The symptoms of turf toe can include pain, swelling, and limited joint movement.

These symptoms they usually begin slowly. If they aren’t addressed properly, they gradually worsen.

Turf toe is essentially a sprain of the ligaments around the big toe joint.

What causes turf toe?

The injury usually results from the excessive forces on the joint associated with running sports, particularly on artificial turf.

Turf toe can also be caused by a direct injury that leads to damage of the bone beneath the cartilage.

Even mild, but repeated, episodes of this trauma can result in severe pain and an inability to walk or run, which is a devastating outcome for a running athlete.

The foot and its functional capabilities maladapt when unhealthy footwear is worn for an extended period of time.

Optimally, the great toe and arch should rise, pre-ground contact, in anticipation of the activity-related forces that are expected during weight bearing and propulsion. This pre-ground contact muscle activation promotes arch system stability and the ideal positioning of the great toe for optimal propulsion during toe off. This generates little or no stress on the big toe joint.

If this muscle firing sequence does not occur, or the big toe is prevented from rising due to tight restrictive footwear, the propulsion load-bearing forces exert extreme stresses on the big toe joint. It is these stresses that cause turf toe.

Turf Toe

For proper function, our feet require the Right Stimulus and the Right Movement.

Right Stimulus consists of the subtle varied stimulus that the soles of our feet receive when we walk, especially when we walk barefoot on natural terrain. With each step, there are subtly different sensations.

These subtle differences in stimulus keep our brain on high alert so that our body’s protective reflexes function properly with optimal muscle function.

When our brain is uncertain about what will happen, it triggers protective reflex muscle activations that support our arches before our feet contact the ground to ensure that our feet and legs can safely manage the forces generated by the activity intensity of our bodies.

As activity-related stimulus intensifies, a progressively higher arch is created. That is why, when they are functioning properly, our arches and toes rise and fall dynamically, in response to the varying activity stimulus intensities. This uninhibited dynamic movement is Right Movement.

Right Stimulus and Right Movement prevent excessive stress on the big toe joint and optimize propulsion efficiency.

Right Stimulus

Conventional footwear impairs optimal foot function in two ways:

First, most conventional footwear dampens Right Stimulus.

This is particularly true for shoes or insoles that support or cushion our feet. They spread the forces evenly across the soles of our feet, creating sensory input that’s muted and repetitive, step after step. Within a short period of time, our brain tunes out the stimulus and stops responding to it.

As a result, our brain doesn’t sufficiently activate the muscles that stabilize our arches and properly align our feet, legs, hips, and lower back, before our feet contact the ground. This “tuned-out” brain response is natural and happens all the time. For example, the same thing happens when we walk into a room and first smell coffee that we no longer notice after only a few minutes.

Soft Cushy Insole

Second, most conventional footwear, especially footwear that is tightly laced, has snug toe boxes or stiff midsoles or outsoles,  restricts the Right Movement dynamic raising of the arches and toes that is critical in the creation of a strong stable arch system and healthy linear propulsion with the toe off forces spread across the forefoot.

Footwear with stiff restrictive toe boxes not only impede Right Movement but also contribute to the excessive stresses on the big toe joint.

Wearing footwear that dampens Right Stimulus and impedes Right Movement trains the foot maladaptation that results in the damaging stresses that cause turf toe.

Conventional treatment methods for turf toe include:

  • Immobilization via taping
  • Ice
  • Cushioning or supportive insoles, or orthotics
Turf Toe

While these methods may temporarily alleviate symptoms, they do not address the poor neuromuscular function that is the cause of the problem. In fact, the more we artificially support or cushion our feet, the weaker and the more dependent we become on these types of products.

These “old school” support and cushioning treatment methods are not recommended in any other area of musculoskeletal medicine as a viable long-term treatment option.

In fact, modern treatment methods for poor neuromuscular function focus on increasing mobility, muscle strength, and proper alignment via Proper Technique exercise, which requires both Right Stimulus and Right Movement. Science has shown that simply challenging the body to “do its job” is the best way to restore and enhance function.

This principle is the foundation for virtually all of today’s sports training/rehabilitation programs.

Recommendations to address the poor neuromuscular function that causes
turf toe and prevents it from reoccurring:

  • Walk barefoot on natural terrain as much as possible. This provides the optimal Right Stimulus and allows for the Right Movement required for healthy neuromuscular function.
  • To attain Right Stimulus in your conventional footwear, use BioPods® Stimsoles® and, for best results, use them in loosely laced, soft, flexible footwear that allows your arches and toes to rise easily.
  • Consult with your healthcare practitioner to ask about employing soft tissue mobilization therapies to address the fibrotic scar tissue that may have formed, prior to using BioPods products.