ask questions about the nature of the injury to find out how the injury occurred. The professional will likely observe the range of motion at the big toe joint to assess if there is limited joint movement. They may also observe any redness or swelling. Often imaging tests may be requested to get a better view of the plantar complex of the first MTP joint to appropriately diagnose turf toe.

Turf toe can be graded into 3 categories of diagnosis:

• Grade 1: Injury or sprain to the plantar complex of the big toe.
• Grade 2: Partial tear to the plantar plate or other tissue at the plantar complex of the big toe.
• Grade 3: Full thickness tear to the plantar plate or other tissue at the plantar complex of the big toe.

For grade 3 injuries, a referral to an orthopaedic surgeon (foot and ankle surgeon) may be appropriate to assess the need for surgical treatment.

There are different stages to treating this injury. Turf toe treatment is often dependent on the severity of the condition and the patient’s goals of treatment.

For severe cases of turf toe, orthopaedic surgeons (foot and ankle surgeons) may be able to provide treatment advice for the injury.

However it is often only recommended to seek surgical intervention after more conservative methods have been considered.

Treatment options can be categorised into three levels when treating turf toe: 

Level 1: This is basic treatment that focuses on resting the injury. This is often recommended for grade 1 injuries, and often for grade 2 injuries as well.

• RICE (rest ice compression and elevation). This is to allow the injured foot time to heal.
• Wearing shoes that are appropriate to the individual’s foot type. For turf toe specifically, these shoes should be cushioned at the front. Stiff soled shoes and footwear with a rocker sole are ideal for this injury.
• Anti-inflammatory medications – it should be noted that these help manage the symptoms but don’t speed up recovery. These medications can be useful to control pain as the injury heals.
• Avoid training on hard surfaces. This can reduce shock on the foot as the healing process is underway.

Level 2: This level of treatment is considered for slightly more severe injuries and persistent cases but is still considered conservative.

• Orthotics: it can be recommended to wear inserts to control the stress at the 1st mtp joint and therefore improve active rest. Orthotics can be custom made or prefabricated (off-the-shelf). Prefabricated orthotics will likely need to be at least modified by a podiatrist to be appropriate for this injury. Custom orthotics are often more comfortable and easy to wear, as well as allowing the podiatrist to have more control over the supportive and shock absorbing structures.
• Turf toe plate: this can be added on to prefabricated or custom orthotics, or perhaps worn on its own. This is an addition to footwear that can reduce range of motion at the
• Walking boot: A special walking boot may be an available treatment option to help the area recover while the patient is still remaining active.

Level 3: This level of treatment is usually recommended for grade 3 injuries.

• Surgical treatment: Performed by orthopaedic surgeons, these specialists may be able to repair torn ligaments. Surgical opinion is recommended for severe cases and those cases that are persistent and painful.