Turf Toe

The symptoms of Turf Toe can include pain, swelling, and limited joint movement.

These symptoms usually begin slowly. If they aren’t addressed properly, they gradually worsen. Turf toe is essentially a sprain of the ligaments around the big toe joint.

 Symptoms       Causes        Solutions

Dr. Sam Dubé discusses turf toe

Learn about the symptoms, causes, and benefits of different treatment options.

 What causes turf toe?

In addition to trauma, turf toe commonly develops as a result of poor foot mechanics caused by footwear use.

Over time, poor foot mechanics become the maladapted functional norm, which predisposes the great toe joint to injury and damaging stresses. Injury typically occurs as a result of the excessive forces on the great toe joint that are created during running sports, particularly on artificial turf.

Turf toe can also be caused by a direct injury that leads to damage of the bone beneath the cartilage.

Even mild, repeated episodes of this trauma can cause severe pain and the inability to walk or run, which is a devastating outcome for a running athlete.

Optimally, the great toe and arch should rise, pre-ground contact, in anticipation of the activity-related forces that are expected during weight bearing and propulsion. This pre-ground contact muscle activation promotes arch system stability and the ideal positioning of the great toe for optimal propulsion during toe-off. This generates little or no stress on the big toe joint.

If this muscle firing sequence does not occur or if the big toe is prevented from rising due to tight restrictive footwear, propulsion load-bearing forces exert extreme stresses on the big toe joint. It is these stresses that cause turf toe.

Modern science has identified that the nervous system plays a critical role in stabilizing the feet and ankles when walking or running. It is now understood that poor foot function is a symptom of inefficient neuromuscular function caused by conventional footwear use. In fact, conventional footwear use causes poor neuromuscular function throughout the feet, legs, hips, and back, when:

  • the soles of the feet don’t receive the subtle, varied stimulus that the nervous system requires for healthy function,

  • snug toe boxes, stiff midsoles/outsoles/uppers and tight lacing restrict healthy foot movement, and

  • footwear midsoles / outsoles feature a concave supporting surface under the metatarsal heads.

To learn more about how footwear affects function and performance, click HERE.



The best way to prevent and treat turf toe is to retrain optimal foot mechanics and to use footwear that is soft, flexible, and roomier in the forefoot.

Conventional treatment methods for the arthritic foot

Since the late 1890s, the standard treatment for turf toe related poor foot mechanics has been to artificially support the arches with an orthotic. Other conventional treatment options include:

  • Immobilization via taping

  • Cushioning insoles

  • Ice

Modern science has transitioned away from using long-term support and cushioning on any body part because it causes a progressive weakening of the body part being supported or cushioned.

The modern approach to treating turf toe

Science has shown that merely challenging the body to “do its job” is the best way to restore and enhance function.

The modern approach to address poor neuromuscular function is to employ a “Proper Technique” rehabilitative therapy to regain healthy function. This approach is extensively used pre- and post-surgery and is also the foundation of virtually all sports training/rehabilitation programs. By employing a therapeutic approach, the feet become stronger and more stable, thereby addressing the cause of the poor foot mechanics that contribute to turf toe.

Proper Technique therapies employ exercise that focuses on safely training healthy neuromuscular function, i.e., optimal mobility, muscle strength, stability, and alignment.

Proper Technique therapies require both Right Stimulus and Right Movement.

Right Stimulus occurs when the information that the brain receives from the senses triggers an efficient protective reflex function or Right Movement. The nerve endings in the soles of the feet play a critical role in providing the brain with the information required for optimal Right Movement throughout the feet, legs, hips, and back. When the brain receives insufficient or inaccurate information from the soles of the feet, the protective reflex function Right Movement will be ineffective or absent altogether. This is what happens when conventional footwear is worn. For more information on Right Stimulus and Right Movement, click HERE.

To therapeutically address the cause of turf toe and to prevent it from reoccurring, do the following:

Walk barefoot on natural terrain as much as possible. This provides the optimal Right Stimulus and allows for the Right Movement required for healthy neuromuscular function.

Use Biopods® Stimsoles® Footwear or Insoles. Biopods Footwear provides the ultimate Proper Technique shoe environment. Biopods Insoles improve the stimulus in your conventional footwear. Use in loosely laced, soft, flexible footwear with ample toe room that allows your arches and toes to rise easily for best results.

Consult with your healthcare practitioner to ask about employing soft tissue mobilization therapies to address the fibrotic scar tissue that may have formed prior to using Biopods.

For more information on what to expect when using Biopods, click HERE.

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