Big toe sprain
What is big toe sprain?
Big toe sprain or 'turf toe' is a hyper-extension injury of the first metatarsophalangeal joint, otherwise known as the big toe joint. Big toe sprain refers to a condition whereby the supporting structures of the big toe joint (ligaments and joint capsule) have been overstretched. Big toe sprain is often seen in those who play on astro turf; hence the name turf toe, this is because there is greater friction between the foot and astro turf which predisposes the big toe to hyper-extension. However, big toe sprain may be seen in anybody who participates in an activity that forces the big toe to push off from a hard surface, or that force the big toe joint into hyper-extension as the heel lifts off the ground.
What causes a big toe sprain?
Big toe sprain is caused when the big toe joint is forced into extension beyond the range of motion normaly seen at that joint; this is referred to as hyper-extension. Many sports and activities can increase the risk of toe sprain, including:
- Running basketball
What are the signs and symptoms of big toe sprain?
The signs and symptoms of a big toe sprain are the same as that of any sprain and may include:
- Pain and tenderness particularly when walking and the propelling phase of gait
- Swelling of the toe joint
Types of big toe sprain?
Big toe sprain can be classified according to the severity of the sprain, these include:
Type 1 is the most common toe sprain; it is considered to be mild and involves the tendons and the joint capsule being stretched. In type 1 toe sprain there is only a small amount of swelling and tenderness is mild
Type 2 is considered to be moderate and involves partial tears to the ligaments with no damage to cartilage. The swelling and pain associated with type 2 big toe sprains tends to be much more diffuse with greater bruising and there will be limited range of motion
Type 3 is the most severe of the three types of big toe sprain. Typically the ligaments and the joint capsule have torn making the big toe joint very unstable. The patient will be unable to weight-bear on the joint due to the pain and there will be very limited range of motion, accompanied with a large amount of bruising and swelling
How is big toe sprain diagnosed?
A podiatrist will be able to diagnose a big toe sprain based on the signs and symptoms a full history and an assessment of the affected toe.
Benefits of podiatry for big toe sprain
If you have a big toe sprain you may benefit from podiatry. The pain experienced from a big toe sprain is the result of inflammation, which has been caused by injury through overstretching of the ligaments that connect the big toe joint. Podiatry can help by stabilising the big toe joint, allowing it time to heal.
What would podiatry for big toe sprain involve?
The podiatrist will begin by taking a thorough medical and social history. They will then make a diagnosis based on the symptoms and an examination and assessment of the big toe joint. Treatment will be specific to you and will depend on the severity of the sprain. Treatment for a sprained big toe may include:
- R.I.C.E: Rest, ice, compression and elevation
- Anti-inflammatory advice
- Advice and education
- Break from activity
- Footwear review
A big toe sprain is an injury that is caused when the big toe joint is extended past its full range of motion; it is what is known as a hyper-extension injury. There are varying types of big tope sprain, categorised according to severity. The signs and symptoms of big toe sprain include pain, bruising, and swelling at the big toe joint following injury.
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