Turf toe, which is actually a sprain of the first metatarsophalangeal joint (MTP), is one of the most common athletic foot injuries. You may not realize how important your big toe is until you sprain it. This seemingly little sprain is a big problem and it can take you out of the game for three or more weeks. If you expect it to heel quickly you have to be able to protect the toe from the constant aggravation of walking.
Turf toe got its name from the injury’s association with artificial turf. The term has become a generic term for any injury to the MTP of the big toe, but the most common cause of this condition is a hyperextension or hyperflexion sprain injury to the joint. It is quite common in football players, especially linebackers and offensive linemen.
Mechanisms of Injury
More of these injuries are reported to occur on artificial turf because of its stickiness. When an athlete plants his foot and flexes his ankle to push off, the shoe sticks to the turf, which may be old and inflexible, causing the big toe to hyperextend as the body’s weight is transferred to it. Alternatively, when an athlete comes to a quick stop the toe may be jammed into the front of the shoe, causing hyperflexion of the MTP. Over-flexible lightweight shoes may be a culprit as they allow the toe this excess motion. Obviously, barefoot athletes may be even more likely to sustain this injury.
Despite how this common injury got its name, however, it can occur on any playing surface. Other predisposing factors are a stiff MTP joint, too little or too much ankle mobility, excess weight, and prior injury. The many variables contributing to these injuries are still inconclusive.
Symptoms and Initial Treatment
The main symptom of an MTP joint sprain is pain at the base of the big toe at the first joint. When the toe is bent upwards the pain can become quite severe. There may be swelling and discoloration in the area of the joint as well, depending upon the severity of the injury. Initial treatment is standard first aid for sprain injuries using rest, ice, compression, and elevation (RICE). Also in the early phase of injury, NSAIDS may be used to reduce pain and inflammation. Although running should not be attempted until the pain goes away, walking may also aggravate the injured tissues because of the extension of the toe during the push-off phase of gait. To protect the toe from the stress of walking and to reduce associated pain, the first thing to do is wear a pair of stiff soled shoes. This in itself may not be enough, however, as it is difficult to keep the big toe motionless even in the best of circumstances. Therefore a special tape bracing procedure is used.
Big Toe Bracing: Turf Toe Taping Technique
This explanation assumes that you do not have access to a professional athletic trainer to tape your toe for you. Although you can perform this procedure yourself, it is much easier to have a friend help out.
The supplies needed to tape a big toe are a roll of 1.5-inch athletic tape and spray adherent. The adherent is used to make sure the tape sticks well to the skin as even adhesive tape tends to slip over time, reducing its effectiveness and causing chafing.
Follow these steps:
1. Prepare the Skin. Skin should always be thoroughly washed and dried before taping. Male athletes may have a bit of hair on the top of their big toe. If desired, carefully shave the toe free of hair to facilitate pain-free removal of the tape later.
2. Spray adherent on the bottom of the big toe and the rest of the bottom of the foot where the tape will be applied. Although it is not absolutely necessary to use a spray adherent if the skin is clean and dry, the feet are so subject to moisture that adherent is advised in this case.
3. Place an anchor strip around the middle of the big toe. This strip is simply there to anchor the other pieces of tape to.
4. Tear off three pieces of tape that are measured to fit from the anchor strip to the heel and combine these pieces into one thick piece of tape. This strip will be the piece that actually holds the toe in position, so it must be extra strong.
5. Secure one end of the thick strip to the anchor strip on the toe and then pull the tape down toward the heel so that the toe is in line with the foot. Maintaining this tension, attach the tape along the bottom of the foot all the way to mid-heel. Be sure that the toe is not bent down (flexed) or bent up (extended). The toe must be held straight and in line with the foot to reduce tension on the injured joint tissues.
6. Tear eight or more pieces of tape long enough to cover the bottom of the foot crosswise. These strips must be able to reach up the lateral surfaces of each side of the foot but they should not reach all the way around the foot. Use these strips to cover the thick strip you placed on the bottom of the foot, to hold it in place. Starting just under the ball of the foot overlap each piece of tape by half the width of the tape until the entire arch of the foot is covered down to the end of the thick strip.
7. Tear a piece of tape in half lengthwise and place this piece around the big toe to help secure the tensioning strip. Walk to make sure the big toe is stabilized.
Watch the following video from PCHS Sports Medicine provides a demonstration of the turf toe bracing procedure.
Tips for Using the Athletic Tape
Tearing athletic tape can be a bit tricky at first but once you know the method it is easy to do, with practice. Using the forefingers and thumbs, pinch the very edge of the tape, placing the fingers of each hand as close to each other as possible. Pinch hard and quickly tear. You may be tempted to use scissors but the blades will stick to the adhesive on the tape, making it difficult to cut and causing the tape to fold over on itself.
Once you know the taping procedure, it is best to tear all of your strips in advance and place them on the edge of your work surface by securing one end of the tape, allowing most of the tape’s length to hang down to be easily retrieved when needed. Place the strips in the order you plan to use them.
Alternatives to Taping for Turf Toe
Chronic turf toe may require daily taping for weeks or months, which may quickly become an unwelcome chore. Fortunately, there are several products on the market called turf toe straps, typically made from mole-skin, which perform the same function as taping the toe. These affordable straps can be easily slipped onto the foot and are much more comfortable than tape. 1Starkey, Chad, and Glen Johnson. Athletic Training and Sports Medicine. Sudbury, MA: Jones and Bartlett, 2006. 65-67. Print.,2France, Robert C. Introduction to Sports Medicine and Athletic Training. New York: Thomson and Delmar Learning, 2004. 236. Print.,3Perrin, David H. Athletic Taping and Bracing. Champaign, IL: Human Kinetics, 2005. Print.,4Baxter, Donald E., David A. Porter, and Lew Schon. Baxter’s the Foot and Ankle in Sport. Philadelphia, PA: Mosby Elsevier, 2008. Print.
|↲1||Starkey, Chad, and Glen Johnson. Athletic Training and Sports Medicine. Sudbury, MA: Jones and Bartlett, 2006. 65-67. Print.|
|↲2||France, Robert C. Introduction to Sports Medicine and Athletic Training. New York: Thomson and Delmar Learning, 2004. 236. Print.|
|↲3||Perrin, David H. Athletic Taping and Bracing. Champaign, IL: Human Kinetics, 2005. Print.|
|↲4||Baxter, Donald E., David A. Porter, and Lew Schon. Baxter’s the Foot and Ankle in Sport. Philadelphia, PA: Mosby Elsevier, 2008. Print.|