Feet > Turf Toe > Treatments

   R.I.C.E., Shoe Inserts

Treatment Introduction

When you are diagnosed with minor, grade I turf toe, physicians typically recommend R.I.C.E. (Rest, Ice, Compression, and Elevation) treatment.

   Rest – take a few days of rest from your sport or activity. Try to limit the amount of time you spend bending your big toe.

   Ice – you should ice your toe for about 15 to 20 minutes every three to four hours for two or three days until your pain decreases. A common ice treatment is to dunk your foot in a bucket of iced water.

   Compression – to help reduce pain and swelling, your physician also may recommend compression. Your big toe may be compressed in a bandage or taped.

   Elevation – resting your toe above the level of your heart can help circulate blood away from your toe.

Over-the-counter, non-steroidal anti-inflammatories often are prescribed to relieve pain.

Turf toe is a difficult injury to heal, and you may be at a high risk for suffering repeat turf toe injuries. Be sure to give your toe ample rest at home before engaging in activities. It is important to let your big toe rest so your tendons and ligaments can heal. For minor, grade I turf toe, two days to a week of rest may be sufficient to ease your pain. For moderate, grade II turf toe, you may need to rest your big toe for one to two weeks. After resting a minor turf toe injury, you can often return to activities with the aid of sturdy shoe inserts that do not allow your toe to bend upward. These inserts are stiff plates that conform to the shape of your foot so that when you step, your big toe does not bend where it meets your foot and therefore reduces strain. Shoe inserts may be made of steel, plastic, or custom-shaped thermoplastic. The custom-shaped inserts usually provide the best protection but you may need larger shoes so that they can fit inside. Taping your big toe can also help you avoid straining sore tendons and ligaments. Taping your own toe is often difficult, and physicians generally recommend having a qualified athletic trainer apply the tape for you. A common method of taping your big toe is to place the middle of a piece of athletic tape on the top of your big toe. The tape wraps around your toe, crosses on the bottom, and attaches to the ball of your foot. For more severe, grade II turf toe that includes partially torn tendons or ligaments, physicians typically recommend taking about two weeks off from sports and activities and undergoing similar treatment with ice, anti-inflammatories, and a solid shoe insert. Try to walk on your injured foot as little as possible -- on every step, your big toe must bend upward and therefore strains the tendons and ligaments. Keep your foot elevated and try to avoid strenuous household chores. When you need to get around, be sure to wear your solid shoe inserts.

Rehabilitation

Though recovering from turf toe often can be done without formal physical therapy, you may want to visit a physical therapist to receive heat treatments, such as whirlpool baths. A therapist also can give you ultrasound therapy, which sends energy waves through your toe to help ease pain. In general, a cardiovascular training program that progresses slowly will help strengthen your toe. As your pain diminishes, walking becomes easier. Increase your activity level slowly as you can tolerate the pain. You should start jogging before you return to running. Running should be pain-free before you return to cutting, jumping, and sprinting. You may be able to return to sports and activities within two to four weeks. If the pain in your big toe flares up while training, you should consult your physician. Turf toe is especially tough for athletes during the middle of a season. Even after treatment and rehabilitation, returning to competitive sports after the injury often causes pain in your big toe. Many athletes can manage the pain through the season by wearing shoe inserts and taping their toes. At the end of the season, if you still have pain, your physician may be able to recommend further treatment. Physicians generally do not recommend corticosteroid injections. Though these injections may ease pain, they may put you at risk for further injury, such as a tendon tear. Corticosteroids should not be used to mask pain so you can return to sports before your toe has healed.

Turf toe can become a chronic condition. People who suffer turf toe typically can return to action, but there is no cure. You usually can calm down the symptoms down and play sports relatively symptom-free with proper protection. The longer you participate in competitive sports and activities on hard surfaces, the greater the chances are that you will reinjure your big toe. The most important preventive measure is to wear a stiff-soled shoe. In athletics, cleats seem to work better because they usually have a built-in plastic sole that is more rigid than a tennis shoe. Your physician may recommend avoiding activities on hard surfaces like artificial turf. Sports like soccer or baseball that are played on grass can be easier on your toes. Wear the stiff shoe inserts prescribed by your physician in all your shoes, whether you are going for a short walk or playing a soccer game. Once you have suffered turf toe, it is a good idea to use the stiff shoe inserts to limit bending of your big toe. Your major concern is to avoid arthritic deterioration of the cartilage where your big toe meets your foot. Continue to visit your physician if symptoms flare up. With proper medical care, most people can prevent reinjury and continue playing comfortably, at close to 100 percent, even though they have may an arthritic toe.