by: Rob Stanborough PT, DPT, MHSc, MTC, CMTPT, FAAOMPT

Turf Toe usually is an injury experienced by athletes but can affect many more. It results in pain around the big toe and its joints. There may be swelling, redness, weakness and loss of range of motion. But fortunately, it can betreated.

The joints in the big toes have motion in two degrees, flexion, which is bending the toe toward the ground and extension, which is moving the toe up, away from the ground. Tendons on the top and bottom of the foot pull on the bones to make this happen.

When the tendon, and sometimes ligaments, on the bottom of the foot are overstretched it causes damage, inflammation and pain.

The tendon may be overstretched due to activities causing repeated or excessive pushing off the ground, joint hypermobility or can be from joint hypermobility.

Sometimes turf toe is mild, will not cause much disruption and will heal quickly. Other times it can be quite debilitating resulting in the use of crutches and braces.

If left untreated, it may result in long-lasting pain and even prolonged loss of motion in the big toe. For these reasons, early intervention/treatment is best.

Early intervention includes rest, ice, compression and elevation (RICE). The tissues have to be allowed to calm down and heal. Pain management is also important. Physical Therapists will use modalities such as therapeutic ultrasound, laser, electrical stimulation and manual therapy.

Once the pain is reduced, range of motion, strength and function need to be restored. Ultimately the cause needs to be addressed, which may include change in activity, footwear or use of orthotics.

I can tell you from personal experience that this injury can cause a lot of trouble. The big toe is used more than one thing, for walking, standing and any type of weight bearing activity. If it is not happy, you will not be happy.

If this is your case, neither you nor your big toe are happy, seek help. Getting help sooner is better than later.

Again, a lesson I learned the hard way. Call us at First Coast Rehabilitation for help.

Rob Stanborough is a physical therapist serving St. Augustine for more than 14 years. He is president and coowner of First Coast Rehabilitation, as well as co-author of Myofascial Manipulation:Theory & Application, 3rd ed by Proed Inc. He is certified in manual therapy, a Fellow of the American Academy of Orthopaedic Manual Therapists and has presented on the topic of soft tissue dysfunction in a variety of venues. Read previous columns posted on