San Diego Chargers star running back LaDainian Tomlinson has been hampered all season by an early turf toe injury. This injury can be devastating and has ended many NFL careers. What is actually the turf tip? How can we avoid this toe pain?
What is the grass tip?
Turf toe is a painful condition at the base of the big toe. This is usually due to traumatically stuck toe or repeatedly pushed 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 soccer and football, makes the turf toe a frequent injury. Some also blame the choice of sports shoes. More flexible shoes, especially used in competition, provide less support to the forefoot joints, possibly contributing to the incidence of the turf tip.
How is the grass tip produced?
When a player suffers this type of toe injury, they are actually tearing the capsule that surrounds the joint at the base of the big toe. Breaking this joint capsule can be extremely painful. In addition, the tear 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 tear and arthritis of the big toe known as Hallux limitis or rigidus. This wasting arthritis can prematurely end a promising career.
How is turf toe diagnosed?
The diagnosis is based primarily on the 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 evaluate the surrounding tendons or to rule out a hidden stress fracture.
What is the turf toe treatment?
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 relieve the weight of the toe joint
5. Anti-inflammatories
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 on cleats is very helpful.
Athletes diagnosed with a turf toe should avoid stress on the joint for three to four weeks to allow the joint capsule to heal. Once you return to activities, functional braces can be worn to limit movement of the big toe and prevent further damage to the joint capsule.
Will the grass tip return?
Unfortunately, the turf toe can return, often more serious than the initial injury, and rehabilitation can be very slow. LaDainian Tomlinson has been held back by his injury all season and most likely not at 100% until he can rest at the end of the season. Most athletes have trouble trying to return to sports too soon after sustaining a turf toe injury. Surgery for turf toe treatment is rarely needed, unless it was a chronic injury and there are spurs in motion that limit the joint. 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 a significant turf toe.