The basic treatment for treating lawn toes is initially a combination of rest, ice, compression and elevation (remember the acronym R.I.C.E.). This basic treatment approach involves giving the injury enough time to heal, which means resting the foot and protecting the joint from further injury. The doctor may recommend an over-the-counter oral medication such as ibuprofen to control pain and reduce inflammation. To rest the toe, the doctor may stick it or attach it to the toe next to it to relieve stress. Another way to protect the joint is to immobilize the foot in a cast or special walking shoe that prevents it from moving. The doctor may also ask you to use crutches so that the injured joint is not strained. In severe cases, an orthopedic surgeon may suggest surgery. First of all, the lawn toe clearly represents a significant injury that deserves proper recognition and treatment, especially considering the complications that can occur if the condition is poorly treated. Imaging often helps diagnose lawn toes. Your doctor will order X-rays to make sure you don`t have problems with your bones. To get a better view of the plantar complex, they might order an MRI.
This is especially useful for grade 2 or 3 injuries. An emergency doctor or general health care provider will diagnose you often. But you could also see a health care provider who specializes in the bones of your skeleton (orthopedist) or a provider who specializes in the foot and ankle (podiatrist). The lawn toe got its name because the injury became more common when football players started playing on artificial turf instead of grass. Artificial grass is harder and absorbs less shock than grass. It is especially common among professional athletes who play football or other sports on artificial turf, but it also occurs in a variety of sports and activities. This is relatively unusual in people who are not athletes. Lawn toe injuries increased in the 1970s when football players began playing on artificial turf instead of grass. Artificial grass is a harder surface than natural grass.
There appears to be an increase in the incidence of lawn toe injuries, possibly due to the use of softer, lighter footwear. It may also be related to changes in the interaction of the surface with shoe wear. Early synthetic surfaces contained a synthetic nylon ribbon that wore out over time. Underneath was a foam cushion that was quickly packed, leaving a virtual asphalt-carpet interface. As a result, it was originally thought that the effect of surface hardness was responsible for lawn toe injuries. To understand how lawn toe injuries occur, a thorough understanding of all anatomical structures in and around the MTP joint is crucial. Unlike a simple hinge joint, the Hallux MTP joint works more like a hammock or hip grip. It contains several centers of motion, including sliding, rolling, and compression. Lawn toes are common among American football players because they often push their toes in a sprint or make sudden movements while running. Most of the time, the injury worsens with treatments such as rest, ice, and medications such as ibuprofen or acetaminophen. Some lawn toe injuries that do not heal with these treatments may need to be repaired surgically. Lawn toes are often associated with athletes competing on a grass surface, but it can happen to anyone.
The injury can occur during various sports and activities, wearing soft or rigid footwear and flat surfaces or lawn. One way to prevent lawn toes is to wear shoes with better support to protect the toe joint from excessive bending and force when pushing. You may also want to consider using specially designed insoles that your doctor or physical therapist may prescribe. Per McCormick JJ., Anderson RB. Big toe: missed lawn toe, chronic lawn toe and complicated sesame injuries. Ankle winks of the foot. 2009 Jun. 14 (2):135-50. [Qx® MEDLINE Link]. Currently, there are no evidence-based treatment guidelines for lawn toes.
[16] Most MTP-related joint injuries can be treated non-surgically; However, if the injury does not respond to conservative treatment, surgery should be considered as an option. It should be noted that the need for surgical management is relatively unusual. George E, Harris AH, Dragoo JL, Hunt KJ. Incidence and Risk Factors for Lawn Toe Injuries in Intercollegiate Football: Data from the National Collegiate Athletic Association Injury Surveillance System. 35 February 2014 (2):108-15. [Qx® MEDLINE Link]. It is caused by an overload of the hallux MTP joint in the hyperdorsiflexion position, as occurs when a player falls on the heel of another player. Excessive grip on the surface, so that the shoe sticks as the body weight advances when the player tries to stop quickly, can cause a sharp toe of the grass. A chronic disease is usually caused by running and frequent jumps with extremely flexible shoes. [2] [4] [5] [6] The injury very often results not only from hyperstretching, but also from a certain valgusian load.
A lawn toe injury can sideline you for days or weeks. But with self-care and proper treatment, lawn toe injuries usually heal without long-term problems. It is important to follow your physical therapist`s instructions and give your body enough time to heal. If you feel pain in your big toe during sports or activities, take a break. Never ignore the pain or try to penetrate it – it can aggravate an injury. Contact your provider for a review so you can get back into the game as soon as possible. Crain JM, Phancao JP, Stidham K. MR imaging of grass toes. Magn Reson Imaging Clin N Am. 2008 Feb. 16(1):93-103, vi. [Qx® MEDLINE Link].
Bowers first described the term turf toe in 1976 as a sprain of the plantar capsular ligament of the metatarsophalangeal joint of the big toe (MTP). It occurs secondary to violent hyperextension of the first MTP joint. An injury to the plantar plate of the big toe leads to pain with rejection and reduced mobility. This can be a devastating injury to the elite athlete and a nuisance to the general population. This activity reviews the assessment and management of budding toes and highlights the role of interprofessional team members in working together to ensure well-coordinated care and improve patient outcomes. To diagnose budding toes, the doctor will ask you to explain as much as possible how you injured your foot and may ask you questions about your profession, your participation in sports, the type of shoes you wear, and your history of foot problems. The doctor will then examine your foot, determine the pattern and location of the swelling, and compare the injured foot with the uninjured foot. The doctor will likely order an X-ray to rule out further damage or fractures. In certain circumstances, the doctor may order other imaging tests, such as a bone scan, CT scan, or MRI.
The most common symptoms of lawn toes are pain, swelling, and restricted joint movements at the base of a big toe. Symptoms develop slowly and gradually worsen over time when caused by repeated injuries. If caused by a sudden and powerful movement, the injury can be painful immediately and worsen within 24 hours. Sometimes, when the injury occurs, a “bang” can be felt. Normally, the entire joint is affected and toe movement is restricted. In 1976, the grass toe was first described by Bowers and Martin. They studied West Virginia University football players and found that there were an average of 5.4 lawn toe injuries over the course of a season. [2] [3] Other studies have shown that injury occurs more frequently when football is played on artificial turf surfaces. If you have budding toes, you`ll likely benefit from physical therapy. Exercises can help stretch and strengthen your big toe. They may not always be able to prevent lawn toes, especially if they result from an accident. To reduce the risk of lawn toes, wear shoes that provide enough stability for your activity.
Footballers and football players should avoid shoes that are too flexible, especially in the toe area. MedTerms Medical Dictionary A-Z List / Health & Living Center / Turf Toe Definition In 1978, a large University of Arkansas study by Coker et al. cited budding toes as the leading cause of missed games and practices. [14] However, it was not until 1986 that Clanton et al. developed a classification system to describe the severity of lawn toe injuries. [15] With some minor revisions since its original release, this system continues to help control processing and predict return to the game. Many people with grass toes do not have long-term problems after recovering from the injury. Some people continue to have joint stiffness, weakness or pain in the big toe (hallux rigidus). Rarely, the big toe protrudes from others and does not lie flat on the floor when standing. Lawn toe injuries most often occur when an axial load is applied to a foot fixed in Equinus.
The typical scenario that often occurs with football linesmen involves fixing the forefoot on the floor in a dorsiflex position with the heel raised. An external force then pushes the foot into another dorsiflexion, resulting in excessive traumatic stretching of the hallux MTP joint (see image below). Although grass toes are most commonly seen in football players [9], they can occur in athletes in any sport (e.g., basketball, football, or rugby).
Recent Comments