Turf toe is caused when the metatarsophalangeal (MTP) joint, the big toe joint, is hyperextended. In other words, this injury occurs when the heel is lifted off the ground and power is applied to the big toe. Turf toe can occur suddenly or gradually, from repeated push-off movements to the ball of the foot.
Anyone can develop turf toe, but athletes are particularly prone. Soft-soled shoes, which provide minimal protection to the front of the foot, and hard athletic surfaces, like artificial turf, are two leading injury causes.
There are several risk factors for developing turf toe, such as:.
- Participation in certain sports. Turf toe is a common sports injury for football players; it also impacts basketball, soccer, field hockey, dance and lacrosse participants. Above all, turf toe may occur during any activity where the front of the foot is planted on the ground and the heel is lifted.
- Artificial surfaces. The ubiquity of artificial turf during the 1960s has caused an increased number of injuries to the first MTP joint.1 In a survey of 80 National Football League players, 45% of athletes experienced turf toe injuries during their professional work—83% of those happened on artificial turf.1
- Soft-soled shoes. Shoes have become increasingly flexible and lightweight, and provide little support at the front of the foot.
Knowing these risk factors, athletes may consider wearing stiff-soled shoes, such as cleats instead of tennis shoes, and changing playing surface to prevent injury.