Turf toe is a sprain of the main joint of the big toe. It occurs when the toe is hyperextended. Sprains of the big toe joint became especially prevalent in football players after artificial turf became more common on playing fields – hence the term “turf toe.” Although often associated with football, turf toe occurs in a wide range of sports and activities.

The big toe is made up of two joints. The largest of the two joints is the metatarsophalangeal joint (MTP), where the first long bone of the foot (metatarsal) meets the first bone of the toe (phalanx). The smaller joint is the proximal interphalangeal joint (PIP). In turf toe, the MTP joint is injured. The joint is surrounded by important structures that hold it in place and prevent it from dislocating. Together these structures are referred to as the “plantar complex.” Turf toe refers to an injury to any soft tissue structure of the plantar complex. As with all sprains, there are three grades of sprains, from mild to severe.

• Grade 1. The plantar complex has been stretched causing pin-point tenderness and slight swelling.
• Grade 2. A partial tearing of the plantar complex causes more widespread tenderness, moderate swelling, and bruising. Movement of the toe is limited and painful.
• Grade 3. The plantar complex is completely torn causing severe tenderness, severe swelling, and bruising. It is difficult and painful to move the big toe.