Toe > Treatments
When you suffer from
a moderate to severe case of turf toe, the pain can
be debilitating and your big toe can become stiff. Your
physician may recommend immobilizing your big toe for
one to two weeks. A common method of immobilization
is a stiff, steel-soled shoe, possibly with a rocker
bottom. The rocker bottom uses a roll bar under your
arch so you can step with a rolling motion instead of
bending your foot and ankle. The steel sole does not
bend, which means your big toe cannot bend when you
walk. Your big toe also may be taped to enhance the
immobilization. Tape typically is wrapped around the
top of your big toe and attached to the ball of your
foot. Your physician may prescribe crutches to help
you keep weight off your toe for one to two weeks.
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 moderate, grade II turf toe, you may need
to rest your big toe for two to four weeks. Wear the
stiff-soled shoes prescribed by your physician as often
as possible. If your toe is taped, your physician will
give you specific instructions on how often to change
the tape. In general, you should keep the tape dry and
have it changed by a qualified physical therapist or
athletic trainer. You should ice your toe for about
15 minutes three or four times a day. A common ice treatment
is to rest your toe on top of an ice pack. Non-steroidal
anti-inflammatories often are prescribed to relieve
pain. Try to walk on your injured foot as little as
possible for the first few days. Even when wearing your
stiff-soled shoes, every time you step, your big toe
bends slightly upward and strains the tendons and ligaments.
Keep your foot elevated and try to avoid strenuous household
chores. After one to two weeks in a stiff-soled shoe,
you may be able to return to normal shoe wear. Your
physician usually prescribes a stiff shoe insert made
of steel, plastic, or custom molded thermoplastic. These
solid inserts limit bending of your big toe.
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, you should undergo a cardiovascular
training program that progresses slowly. When you begin
normal shoe wear about two weeks after your injury,
you can usually begin light exercise. Depending on your
degree of pain, you can progress from walking to running.
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 four weeks. If the pain
in your big toe flares up while training, you should
visit 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 their 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 for the condition. You usually
can 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. Have a trainer or physical therapist
tape your big toe before engaging in competitive sports
and activities. 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 may have an arthritic