TURF TOE

Common Symptoms

Turf Toe symptoms include redness, pain, swelling and reduced movement specifically at the big toe joint. Symptoms may present over time or immediately after a traumatic event involving the big toe.

How it occurs

As seen in the image, turf toe is a common term used to describe a sprain of the ligament’s surrounding the big toe joint. Factors contributing to turf toe include:

Trauma such as, sudden jamming within the big toe joint due to stop/start running or rapid changing of direction.
Dynamic sports that require the big toe to pushing off the ground repeatedly and forcefully.
Inappropriate flexible footwear.

Mild turf toe usually feels like soreness or swelling at the base of the big toe after pushing off - you can still walk, though sprinting or jumping may hurt. More serious cases involve significant swelling, bruising, and loss of push-off strength, sometimes even a “pop” at the time of injury. If pain is severe, you can’t bend your toe, or walking remains painful after a few days, imaging (X-ray or MRI) is worth doing to rule out capsule tears or small fractures.
Leaving turf toe untreated can lead to chronic stiffness or instability in the big toe joint. This can alter your push-off mechanics, cause compensation up the chain (like calf or Achilles pain), and in some cases lead to early arthritis of the joint. Proper early management including rest, gradual loading, and strengthening can greatly reduce the risk of long-term issues.
Ultimately, it depends on the severity. Mild sprains might settle in 2–3 weeks, while more significant injuries can take 6–8 weeks or longer. The key milestones before returning to running are:
- Full, pain-free range of motion of the big toe.
- Ability to push off strongly on the injured foot.
- No swelling after walking or gym sessions.
Once these are met, a gradual walk–run and change-of-direction progression can start.
A few simple habits go a long way:
- Strengthen your foot and calf muscles, particularly the big toe flexors.
- Check footwear flexibility: shoes with very soft or bendy soles can overload the toe joint.
- Avoid hard or slippery surfaces for high-speed or agility drills early on.
- Maintain good ankle and toe mobility, so force spreads evenly during push-off.
These habits help protect the big toe joint and reduce the chance of re-injury as training ramps up.

What we may assess to obtain a diagnosis

Diagnosis is always subject to symptomatic complaint in conjunction with clinical testing performed by your podiatrist. Test performed may include touching (palpation) of the painful area, joint range of motion and an assessment of your walking or running (gait).

At The Running Room and Posh Pod, we are equipped with a pressure plate treadmill (Zebris) allowing us to comprehensively assess plantar pressures within the feet. There are three grades of severity for this condition all of which, have slightly differing management strategies. Due to this it is likely your podiatrist may send you for ultrasound or MRI imaging to assess the severity.

Management and how long does it take?

Imaging findings will appropriately grade the turf toe which will indicate the best course of management with treatment time frames varying subject to the grade of severity.

Grade 1: exercise perform as tolerated and icing. Grade 2: up to 2 weeks walking in boot and use of crutches if required. Grade 3 protocol required 6-10 weeks long term immobilisation with the effect foot in a boot or cast, crutches may also be used. For grade 3 turf toe and in collaboration with your general practitioner an appropriate referral will be made to an ankle foot surgeon for further consideration.

In all three grades including post-operative interventions treatment can be provided by your podiatrist. Other adjunct management modalities include tape/padding techniques, footwear advice, custom orthotics, foot exercises and oral anti-inflammatory medication may be discussed with general practitioner consideration.

Author: Maddie Parker -

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