Turf Toe Injuries and Artificial
Surfaces: The Future of Your
Fantasy Football League
Daniel Desautels, David Mosko, Jacob Riley
Where are We Going Today?
What Is Turf Toe and Why Do We Care?
How is Turf Toe Caused and How is It Currently Treated?
New Ideas Regarding Treatment and Prevention of Turf Toe
Why is Turf Toe Important?
• Artificial Surfaces are Becoming More Common
• Professional sports fields
• Collegiate sports fields
• High school sports fields
• Public parks being converted
• Economic Costs to NFL, NCAA
• Potential for long-term injury
• You can suddenly lose your fantasy football league
Anatomy of the Foot
Gray, Henry. Anatomy of the Human Body. Philadelphia: Lea & Febiger, 1918; Bartleby.com, 2000. www.bartleby.com/107/
Normal Range of Motion
DeLee and Drez’s Orthopaedic Sports Medicine: Principles and Practice, 3rd Ed., Elsevier 2009. Figure 25H-24
Typical Injury
• Injury to the 1st (great) toe
• Injury to the 1st metatarsophalangeal (MTP) joint
• Forced hyper-dorsiflexion of 1st MTP joint
• Sprain/strain of ligamentous structures
• Partial or full tear in more serious cases
Hockenbury, R.T. “Forefoot Problems in Athletes.” Med. & Sci. in Sp. & Ex. Vol. 31 Issue 7 Supplement. S448-S458. 1999.
Typical Symptoms
Physical Examination
• 1st MTP joint swelling
• Bruising adjacent to the area of capsular injury
• Plantar tenderness at the MTP joint
• Pain with passive MTP joint dorsiflexion
• Pain with joint loading
• Decreased dorsiflexion of the MTP joint
Radiographic Examination
• Soft tissue swelling
• Small periarticular bony avulsions
• Intra-articular loose bodies
• Dislocation of bipartite sesamoid
• Sesamoid fracture
• Migration of sesamoids
DeLee and Drez’s Orthopaedic Sports Medicine: Principles and Practice, 3rd Ed., Elsevier 2009. Box 25H-14
Mechanism of Injury
•Blow to back of leg/heel while foot is flexed
•This injury basically never existed until the creation of artificial
playing surfaces