“…As much playing time is now lost in the NFL because of turf toe as ankle sprains, and it has become the most common injury reported by some 600 college players…”   

Sports Illustrated – December 1988

 

A great amount of interest has been paid to “A Fix for Turf Toe”, which was posted in this blog one year ago. Since that time, hundreds of athletes have emailed me seeking help with this problem. Many parents have reached out with concerns about a child athlete’s turf toe. While many inquiries have been from football players, I was surprised to receive numerous emails from athletes in basketball, tennis, soccer and track & field as well.  At the time of inquiry, some of the injuries were fresh, which is my favorite point of entry, but many others were chronic.  For those long lasting cases, most of the athletes had tried conventional treatment methods with little success. So, with Super Bowl #51 in mind, I have penned this sequel, to give you more information about my revolutionary treatment protocol.

NFL athletes who have been laid low by Turf Toe include:

LaDainian Tomlinson – San Diego Chargers running back

Darren McFadden – Raiders running back

Charles Woodson – Oakland cornerback

Jonathon Ogden – Ravens offensive tackle

Matt Ryan – Falcon’s quarterback

Jack Lambert – legendary Steelers linebacker

(For more about football and turf toe, check out this article on NFL Greats Who Have Been Grounded by Turf Toe.)

Conventional treatment protocol for turf toe has not changed in the 35 years since I played high school football. RICE – rest, ice, compress, elevate – remains the go-to method for dealing with this type of injury. This protocol involves immobilizing the toe joint – that’s the “rest” part. Immobilization is generally recommended for up to 4 weeks following injury. While the Sports Illustrated quote above is from 1988, I imagine the incidence of turf toe has only increased with an increase in artificial turf fields. Still, the recommended treatment is the same old thing and the results are not impressive.

Mobilization:

In my method, I take the opposite approach to convention and actually encourage mobilizing the affected joint – and here’s why. The underlying problem with the turf toe is that you have 2 bones that meet at a joint, which is inflamed, possibly calcified and likely damaged. Moving and separating those two bones promotes micro-circulation, which works to flush out excess calcium and reduce swelling, allowing the joint to recover. The joint will only get better with movement.

So, the question is, how exactly do we mobilize the joint capsule? We do it by grabbing bone A and bone B and moving them away from each other.  Watch this sort video to see how it works.

 

Taping:

Another essential component of my method is taping. My taping protocol was developed specifically for turf toe and the results are stellar. I like taping a toe because it keeps it safe and there is not an advantage to not taping it. Especially if the issue with the turf toe is recent.  Check out the below video for all you need to know about taping a turf toe.

In general, the rule of thumb in injury prevention/rehabilitation is that you do what it takes to keep the area out of pain. So, on extreme cases, the toe should be taped throughout the day, then re-taped after mobilization exercises. I will often recommend that an athlete continue to tape their toe for all games and practices, even after it is healed, just as they would do for an injured ankle. The toe is still vulnerable and taping will help prevent further injury.

I recently worked with a college football player who had had 2 toe surgeries before I met him, yet still, he was in chronic pain and the toe joint was completely immobile. After one appointment at my office and a few FaceTime updates, however, he had 100% mobility and was back playing football. He is now in his senior year and going strong and is dedicated to using my mobilization and taping techniques for treatment as well as for prevention.

Self-Massage:

Take a look at this short video called “Have a Ball on your Feet”. It demonstrates a unique stretching method for the foot in which all the bones of the foot are activated and “rolled out” using a tennis ball or similar therapeutic device. Few people understand the importance of having free bone movement throughout the foot so that the total amount of tension doesn’t end up localized in one area, in this case, the big toe joint.

With this exercise, the principle of supply and demand is useful. If you’re putting more stress on the feet, training more, traveling more, working out more, then you want to do more recovery. That being said, if you are serious about taking care of a turf toe, step one is getting it out of the painful stage and that’s a daily process. The exercise can be completed in as little as 10 minutes or can take as long as 30-40 minutes.

If you are dealing with the pain and inconvenience of turf toe, you are in good company. Julio Jones, Falcon wide receiver and Eli Rogers, starting slot receiver for the Pittsburgh Steelers are two high-end NFL athletes who are also been struggling with turf toe.  Just like you, they too, can be on the road to recovery using the three steps outlined above.

Mobilization, taping and “rolling out” the foot are key to fixing turf toe problems.   Mobilization promotes circulation and allows the joint to heal. Taping protects and stabilizes the joint. Rolling out reduces tension in the entire foot and helps prevents future injuries. Go ahead, give it a try, experience the results for yourself.  Your toes and feet will feel better forever.

 

Brian Dorfman is available for video consultation via FaceTime or Skype if you want to talk with him about your turf toe but cannot make it to one of his California clinics.