3-4 days free worldwide delivery

Orthotic Intervention for Turf Toe Injuries

by MASS4D® Prescription Orthotics February 08, 2017

 Turf Toe Injuries

A turf toe injury refers to a sprain of the ligamentous structure of the first metatarsophalangeal joint (MTPJ).

The mechanism of turf toe injuries involves hyper-extensive force delivered to the first MTPJ resulting in a disruption of the plantar joint complex. This is caused when axial load passes through the heel with the foot in a fixed equinus position.

If dorsiflexion of the first MTPJ remains uninterrupted, the base of the proximal phalanx impacts the central dorsal articular surface of the metatarsal head leading to further injuries of the joint surface.

The term “turf toe” was first coined by Bowers and Martin in 1976 when they observed an increase in the incidences of sprains in the plantar capsule-ligament complex of the first MTPJ among players, after the installation of an artificial turf on West Virginia University’s football field.


Offer your Patients a Custom Calibrated Insole with a 98% Patient Satisfaction Rate     know more


The authors noted that the combination of a relatively flexible football shoe with a hard artificial surface predisposed the players to turf toe injuries, necessitating the use of firm-soled football shoes.

According to McCormick and Anderson, turf toe injuries can be categorised as – hyperextension, hyperflexion and dislocation injuries – distinguished by history and physical examination.

Hyperextension turf toe includes any stretching or tear of the plantar capsular ligamentous complex causing tenderness, swelling and ecchymosis. This occurs when a player’s leg is injured on the field with the foot plantar flexed at the ankle and the hallux in full extension.

Hyperflexion (sand toe) refers to an injury of the hallux MTPJ or any of the lesser MTP joints. This is less common and occurs when a tackle from behind pushes the player’s knee forward, while the foot is plantar flexed and the body is in continuous movement.

A dislocation involves a disruption of the hallux with the sesamoids, or an associated disruption of the intersesamoid ligament. There could also be a transverse fracture of any of the sesamoids or a complete disruption of the intersesamoid ligament with fracture of one of the sesamoids.

The risk associated with a compromised medial longitudinal arch is the additional stress placed on the foot which predisposes a player to a valgus or varus injury of the first MTPJ.

In the case of hyperextension injuries, a stiff-soled shoe paired with customised orthotics such as MASS4D® can help limit hallux MTPJ extension, improve plantar flexion of the first ray and enable a smooth transition of the player to pre-injury performance level.

As part of an active rehabilitation programme, customised orthotics with added rigidity would be beneficial in reducing dorsiflexion stress to the MTPJ and supporting the peroneal and tibialis posterior muscles which are responsible for the stabilisation of the foot in motion.

This will help restore the medial longitudinal arch and improve range of motion of the foot and ankle, helping enhance the player’s performance on the field.

Copyright 2017 MASS4D® All rights reserved. 


Offer your Patients a Custom Calibrated Insole with a 98% Patient Satisfaction Rate     know more


Related Links

References:

  1. VanPelt D. M., Saxena A., Allen A. M. (2012) Turf Toe Injuries. Sports Medicine and Arthroscopic Surgery of the Foot and Ankle. Springer-Verlag.
  2. McCormick J. J., Anderson B. R. (2009) The Great Toe: Failed Turf Toe, Chronic Turf Toe, and Complicated Sesamoid Injuries. Foot and ankle clinics: July 2009, DOI: 10.1016/j.fcl.2009.01.001
  3. Williams E. B. (2008) How To Treat Turf Toe Injuries. Podiatry Today: September 2008, Vol. 21, No. 9, Retrieved from: http://www.podiatrytoday.com/
  4. Bowers D. K., Martin B. R. (1976) Turf-Toe: a shoe-surface related football injury. Medicine and Science in Sports: February 1976, Vol. 8, No. 2, pp. 81-83

Leave a comment

Comments will be approved before showing up.


Also in Clinicians Blog

Lower Limb Injuries In Fencing
Lower Limb Injuries in Fencing

by MASS4D® Prescription Orthotics October 21, 2018

There are various injuries of the lower extremity that can occur in the sport of fencing because of, for instance, quick ‘propulsion’ and ‘dodge’ offense/defense movements and other risk factors. 

Read More

Piriformis Syndrome
Managing Piriformis Syndrome

by MASS4D® Prescription Orthotics October 16, 2018

Piriformis syndrome is caused by the entrapment or compression of the sciatic nerve by the piriformis muscle at the infra-piriformis canal. This is commonly felt as sciatica which can intensify with certain triggering positions.

Read More

Patellar Tendinopathy
Patellar Tendinopathy

by MASS4D® Prescription Orthotics September 30, 2018

Repetitive movements such as those found in basketball and volleyball involve the constant release and storage of energy from the patellar tendons without adequate rest. This can result in patellar tendinopathy.

Read More