Turf toe - more than meets the eye?

Recently, two of our Bartold Clinical members, almost simultaneously requested an update on this most troubling of injuries. It is especially a problem in the Rugby codes and American Football. Let's take a look.

In 1976, Bowers and Martin coined the term “turf toe” to describe an increasingly prevalent injury to the 1st metatarsophalangeal joint in athletes competing on artificial turf. In fact this injury represents a simple hyperextension injury to the 1st metatarsophalangeal joint and may occur on any athletic surface. 

The injury occurs when the 1st metatarsophalangeal joint is dorsiflexed beyond its physiological range during weight bearing, resulting in initial stretching of the 1st metatarsophalangeal joint capsule and plantar plate. If the injurious load is maintained, these structures may tear.

Hyperflexion of the 1st metatarsophalangeal joint may result in a similar injury to the dorsal capsule.  This injury may have associated avulsion fracture of the base of the proximal phalanx, osteochondral fracture of the metatarsal head, or even frank dislocation of the 1st metatarsophalangeal joint.

Simon Bartold
Director of Bartold Clinical