Turf toe is an injury to the big toe caused by sudden forced extension of the toe upwards beyond its normal range of motion. This can occur during sports on hard artificial surfaces when an athlete's foot is forcibly stopped by their shoe gripping the ground. It damages the ligaments and joint capsule of the big toe, causing pain, swelling, and reduced motion. Treatment focuses on RICE and may include immobilization, physical therapy, or surgery for severe cases. Prevention involves wearing shoes with better support and limiting time on hard artificial surfaces.

1. TurfToe Megan Vogelsong

2. What is turf toe? A severe case of jamming the big toe The big toe extends upward much more than normal This causes: •pain at the bottom of the big toe •damage to the ligaments (a tough band of tissue connecting bone to bone) •damage to the joint capsule (saclike structure of tissue surrounding the ends of bones in joints and contains a clear fluid allowing bones to move easier) Form of hallux limitus Hallux limitus is a condition that causes pain and a decrease in the range of motion in the big toe.

3. Turf Toe

4. Who usually gets it? Turf toe is usually a sudden injury that athletes can get Athletes playing on turf or other artificial surfaces are more likely to get turf toe Turf is harder than grass making cleats more likely to stick This can also occur in grass, especially if the shoe or cleat does not support the foot Soft, flexible shoes are more likely to cause turf toe than one that supports the foot and toes better Football players, soccer players, baseball players, softball players, and martial arts

5. Football

6. Causes of turf toe In sports: •the shoe or cleats grip into the surface •the shoe sticks to the ground as a person stops quickly •the gripping causes the athletes body weight to shift forward and the big toe to hit the inside surface of the shoe •the big toe gets jammed •the big toe, ligaments, and joint capsule bend abnormally upwards causing overextension

7. Causes of turf toe continued Sometimes it may take repeated jamming Person standing on toes or front of feet and is pushed forward Pushing off the front toe repeatedly while jumping or running

8. Signs & Symptoms of turf toe Pain Restricted movement Tenderness Swelling at joint Limping while walking Toe may appear red and bruised Sometimes when injury occurs a “pop” may be felt

9. Different types of turf toe Grade I- ligaments and joint capsule stretched; localized tenderness, minimal swelling, and no bruising Grade II- ligaments and joint capsule partially torn; widespread tenderness, mild to moderate swelling and bruising, range of motion moderately restricted, pain with weight bearing Grade III- ligaments and joint capsule completely torn; severe tenderness and swelling, moderate to severe bruising, painful range of motion

10. What is the treatment? Centered on decreasing inflammation and promoting healing with rest, ice, compression, and elevation (RICE) Nonsteroidal anti-inflammatory drugs help minimize pain and inflammation In severe conditions, crutches and a short leg cast or a walker boot may be used for the first week or more Big toe taped to lesser toe to prevent movement Insole in shoe to prevent forefoot movement Physical therapy to help with range of motion and resistance exercise (toe stands, pick up objects with toes)

11. Treatment continued Ultrasound treatment: high-frequency sound waves directed to soft tissues to reduce swelling and speed up healing Electrotherapy: electricity is used to treat the tissues Iontophoreisis: ions (electrically charged atoms) of certain salts are introduced into the tissues by electric current Surgery in severe conditions to repair damage to ligaments and joint capsule or to shorten two bones that make up big toe Surgery can also be used to remove bone spurs, which are knobby, abnormal bone growths, that may have formed

12. Surgery

13. Prevention Limit activity on turf or other artificial surfaces Wear shoes with better support Use of specially designed inserts in shoes A physical therapist or sports medicine specialist can work with people on correcting any problems in their gait that can lead to injury and develop training techniques to reduce the chance of injury.

14. Sources: http://physicaltherapy.about.com/gi/o.htm?zi=1/XJ&zTi=1&sdn=physicaltherapy&cdn=health&tm=64&gps=48_1985_1259_848&f=00&tt=14&bt=0&bts=1&zu=http%3A//www.medfriendly.com/turftoe.html%23whatisit http://www.wisegeek.com/what-is-hallux-limitus.htm http://www.webmd.com/fitness-exercise/turf-toe-symptoms-causes-and-treatments