Metatarsalphalangeal joint sprain
Encyclopedia
A metatarsalphalangeal joint
Metatarsophalangeal articulations
The metatarsophalangeal articulations are the joints between the metatarsal bones of the foot and the proximal bones of the toes...

 sprain
Sprain
A sprain is an injury in a joint, caused by the ligament being stretched beyond its capacity. A muscular tear caused in the same manner is referred to as a strain. In cases where either ligament or muscle tissue is torn, immobilization and surgical repair may be necessary...

is an injury to the joint and connective tissue
Connective tissue
"Connective tissue" is a fibrous tissue. It is one of the four traditional classes of tissues . Connective Tissue is found throughout the body.In fact the whole framework of the skeleton and the different specialized connective tissues from the crown of the head to the toes determine the form of...

 between the foot
Foot
The foot is an anatomical structure found in many vertebrates. It is the terminal portion of a limb which bears weight and allows locomotion. In many animals with feet, the foot is a separate organ at the terminal part of the leg made up of one or more segments or bones, generally including claws...

 and one of the toes. When the big toe
Hallux
In tetrapods, the hallux is the innermost toe of the foot. Despite its name it may not be the longest toe on the foot of some individuals...

 (1st phalange) is involved, it is known as "turf toe".

Causes

Turf toe is named from the injury being associated with playing sports on rigid surfaces such as artificial turf
Artificial turf
Artificial turf is a surface manufactured from synthetic fibers made to look like natural grass. It is most often used in arenas for sports that were originally or are normally played on grass. However, it is now being used on residential lawns and commercial applications as well...

 and is a fairly common injury among professional American football
American football
American football is a sport played between two teams of eleven with the objective of scoring points by advancing the ball into the opposing team's end zone. Known in the United States simply as football, it may also be referred to informally as gridiron football. The ball can be advanced by...

 players. Often, the injury occurs when someone or something falls on the back of the calf while that leg's knee and tips of the toes are touching the ground. The toe is hyperextended and thus the joint is injured. Additionally, athletic shoes with very flexible soles combined with cleats that "grab" the turf will cause overextension of the big toe. This can occur on the lesser toes as well.

A variation of "turf" toe can also happen when the nail bed is forced into the cuticle
Cuticle
A cuticle , or cuticula, is a term used for any of a variety of tough but flexible, non-mineral outer coverings of an organism, or parts of an organism, that provide protection. Various types of "cuticles" are non-homologous; differing in their origin, structure, function, and chemical composition...

and swelling with isolated pain may occur.

It can also be caused by not cutting one's toenails properly. If toenails are sufficiently long enough that they rub on ones shoes, the metatarsal can become hyper-extended, especially when engaged in running or other physical activity.

Treatment and prognosis

The injury can be debilitating for athletes who need to accelerate, quickly change direction, or jump. Use of the toes is not possible during the healing process. Since the toes are necessary for proper push-off when accelerating, those sorts of athletic activities can be almost completely curtailed. A healing period of one or more months is often required.

Because of the anatomy of the distal foot and the unique use of the foot, it is often impossible to properly tape or brace the joint. Although difficult, it is not impossible to tape the toe to limit dorsiflexion (upward bend of toe). Additionally, wearing a shoe with a rigid sole (often a metal plate) and cushioned innersole will help minimize extension of the joint. Anti-inflammatory medication as well as physical therapy is recommended.

Turf toe can often progress into a chronic problem, in which the joint(s) never really heals or heals too slowly to return to usual physical activities.

Turf toe can become more serious if left untreated, and may cause serious problems for the athlete.
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