Explanation of Diagnosis

Turf toe is a sprain of the big toe joint (metatarsophalangeal joint) caused by forceful hyperextension (bending backward) of the toe. It commonly occurs in athletes playing on artificial turf, but can also result from sudden stops, pivots, or jumping motions. Symptoms include pain, swelling, stiffness, and difficulty pushing off while walking or running.

Specific Work Modifications

• Avoid prolonged standing, walking, or weight-bearing on the affected foot.
• Wear a stiff-soled or carbon fiber insert shoe to prevent excessive toe bending.
• If needed, use crutches or a walking boot to reduce strain on the toe.
• Modify tasks to allow seated work or limit foot stress.
• Apply ice and elevate the foot during breaks to reduce swelling.

Specific Activity Modifications

• Avoid high-impact activities such as running, jumping, or sports that require quick direction changes.
• Modify workouts by switching to low-impact exercises such as swimming or cycling.
• Use taping or a turf toe brace when returning to activity.
• Gradually reintroduce movement as pain and swelling improve.

Recommended Supplements

• Collagen peptides (10 g daily) – Supports ligament and joint healing.
• Vitamin C (500 mg daily) – Aids in collagen synthesis for tissue repair.
• Magnesium (300-400 mg daily) – Helps muscle relaxation and recovery.
• Omega-3 fatty acids (1000 mg daily) – Reduces joint inflammation.
• Turmeric (500 mg twice daily) – Provides natural anti-inflammatory benefits.

Recommended Nutrition and Hydration

Diet Recommendations:

• Anti-inflammatory foods: Fatty fish (salmon, sardines), turmeric, berries, nuts, and leafy greens.
• Collagen-boosting foods: Bone broth, citrus fruits, and bell peppers.
• Protein-rich foods: Chicken, eggs, lentils, and dairy to support ligament healing.
• Limit processed foods, sugar, and alcohol, which can worsen inflammation.

Hydration Tips:

• Drink at least 2–3 liters of water daily to maintain tissue hydration.
• Limit caffeine and alcohol, which can slow healing.

Home Exercise Prescription

⚠ Rest and limit motion initially; once pain decreases, start mobility and strengthening exercises.

Phase 1: Early Recovery (Days 1-7, Reduce Swelling & Pain)

1. Toe Taping or Splinting

1. • Use turf toe taping technique to restrict movement and support healing.

2. Toe Range of Motion (Gentle)

1. • Slowly bend and straighten the big toe without force.
   • 10 reps, 2-3 times daily.

3. Ice & Elevation

1. • Apply ice for 15-20 minutes, 3-4 times daily to reduce swelling.

Phase 2: Strength & Mobility (After Pain Improves, 1-2 Weeks In)

4. Toe Flexor Stretch

1. • Pull the big toe downward gently to stretch the joint.
   • Hold for 20-30 seconds, repeat 3 times.

5. Toe Towel Scrunches (Arch & Toe Strengthening)

1. • Place a towel under your foot and scrunch it toward you using your toes.
   • 10 reps, 2 times daily.

6. Seated Heel Raises (Once Pain Allows)

1. • Sit in a chair and lift your heels off the ground, engaging the toe muscles.
   • 10 reps, 2-3 times daily.

Phase 3: Return to Activity (Once Pain is Minimal, 3+ Weeks In)

7. Standing Heel Raises

1. • Stand and slowly raise onto your toes, then lower.
   • 10 reps, 2 times daily.

8. Single-Leg Balance Exercise

1. • Stand on the affected foot for 15-30 seconds, increasing time as tolerated.
   • Repeat 2-3 times per leg.

⚠ Avoid running, jumping, or pushing off forcefully until fully healed (typically 3-6 weeks).

Helpful Books

1. "Sports Injuries Guidebook" – Robert Gotlin, DO
2. "The Healthy Athlete’s Guide to Injury Recovery" – Jordan Metzl, MD

Contact the Key West orthopedic clinic or reach out to Dr. Jason Pirozzolo.