Turf Toe ,Big toe pain - Everything You Need To Know - Dr. Nabil Ebraheim

Dr. Ebraheim's educational animation video describing the condition of Turf Toe. Injury of the plantar plate sesamoid complex.Turf Toe Causes, Symptoms, Treatment .turf toe tapping ,massage rehab and turf toe exercises and turf toe surgery .turf toe treatment big toe pain .big toe arthritis, hallux rigidus exercises , tapping , therapy and surgery.
It is a hyperextension, dorsiflexion injury of the big toe’s first MTP joint.
This injury tears the insertion of the planter plate from the proximal phalanx which leads to incompetent sesamoid complex.
It is seen more in contact sports when they play on rigid surfaces, the big toe, MTR joint is positioned in hyperextension and the forefoot is fixed to the ground, and with axial load to the heel, the planter plate sesamoid complex tears.
The sesamoid can fracture or proximally migrate.
You may have an occult fracture of the proximal phalanx.
When you classify these injuries, they can be either a sprain, a partial tear, or a complete tear.
Injuries:
- There are many factors implicated with an increased incidence of turf toe.
- Increased hardness of the artificial turf
- Increased shoe flexibility
Factors associated with the patient:
- Weight of the athlete/ patient.
- Age
- Type of sport being played
- Factors associated with the foot itself.
Turf toe is seen in a lot of different sports, but more common with football players.
Clinical picture:
- The patient will present with pain, swelling, and inability to “push off” with the big toe.
- The patient will have planter swelling, tenderness, and ecchymosis.
- The vertical lachman’s test is positive.
- Varus and valgus instability is present; always compare the injured foot to the other side.
- Get an x-ray.
- Either fracture or proximal migration of the sesamoid bone will be seen.
- If seen on an AP view x-ray, this means that there is complete rupture of the planter plate.
- The sesamoid bone will not move under fluoroscopy with range of motion of the first MTP joint.
Treatment:
- These injuries have the potential to become a chronic problem.
- Hallux valgus, hallux rigidus.
- Most of the athletes and coaches perceive this injury as a small, trivial injury.
- Most athletes return to sports without sufficient time for healing and recovery.
- Approximately 50% of these patients will complain of persistent symptoms, such as stiffness of the big toe or hallux valgus deformity after more than five years after the injury occurred.
- This will lead to chronic disability and prevent the athlete from competing.
- Most of these injuries can be treated conservatively:
• Ice
• Rest
• Taping
• Orthotics, rigid morton’s extension.
More severe cases:
• Boot or cast for a few weeks then therapy for motion.
• Surgery for repair is rare
• Surgery is done if there is failure of conservative treatment, or if there is grade III tear, which is a complete tear of the plate.
• So you will repair the planter plate to the proximal phalanx through a planter approach.
• The sesamoid bone may be excised partially or completely if it is fractured.
• Return to play is usually about 3-4 months after surgery.
What is the Late Sequelae: it is hallux rigidus which may need rigid morton’s extension or surgery (cheilectomy).

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[Marcgeforce]

Been dealing with every symptom you’ve stated in this video, which is explained so effectively! I will update you on my recovery. Thank you from a lot of us!

[lila]

As a med student, all I have to say is Thank YOU very much- you were very helpful ❤️

[sonniekunkle]

I've been to the podiatrist 3 times and my regular doctor once and neither could figure out what was wrong with my foot, they said probably gout but my labs were great with no sign of that. This is exactly what I have and I've been in pain for several months and on medicine that is not helping (because it's not gout!). Looks like I need to tape and rest it. Thanks so much!

[purnarai]

Thank you sir for your kind Information. I have this problem for 1month. I was taking normal but now I'm caring self at home. Thank you

[bubaa]

Thanks for the info...looks like I have the turf toe from two days ago while on vacation....you won't believe which activity did was wearing my soft waterboots negotiating the slippery rocks....I must have over extended my right toe while trying not to fall in the water while the waves were hitting me. I only realised how painful it was until I got home. Now I have to see the doctor tomorrow....bummer...no more fishing for a few months. The pain is excruciating to say the least. Driving home was so painful. Thank god for adaptive cruise control.

[sandhyapj]

Thanks for the full description of hallux injuries

[danielbohn]

Thank you, Dr. ! The best content by far !

[tedjohnson]

Very interesting video, excellent illustrations. Now I understand why it’s a more serious injury than the name “turf toe” implies.

[kathysharp]

Fantastic. Detailed and competent info. Thank you!

[FAhS]

Your experience says u are helpful to all

[skaterpanda]

I had every symptom of this injury and exhibit qualities of those who are susceptible to it. I’ve even had x-rays though doctors have not yet told me what my injury is. Have had occasional reoccurring symptoms of this injury for the past 6 years almost always after strenuous activity such as basketball.

[kevykev]

I need to hear this guy sing
“What a wonderful world” 😂

[abhijitshukla]

Very informative and you explained lucidly. Thank you

[amrbasri]

do u know if a turf toe can still fully heal if it was semi rested and then neglected and constantly stretched by running or playing a sport and left in tht condition for about 2 yrs ?

[climbhigh]

I was rock climbing and as I fell of wall my right big toe stayed in place on hold resulting in hyperextention (turf toe). That was 6 weeks ago. Xrays negative for fracture. Very slow healing and frustating. Rest, ice, tape in the 1st weeks.

[KonataSmall]

What if the pain is in the middle toe. But just like you are describing

[tomtresco]

I have all the symptoms of Turf toe now, it`s very very painful, 5 weeks on l was getting a little better then suddenly BANG, woke up and I was back to square one, however, l have never had swelling,
I`m 70 I did it laying flooring and springing up from a crouched position, Went to hospital they didn't have a clue what it was, should I see the doctor again?

[normandavies]

Excellent explanation of an injury I have recently experienced, Thank you.

[kylecontreras]

Great, informative video as always! Thank you sir

[Swenser]

Both my big toes are problematic. Cold weather makes it a lot worse. Poor quality/positioned x-rays show small bunions, reduced gaps, and possible bone spurs. I've seen podiatrist but did not get a confident accurate assessment. Rather an offer for 600 dollar orthodixs. Dr has given some annti swelling meds and they seem to help a bit. I'll head to Thailand soon and try a specialist there and redo x-rays for a better view. For now I'll just do the extension and stretching exercises using tape and supports. Im prepared to do surgery but only if everything is clearly stated and a good outcome guaranteed. I generally get a sharp sting pain and inability to move toe. But strangely pressing all over the toe doesn't increase or initiate pain. Good luck all.