Metatarsophalangeal joint sprain
| Metatarsophalangeal joint sprain | |
|---|---|
| Classification and external resources | |
| Specialty | emergency medicine |
| ICD-10 | S93.5 |
| ICD-9-CM | 845.12 |
| eMedicine | orthoped/572 |
A metatarsophalangeal joint sprain is an injury to the connective tissue between the foot and one of the toes. When the big toe is involved, it is known as "turf toe".[1][2]
Causes
Turf toe is named from the injury being associated with playing sports on rigid surfaces such as artificial turf[3][4] and is a fairly common injury among professional American football players. Often, the injury occurs when someone or something falls on the back of the calf while that leg's knee and tips of the toes are touching the ground. The toe is hyperextended and thus the joint is injured. Additionally, athletic shoes with very flexible soles combined with cleats that "grab" the turf will cause overextension of the big toe. This can occur on the lesser toes as well. It has also been observed in sports beyond American football, including soccer, basketball, rugby, volleyball, and tae kwon do.[5] This is a primary reason why many athletes prefer natural grass to turf, because it is softer.[6]
Treatment and prognosis
The injury can be debilitating for athletes of many sports who need to accelerate, quickly change direction, or jump. Use of the toes is not possible during the healing process. Since the toes are necessary for proper push-off when accelerating, those sorts of athletic activities should be almost completely curtailed. An extended healing period of one or more months is often required.
Because of the anatomy of the distal foot and the unique use of the foot, it is often impossible to properly tape or brace the joint. Although difficult, it is not impossible to tape the toe to limit extension (upward bend of toe). Additionally, wearing a shoe with a rigid sole (often a metal plate) and cushioned innersole will help minimize extension of the joint. Anti-inflammatory medication as well as physical therapy is recommended.
Turf toe can often progress into a chronic problem, in which the joint(s) never really heals or heals too slowly to return to usual physical activities. It can become more serious if left untreated, and may cause serious problems for the athlete. Treating the injury includes icing of the area, elevating the foot, or possibly the use of custom orthotics.[7]
References
- ↑ Allen LR, Flemming D, Sanders TG (2004). "Turf toe: ligamentous injury of the first metatarsophalangeal joint". Mil Med 169 (11): xix–xxiv. PMID 15605946.
- ↑ Kubitz ER (2003). "Athletic injuries of the first metatarsophalangeal joint". J Am Podiatr Med Assoc 93 (4): 325–32. PMID 12869604.
- ↑ Childs SG (2006). "The pathogenesis and biomechanics of turf toe". Orthop Nurs 25 (4): 276–80; quiz 281–2. doi:10.1097/00006416-200607000-00012. PMID 16900075.
- ↑ Bowers KD Jr, Martin RB (1976). "Turf-toe: a shoe-surface related football injury". Med Sci Sports 8 (2): 81–83. PMID 957935.
- ↑ Frimenko RE, et al. (2012). "Etiology and biomechanics of first metatarsophalangeal joint sprains (turf toe) in athletes". Crit Rev Biomed Eng 40 (1): 43–61. doi:10.1615/CritRevBiomedEng.v40.i1.30. PMID 22428798.
- ↑ "Turf Toe – Every Athlete’s Nightmare". Joint, Aches, and Pain Org. Retrieved 3 March 2013.
- ↑ http://www.merckmanuals.com/professional/musculoskeletal-and-connective-tissue-disorders/foot-and-ankle-disorders/metatarsophalangeal-joint-pain
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