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Well wouldn’t you know it? I’ve covered several different foot, ankle, and lower leg ailments that I’ve suffered through, and now I have a new one for you.

It’s called turf toe and by looking at what doctors and physical therapists typically say, I was prone to getting it at some point.

Soccer season has just started up for me and because it’s wintertime, we’re playing indoors. The field we’re playing on is made of artificial turf, which I originally thought was an incredible luxury; apparently not for my toes. 

What It Is

Turf toe is the sports-oriented way of saying a sprain of the metatarsophalangeal joint, which is the big toe joint. It’s the result of an acute or chronic hyperextension of the big toe.

The reason it got the name turf toe is because so many athletes who played on artificial turf would suffer this same injury. Football players, soccer players, and even some basketball players find this injury to be a common one in their sport.

The introduction of artificial turf and newer, more advanced cleats in recent years meant that athletes can generate more friction against the ground.

Previously, with real grass and less advanced cleats, the toe inside the shoe would’ve taken grass with it as friction was created. Now, the turf isn’t moving and the cleat isn’t moving so something has to give. Unfortunately, the tendons across the bottom of the big toe now have to take the majority of that force. 

The injury actually happens when there is a forced hyperextension of the big toe, most notably when an athlete is running forward and comes to a sudden stop, bending the big toe back into hyperextension while force is still coming down on the heel of the same foot.

This amount of force can cause a tear in the tissues along the bottom of the toe and that’s what the injury actually is. 

Apparently, this is what I did to myself as well. I felt some pain in and around the big toe joint after playing and I figured I just got kicked and stepped on a couple times. While that wasn’t wrong, that’s not where the pain was coming from.

Clearly after 2-3 weeks of having this same problem, and being uncomfortable when I bend my toe too far back or push it down too much, this must be turf toe. 

How to Treat It

As for what I’m now doing to solve this issue, it’s quite a tough one to work on.

The fact that I didn’t realize what I needed to be treating for the first week was a big mistake on my part. That would’ve been crucial healing time I wish I took advantage of.

It’s tough to work on anyway though because every step you take with that foot can be a slight irritation of the tendons you tore with the injury, so it becomes hard to treat.

Most doctors and physical therapists will still recommend the R.I.C.E. protocol even though that should never be considered a treatment. The “rest” portion of that protocol is going to be necessary in terms of taking a break from exercise on that foot but beyond that, ignore the rest.

Just like with any healing process within the body, you’re going to have to activate the tissues in and around the site of the injury if you want to stimulate any of the healing process, otherwise you’re going to allow even more of the surrounding tissues to be damaged. What this means is that some movement and activity is required if you want to heal. 

Manual Movement

To get the toe, toe joint, and musculature moving a little bit, you can manually move them around by hand.

One thing I’ve seen recommended several times is to put pressure around the big toe joint with one hand by firmly grabbing the area around it where it’s comfortable, and pulling the toe directly outward. This movement should never hurt but if it does, you should of course stop.

While pulling the toe straight out, you can twist it medially and laterally, or to the inside and the outside to stimulate some activity. 

Myofascial Release

For more serious problem-solving and most likely where you’ll see real improvement, we can use myofascial release.

For maximum effect, use a firm foam roller that can support your bodyweight if standing on it or a firm massage ball for smaller muscle groups that need to be loosened up.

This is a way to unglue some of our muscles and fascia that are higher up the foot and leg so we can allow for better circulation, giving improved blood flow to our toes to promote faster healing.

Start close to the site of the injury to see what is painful versus what is just tight. My arch muscles are actually still tight even though I’ve done some myofascial release work on them before.

So I’m going to start by rolling out the bottom of my feet, mainly the innermost arch muscles to loosen them up. Do this all along the inside bottom of your foot all the way to the heel.

Certainly try to roll out around your heel cords and all through the calves because what we really want to do is release all the muscles that eventually connect to that big toe. That’s why we started with the inner arch muscles of the foot and are now continuing up the leg while staying on the inside of it because those are the muscles that directly connect to the site of the injury.

In particular, the flexor hallucis longus, posterior tibialis, and flexor digitorum longus muscles of the calf are the ones we’re looking to release because they run inside the lower calf down the inside of the leg and feed into the arch and big toe muscles, controlling a lot of the movement that happens there.

If we can get these bigger calf muscles moving better, we will also allow better movement of the foot and toes below.