From the Research
The treatment algorithm for turf toe should prioritize conservative management for grade I and II injuries, with a focus on rest, ice, compression, and elevation, as well as the use of kinesiology taping to reduce pain and improve functional ability, as supported by the most recent study 1. The treatment approach for turf toe injuries can be broken down into several key components, including:
- Conservative management for grade I and II injuries, which includes the RICE protocol, as well as the use of a stiff-soled shoe or walking boot to limit toe motion, and taping techniques to stabilize the first metatarsophalangeal (MTP) joint 2, 3.
- Pain control, which typically involves NSAIDs such as ibuprofen (400-600mg three times daily) or naproxen (500mg twice daily) 2, 3.
- For grade III injuries with complete ligament tears or joint instability, orthopedic consultation is necessary, and surgical intervention may be required if there are displaced sesamoid fractures, vertical instability, or large capsular avulsions 2, 3.
- Return to activity should be gradual, beginning with protected weight-bearing and progressing to sport-specific activities once pain-free range of motion is achieved, with the goal of achieving pre-injury levels of performance, as reported in the most recent review 3.
- Long-term management may include custom orthotics with a Morton's extension or carbon fiber plate to limit first MTP joint motion, as well as ongoing rehabilitation and strengthening exercises to prevent future injuries 2, 3. The use of kinesiology taping, as studied in the most recent clinical trial 1, has been shown to be a useful complementary modality to exercise in patients with turf toe, resulting in significant improvements in pain, gait characteristics, and functional abilities. Key considerations in the treatment of turf toe injuries include:
- The severity and classification of the initial sprain, which will guide the treatment protocol and return-to-play criteria 3.
- The need for individualized treatment plans, taking into account the specific needs and goals of each patient 2, 3.
- The importance of ongoing rehabilitation and strengthening exercises to prevent future injuries and maintain optimal functional ability 2, 3.