Sports Medicine: Turf Toe

A Spine Center physician reviews an X-ray.

Turf Toe

What is a turf toe?

“Turf” toe is so named because it is a condition that started to become more common after artificial turf replaced natural playing fields. It refers to a sprain or injury in or around the main joint of the big toe, and it occurs when the toe is bent upwards with more than usual force. It affects the metatarsophalangeal (MTP) joint in the toe, where the first long bone of the foot meets the first bone of the toe. The joint is held in place by fibrous tissue, ligaments, a tendon, and two small bones, together known as the plantar complex.


There is a range of symptoms associated with this condition that corresponds to the severity of the injury. If the plantar complex has been slightly stretched, your toe may be tender and have slight swelling. If it has been torn slightly, similar symptoms will be felt more deeply and in a larger area. Severe tenderness and swelling will be present if there is a complete tear, and it will be hard to move your toe, inhibiting the up-and-down motion you need to walk.


The biggest cause of turf toe is instability in the front of your foot when you are moving forward. The injury occurs most frequently on artificial turf, which is harder and less shock absorbent than natural turf. However, any activity in which the front of your foot is planted on the ground while the heel is raised, pushing the big toe into hyperextension, can cause the condition — so dancers, basketball players, and other athletes are also at risk.

Any time you move forward, even in walking, you are transferring your body weight onto the plantar complex area, expecting to use it to push off the ground. But if your toe doesn’t move — if, for example, your cleat gets stuck in the ground — that complex will get injured.


“If you’ve done RICE — rest, ice, compression, and elevation — and you are still in pain, your doctor will most likely do an imaging test like an x-ray, to see if there are any bone problems, or an MRI, to get a clear view of any tissue damage. Once the diagnosis is made, depending on the severity of the injury and how quickly you heal, you may be able to get away with simply adding an orthotic to your athletic shoe. Or you may need to immobilize the area by having a cast put on or wearing a walking boot for several weeks,” says Kevin White, DO, an orthopedic physician at OINJ. “Physical therapy goes along with this as well.”

“Most patients with turf toe respond well to these kinds of conservative treatments. But if you are still in pain, surgery may be an option. Generally this is reserved for severe tears, fractures, or cartilage damage,” says Dr. White.

Why Choose The Orthopedic Institute of New Jersey

At OINJ, board certified physicians work collaboratively to come up with the best solutions for you. Using innovative techniques and the most up-to-date research and technologies available, our specialists have one goal: to get you back into the best of orthopedic health. We work with each other, as well as with other partners in your care, to develop the treatment plan that will work for you.

Our multiple office locations that can be reached by one centralized call center make it easy to schedule and get to appointments, and we treat patients of all ages with injuries and orthopedic conditions of all kinds.

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Kevin White, DO – Orthopedic Physician

Dr. White held his fellowship in foot and ankle surgery at St. Vincent Catholic Medical Center in New York City, and completed his residency in orthopedic surgery at the School of Osteopathic Medicine at the University of Medicine and Dentistry of New Jersey (UMDNJ), where he was chief resident. He received his medical degree there as well, and earned his undergraduate degree from Rutgers University.

Dr. White’s areas of expertise include ligament reconstruction for the foot and ankle, lower extremity trauma, total ankle replacement, and injuries and conditions of the foot and ankle.

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The Orthopedic Institute of New Jersey is a premier multi-disciplinary center offering complete orthopedic care, rehabilitation and pain management services to patients of all ages and activity levels using a customized treatment plan to fit individual needs.

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