San Diego Chargers star running back LaDainian Tomlinson has been hampered all season by an early toe injury. This injury can be devastating and has ended many careers in the NFL. What really is grass toe? How can we avoid this toe pain?
What is grass toe?
Turf toe is a painful condition at the base of the big toe. This is usually due to a traumatic jam in the toe or repeated pushing while running or jumping. The most common complaints are pain, stiffness, and swelling. The pain can be so intense that pushing in soccer is practically impossible.
This injury is especially common among athletes who play on artificial turf, hence the name. The hard surface combined with running, jumping, and cutting in football and soccer make turf toe a common injury. Some also blame the choice of sports shoes. More flexible shoes, especially those worn in competition, provide less support to the forefoot joints, possibly contributing to turf toe incidence.
How does turf toe occur?
When a player sustains this type of toe injury, they are actually tearing the capsule that surrounds the joint at the base of the big toe. Tearing this joint capsule can be extremely painful. Additionally, tearing of the joint capsule can lead to significant instability and even dislocation of the joint at the base of the toe. This can lead to accelerated cartilage wear and arthritis of the big toe known as Hallux limitis or rigidus. This wear-and-tear arthritis can prematurely end a promising career.
How is turf toe diagnosed?
Diagnosis is based primarily on physical examination of the patient. X-rays may be taken to make sure there is no fracture or evidence of arthritis. Occasionally, an MRI is needed to assess surrounding tendons or to rule out an occult stress fracture.
What is the treatment of turf toe?
Treatment of toe injuries usually consists of trying to control the inflammation of the joint capsule.
The treatment protocol may include:
1.Rest
2. Ice
3. Elevation
4. Bandage or padding to take weight off the toe joint
5. Anti-inflammatory
6. And in chronic cases, steroid injections into the joint can be helpful.
7. Long-term use of a functional foot orthosis to balance the forefoot in cleats is very helpful.
Athletes diagnosed with turf toe should avoid stress on the joint for three to four weeks to allow the joint capsule to heal. Once you return to your activities, functional braces may be used to limit the movement of the big toe and prevent further damage to the joint capsule.
Will grass toe come back?
Unfortunately, turf toe can return, often more severe than the initial injury, and rehabilitation can be very slow. LaDainian Tomlinson has been hampered by his injury all season and he most likely won’t be 100% until he can rest at the end of the season. Most athletes have problems when they try to return to sports too soon after sustaining a toe injury. Surgery is rarely needed to treat turf toe unless it has been a chronic injury and there are spurs in the joint that limit movement. If a bone spur has formed and severely limits movement of the toe joint, surgery to remove the spur may be helpful.
Prevention and early treatment really are the key! If you experience joint pain after running in practice, your shoes should be evaluated for a functional orthotic to balance your biomechanics and hopefully avoid significant turf toe.