Treatment of Turf Toe
Most turf toe injuries are treated non-surgically. If surgery is performed for this condition it is usually after years of repetitive jamming and destruction of the joint requiring joint replacement surgery. Prevention by addressing the biomechanical influences for turf toe is the key to treating this condition pallitively.
An initial assessment to rule out fractures or dislocations is made. Once ruled out, treatment is geared at protecting the soft tissues and allowing for functional rehabilitation.
- R.I.C.E. protocol: Rest and restricted motion at the 1st MPJ. Rigid soled shoes to limit hyperextension during propulsion. Ice during the first 48 hours of injury. Compressive dressing and elevation. A stronger breakdown of R.I.C.E:
- Rest—Avoid using the injured toe.
- Ice—Apply ice or a cold pack to your toe for 15 to 20 minutes, four times a day for 2 to 3 days or until the pain goes away. Wrap the ice or cold pack in a towel. Do not apply the ice directly to your skin.Do Not Sleep With The Ice Pack Because You Could Get Frostbite.
- Compression—If the injured toe is the big toe, wrap a two-inch elastic compression bandage around it. Put several wraps around the big toe and then include the rest of the forefoot within the bandage. This will limit swelling of your big toe. Other toes cannot be effectively compressed with a bandage. It is important not to cut off blood circulation to your toe or any body part when using such wraps – do not make them very tight.
- Elevate— Keep your toe elevated above the level of your heart whenever possible for 48 - 72 hours. This helps reduce both swelling and pain.
- NSAIDs as an adjunctive therapy to reduce inflammation of the joint
- Taping of the hallux with a crossing loop over the top of the proximal phalanx to splint the first MPJ and protect the soft tissues while restricting hyperextension
- Physical therapy modalities such as whirlpool and ultrasound with cold compression to improve motion by actively reducing edema and prevent scarring.
- Functional orthotic control, more specifically a kinetic wedge orthotic which plantarflexes the 1st ray allowing less jamming at the MPJ
- HA padding which preloads the hallux also allowing the 1st metatarsal to drop
