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Turf Toe

First Metatarsophalangeal Joint Sprain


Presentation

  • An occult fracture of the proximal phalanx may be present. When you classify these injuries, they can be a sprain, partial tear, or a complete tear. Injuries There are many factors implicated with an increased incidence of turf toe.[huffpost.com]
  • […] hyperextension or hyperflexion of the MTP of great toe turf toe Sports medicine A ligamentous sprain of the metatarsophalangeal–MTP joint of the great toe affecting athletes in various sports–baseball, football, soccer played on artificial turf Clinical Commonly presents[medical-dictionary.thefreedictionary.com]
  • Characteristics/Clinical Presentation It is characterized by pain as a first symptom, localized swelling, ecchymosis and stiffness of the joint.[physio-pedia.com]
Pain
  • Tenderness Swelling Bruising Limited movement Pain when moving the toe or walking If you experience severe pain in your big toe or pain that lasts longer than 48 hours, contact your primary care provider or an orthopedic specialist for diagnosis and treatment[bonejoint.net]
  • Symptoms: The most common symptoms of turf toe include pain, swelling and limited joint movement at the base of one big toe. If caused by a sudden forceful motion, the injury can be painful immediately and worsen within 24 hours.[sportsptcenters.com]
  • Once the pain and swelling have subsided, physical therapy can be helpful to stretch the first MTP joint with range-of-motion exercises.[luriechildrens.org]
  • To increase the range of motion and reduce the pain, passive joint mobilizations are indicated.[physio-pedia.com]
  • MTP of great toe turf toe Sports medicine A ligamentous sprain of the metatarsophalangeal–MTP joint of the great toe affecting athletes in various sports–baseball, football, soccer played on artificial turf Clinical Commonly presents as an intensely painful[medical-dictionary.thefreedictionary.com]
Swelling
  • There may also be some swelling and stiffness. Symptoms depend on the severity of the injury.[luriechildrens.org]
  • Grade I injury symptoms are: local swelling, plantar structures attenuation or stretching, minimal ecchymosis. Grade II injury symptoms are: moderate swelling, partial tear of plantar structures and restricted motion as result of pain.[physio-pedia.com]
  • Clinical Picture The patient will present with pain, swelling and an inability to "push off" with the big toe. The patient will have plantar swelling, tenderness and ecchymosis (Figure 5). The vertical Lachman's test will be positive (Figure 6).[huffpost.com]
  • Symptoms: The most common symptoms of turf toe include pain, swelling and limited joint movement at the base of one big toe. If caused by a sudden forceful motion, the injury can be painful immediately and worsen within 24 hours.[sportsptcenters.com]
  • Tenderness Swelling Bruising Limited movement Pain when moving the toe or walking If you experience severe pain in your big toe or pain that lasts longer than 48 hours, contact your primary care provider or an orthopedic specialist for diagnosis and treatment[bonejoint.net]
Inflammation
  • See Sports dermatology. turf toe ( tŭrf tō ) Sprain and subsequent inflammation of the first metatarsophalangeal joint.[medical-dictionary.thefreedictionary.com]
  • Treatment: Rest, ice, compress and elevate (R.I.C.E) Use over-the-counter medication such as ibuprofen to control pain and reduce inflammation.[sportsptcenters.com]
  • To control inflammation and assist the healing of the soft tissues, pulsed ultrasound or ionophoresis can be applied.[physio-pedia.com]
Physician
  • The physician should always compare the injured foot to the other side. An x-ray will need to be obtained. Either a fracture or proximal migration of the sesamoid bone will be seen.[huffpost.com]
  • Turf toe is diagnosed based on your mechanism of injury and physicians’ examination of your foot. Imaging studies are not required to make the diagnosis, but x-rays of the foot may be performed to evaluate for other causes of foot pain.[luriechildrens.org]
  • -Diagnostic and Therapeutic Injection of the Ankle and Foot, American Academy of family Physicians 2003;68:1356-62 Levels of evidence: A 10.0 10.1 Paul K.[physio-pedia.com]
Ecchymosis
  • Characteristics/Clinical Presentation It is characterized by pain as a first symptom, localized swelling, ecchymosis and stiffness of the joint.[physio-pedia.com]
  • The patient will have plantar swelling, tenderness and ecchymosis (Figure 5). The vertical Lachman's test will be positive (Figure 6). Varus and valgus instability will be present.[huffpost.com]
Fracture
  • The sesamoid bone may fracture or proximally migrate (Figure 3). An occult fracture of the proximal phalanx may be present. When you classify these injuries, they can be a sprain, partial tear, or a complete tear.[huffpost.com]
  • Surgery may be recommended for turf toe if symptoms do not improve after several months of rest and physical therapy, if joint range of motion is severely limited, or if there are associated injuries such as a capsular avulsion fracture.[luriechildrens.org]
  • A grade-3 sprain or fracture takes several weeks to heal in a brace or cast. After the brace is removed, physical therapy may be necessary to regain function, prevent stiffness and preserve future joint movement.[bonejoint.net]
  • ] Medical Management Injection therapy may be considered a therapeutic adjunct. [9] The indications for a surgical treatment are the following: [2] Large capsular avulsion with unstable MTP joint Diastasis of bipartite sesamoid Diastasis of sesamoid fracture[physio-pedia.com]
Foot Pain
  • Imaging studies are not required to make the diagnosis, but x-rays of the foot may be performed to evaluate for other causes of foot pain. An MRI may be performed to confirm the diagnosis or determine the extent of the injury.[luriechildrens.org]
  • Foot and Ankle, Foot Pain, Injury Prevention Turf toe is a common condition with a unique name.[bonejoint.net]
Positive Lachman Test
  • Lachman test result) Loose body in MTP joint Chondral injury in MTP joint Failed conservative treatment Physical Therapy Management The three grades of the injury got a different physical therapy but the initial approach for all three consists in the[physio-pedia.com]
Distractibility
  • Distraction and dorsal and proximal sliding of the proximal phalanx on the first metatarsal can help restoring a normal ROM and strength. [10] The patient may do athletic activity as bicycling, pool therapy and elliptical training. [2] It’s advisable[physio-pedia.com]
Suggestibility

Treatment

  • Anderson, MD -Turf Toe: Anatomy, Diagnosis, and Treatment, Clin Sports Med. 2010 Apr;29(2):313-23 Levels of evidence : A 3.0 3.1 3.2 Robert B. Anderson, MD, Kenneth J. Hunt, MD, Jeremy J.[physio-pedia.com]
  • Treatment These injuries have the potential to become a chronic problem. Most athletes and coaches perceive this injury as a small, trivial injury. Most athletes return to sports without sufficient time for healing and recovery.[huffpost.com]
  • As with all joint injuries, early treatment leads to the best range-of-motion in the future. Treat mild cases of turf toe like other mild sprains or strains; PRICE them. Protect your toe. Rest your toe; stay off your feet.[bonejoint.net]
  • […] metatarsophalangeal–MTP joint of the great toe affecting athletes in various sports–baseball, football, soccer played on artificial turf Clinical Commonly presents as an intensely painful, swollen, red, accompanied by acute flexor and extensor tendinitis Treatment[medical-dictionary.thefreedictionary.com]
  • Treatment: Rest, ice, compress and elevate (R.I.C.E) Use over-the-counter medication such as ibuprofen to control pain and reduce inflammation.[sportsptcenters.com]

Etiology

  • […] plantar capsule and the collateral ligaments, the MTP joint is dynamically stabilized by the flexor hallucis brevis (FHB)(the hallucal sesamoids embedded in the FHB tendons), the adductor hallucis and the abductor hallucis tendons. [2] Epidemiology /Etiology[physio-pedia.com]

Epidemiology

  • Additionally to the plantar capsule and the collateral ligaments, the MTP joint is dynamically stabilized by the flexor hallucis brevis (FHB)(the hallucal sesamoids embedded in the FHB tendons), the adductor hallucis and the abductor hallucis tendons. [2] Epidemiology[physio-pedia.com]
Sex distribution
Age distribution

Prevention

  • —played on artificial turf Management Ice, NSAIDS, immobilisation, rest, footwear designed for artificial turf, increased stiffness of shoe plus taping help to prevent hyperextension or hyperflexion of the MTP of great toe turf toe Sports medicine A ligamentous[medical-dictionary.thefreedictionary.com]
  • How to Prevent Turf Toe Athletes with turf toe are prone to re-injury. Taking the following precautions can help prevent a recurrence.[luriechildrens.org]
  • Foot and Ankle, Foot Pain, Injury Prevention Turf toe is a common condition with a unique name.[bonejoint.net]
  • –Sports Injuries Mechanisms Prevention Treatment – Williams & Wilkins (1994) p. 620 Levels of evidence: D Thompson FM, Hamilton WG – Problems of the second metatarsophalangeal joint,Orthopedics 10:83, 1987 Gerard V.YU, Molly S.Judge, Justin R.[physio-pedia.com]
  • This will lead to chronic disability and prevent the athlete from competing. Most of these injuries can be treated conservatively with ice, rest, taping, and orthotics (rigid Morton's extension) (Figure 8).[huffpost.com]

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