“…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.
Wow, terrific article, Brian. It amazes me that more professionals have not yet discovered you.
You are incredibly gifted and skillful at repairing broken bodies. I am ever grateful for the incredible results you achieved for me as a long distance racewalker.
Thank you, Dave Thorpe
Thanks Dave!
I’m in Ultimate Frisbee player who recently suffered a turf toe injury while playing two days ago. I’m using your suggested self treatment and the mobility of the joint seems to be improving. It’s still painful though. My question is: when can I return to playing? Should I let pain be my guide? All of the other sites (the traditional recovery method) say to stop activity for up to 6 weeks.
Becky, Thanks for your comment. Glad the joint is improving. Try keeping it taped while you play. Without doing an assessment I can’t really give advice on when to get back in the game. I’m available for FaceTime consultation if want more information about your situation.
Brian
Hi, I have had an ultrasound scan on my foot following a running injury to my big toe joint, and I am found to have a sprain of the transverse metatarsal ligament. I don’t think this is the same as turf toe, but should I treat it similarly in terms of taping?
Thank you for your email. Without more information I am not able to give you advice for your specific needs. If you like, we can schedule a video consultation to go over the situation. Contact me at info@briandorfman.com if you want to go this route.
YES!!!! I AM LIVING PROOF BRIAN KNOWS WHAT HE’S TALKING ABOUT.
I had turf toe in my senior year of college soccer, never felt a pain like that when it happened that i thought i was going to sit out my final year. Research and prayer for miracle was the only hope I had left if i was going to play. Well, thankfully God listened to me and led me to this blog. I reached out to Brian and after one video consultation with him, I was able to play the whole season while my toe was healing. RICE was what i was advised to do which would have sidelined me for ages. But with the mobilization method and taping, I was able to play while it healed, and now my toe is completely healed.
Thanks Brian! (sorry for the long paragraph, but it had to be said). YOU ARE THE MAN!! which is why you’re my go-to-guy, when I’m confused about certain injuries.
Tobi, so glad to know your toe is healed! And thanks for the excellent review. Brian
With an acute turf toe injury from trauma, how soon do you recommend starting this rehab process? My foot slipped off of a bench doing a split squat, and my toes jammed down onto the garage floor. My injury is just under 24 hours old. Thanks!
Carrie,
Thanks for your email. You can start taping right away. Go to BrianDorfman.com and check out the video and blog sections for taping information. You can search for Turf Toe within those sections and the relevant content will come up. Good luck. Also know that I am available for virtual consultation if you should want more individualized care. Brian
Thank you very much. I started your therapy yesterday and I have great improvement this morning. I am super impressed with your methods. I will probably reach out to do a video consult as to make sure I have all bases covered. Thanks again’
With an acute turf toe injury from trauma, how soon do you recommend starting this rehab process? My foot slipped off of a bench doing a split squat, and my toes jammed down onto the garage floor. My injury is just under 24 hours old. Thanks!
Hey! Great article. I have turf toe I think ? Or hyper extended all my toes 🙁 just trying to get a idea on how to handle this. I’m super active and would like to get back to running ASAP so I can be solid for 2021 race season.
Miranda, Thanks for the good word. I am available for virtual consultations if you are interested in a more personalized program. Reach out to me at info@briandorfman.com if you want more info or to schedule. Take care, Brian
@Brian- I suffered a turf toe injury in 2003 and the joint it still giving me issues, and I cannot run anymore as I think it’s causing IT band issues as well as other issues throughout my leg. Is there anything I can do in terms of possibly using one of those daily braces suggested for turf toe?
Thanks for your inquiry. We can definitely help with your turf toe and resulting issues. You can follow the turf toe protocol on the website and Brian is also available for a virtual consultation to go over your specific needs and Brian can offer personalized advice. Consultations are $90 for 30 minutes. Following the consultation, you can also email Brian for follow up with no additional cost.If you would like to schedule an appointment, please let me know your availability in the coming week along with what time zone you are in.