Two pea-sized bones, called sesamoids, are embedded within the soft tissues under the main joint of the big toe. Even though they are small in size, the sesamoids play an important role in how the foot and big toe work. If the sesamoids are injured, they can be a source of severe pain and disability.

 

Sesamoiditis is a common ailment that affects the forefoot, typically in young people who engage in physical activity like running or dancing. Its most common symptom is pain in the ball-of-the-foot, especially on the medial or inner side. ...The term is a general description for any irritation of the sesamoid bones, which are tiny bones within the tendons that run to the big toe. Like the kneecap, the sesamoids function as a pulley, increasing the leverage of the tendons controlling the toe. Every time you push off against the toe the sesamoids are involved, and eventually they can become irritated, even fractured. Because the bones are actually within the tendons, sesamoiditis is really a kind of tendinitis - the tendons around the bones become inflamed as well.


Cause
Sesamoiditis typically can be distinguished from other forefoot conditions by its gradual onset. The pain usually begins as a mild ache and increases gradually as the aggravating activity is continued. It may build to an intense throbbing. In most cases there is little or no bruising or redness. One of the major causes of sesamoiditis is increased activity. You've probably stepped up your activity level lately, which has forced you to put more pressure on the balls of your feet. Speedwork, hillwork, or even increased mileage can cause this. If you have a bony foot, you simply may not have enough fat on your foot to protect your tender sesamoids. Also, if you have a high arched foot, you will naturally run on the balls-of-your-feet, adding even more pressure.


Treatment and Prevention

Treatment for sesamoiditis is almost always non-invasive. Minor cases call for a strict period of rest, along with the use of a modified shoe or a shoe pad to reduce pressure on the affected area. This may be accomplished by placing a metatarsal pad away from the joint so that it redistributes the pressure of weight bearing to other parts of the forefoot. In addition, the big toe may be bound with tape or athletic strapping to immobilize the joint as much as possible and allow for healing to occur. It is recommended to decrease or stop activity for awhile. This will give your sesamoids time to heal. You should apply ice to the area for 10 to 15 minutes after exercise, or after any activity that aggravates the area. As with icing, anti-inflammatories will help the swelling go down so healing can begin. While the injury is healing, women should wear flat shoes on a daily basis.
From health forum

Getting results? One sufferer wrote this information
1) Wear comfortable tennis shoes every day, put arch supports in them. I bought "Happy Feet" from the Kaiser pharmacy.
2) Stop working out! To a certain degree it felt to me like working out didn't make it any worse, but I guarantee you that you won't get better unless you stop all exercise for at least a week, maybe two. After a week you can start to reintroduce some things, like carefully riding a stationary bike without bending your toes, or weights and machines at the gym. Basically you need to stop all exercises that require bending or pushing off of the ball of your feet.
3) Get a gel metartasal pad!!! I ordered one on Amazon, it came with a toe loop, I cut this loop off because it hurt my toe and wore it under a snug pair of socks every day. After two days of wearing this pad my pain was almost completely gone.
4) Ice the area. Fill up a large water bottle with water and put it in the freezer. Roll your foot over this bottle for about 20 minutes a few times a day.
5) Take Alieve. This stuff is pretty harsh on your stomach, so don't take too much, I only took one a day.
6) Try not to bend your toes when you walk. Walk with a flat foot.
7) Use a hand held massager on the area a couple times a day for about 10-20 minutes.

I have been doing all of the above for about 10 days and I can now put full pressure back on my foot while walking. Yea!! I will continue to take it easy with the exercise and wear my tennis shoes and the pad for a few more weeks.
Unfortunately, sesamoiditis can be a real pain. One of the problems is that they actually make up a joint under the great toe.

By definition, a sesamoid is a bone contained within a tendon, which acts as a pulley. One side of the bone is in the tendon and the other side actually has an articular cartilage surface. The largest sesamoid in the body is the patella (kneecap).

Everyone has two sesamoids under each great toe and in each thumb. These, and the patella, are the most consistent. There are several others located throughout the body.

Again, the problem comes from the fact that they make up a joint. So, sesamoiditis is actually more of a degenerative joint disorder, than a tendonitis.
One of the main causes of sesamoiditis in the foot, is from a misalignment. If sesamoids do not sit correctly in their grooves under the metatarsal head, it is just like the patella maltracking in the knee. It causes abnormal wear and tear on the joint surface.

But, if they are sitting correctly, then it is mainly an inflammatory process. If the nonsteroidal anti-inflammatory take care of the problem, great. Sometimes, a cortisone (steroid) injection is used to calm down the inflammation, if the NSAIDs don't work.

Special orthotics can be used. These usually consist of a padded insert, which has an area cut out just under the first metatarsal head. This just takes the pressure off the the tender area.

As a last resort, they can be surgically taken out. HOWEVER, this is rarely recommended. It changes the biomechanics of the forefoot. It's one of those last ditch efforts. Again, most surgeons will try to avoid this at all costs.
---------------------------------------------------------------------------------------------------------------------

There are three variances of sesamoiditis:

The first variance is turf toe,

(there is a seperate article at the foot of this page on Turf Toe)

an injury to the soft tissue around the big toe joint. The big toe joint is usually injured when extended past the normal range, immediately causing sharp pain and swelling. Turf toe most often affects the entire joint and limits its range of motion. Possible outcomes of turf toe include a sesamoid fracture or an injury to the soft tissue attached to the sesamoid. Patients may feel a “pop” when injury occurs.

The second type is either an acute or chronic fracture in the sesamoid bone. An acute fracture results from trauma as a direct hit or impact to the bone. Patients will immediately feel pain and swelling at the injured area, not the entire big toe joint. A chronic sesamoid fracture is a stress fracture that normally results from repetitive stress or excessive use. This fracture is accompanied by longstanding intermittent pain in the ball of the foot, beneath the big toe joint. Pain is often worsened by physical activity and relieved with rest.

The third type of sesamoid injury is sesamoiditis, resulting from overuse of the sesamoid bone. Sesamoiditis is an outcome of increased pressure to the sesamoids, and presents with chronic inflammation of the sesamoid bones and tendons. Patients often experience longstanding, intermittent pain beneath the big toe joint, normally aggravated by wearing certain shoes and partaking in dance

Sesamoid injuries of the foot can be treated with a combination of these non-surgical options. Non-surgical treatments may vary based on the type of injury and its level of severity:

Padding, strapping or taping may relieve the area of tension or inflammation. For example, a pad worn in the shoe would provide

strapping the toe can help relieve tension in the sesamoid area.

Immobilizing the foot in a cast or a removable walking cast may aid in healing of the injured sesamoid. Dr. Radovic may also recommend crutches to relieve weight from the foot.

Ibuprofen, aspirin or other non-steroidal anti-inflammatory drugs (NSAIDs) may help reduce pain and inflammation.

Physical therapy exercises andSesamoid Injuries ultrasound therapy may be beneficial after a period of immobilization to strengthen, condition and increase range of motion of the sesamoid area.

Select cases may benefit from a cortisone injection in the joint to reduce pain and inflammation.

Custom orthotic inserts may be recommended as a long-term treatment for balance when walking and putting pressure on the ball of the foot.

(Dr Radovic)

http://www.feetfixer.com/html/sesamoid_injuries_children.html

 

 

 

 

 

 

 

 

 

Treatment

What can be done for the condition?

Many cases of sesamoiditis can heal completely with careful treatment. There are two methods for treating sesamoid problems, nonsurgical treatment and surgery. Surgery is most often used as a last resort, when other forms of treatment aren't helping.

Nonsurgical Treatment

Doctors prefer to begin with nonsurgical treatment. Your doctor may recommend treating the inflammation and pain of sesamoiditis with nonsteroidal anti-inflammatory drugs (NSAIDs), such as aspirin and ibuprofen. Special padding in the shape of a J can be placed inside your shoe to ease pressure on the sesamoids as you stand and walk. You may need to limit the amount of weight placed on your foot when you're up and about. Shoes with low heels may also ease the pressure. Occasionally, doctors inject steroid medication into the soft tissues around the sesamoids to decrease the inflammation.

Some doctors place a patient with a fracture in a cast for about six weeks. Afterward, the patient must wear a stiff-soled shoe until the pain goes away. The stiff sole of the shoe keeps the toe steady and prevents it from bending while you walk. Other doctors prefer not to cast fractures. Instead, they have their patients wear a stiff-soled shoe right away.

Stress fractures are a bit more complicated. If a stress fracture doesn't heal, it becomes a nonunion fracture, an extremely painful condition that can cause significant disability. If the problem isn't better in eight to 12 weeks, surgery may be needed to remove the pieces of unhealed bone. To avoid the problems of a nonunion fracture, some doctors use a cast and require patients to avoid putting any weight on the foot for up to eight weeks.

Surgery

If surgery becomes necessary, several procedures are available to treat sesamoid problems. Which one your surgeon chooses will depend on your specific condition.

Bone Removal

Your surgeon may recommend removing part or all of the sesamoid bone. When bone is removed from only one sesamoid, the other sesamoid bone can still provide a fulcrum point for the toe flexors. However, if both of the bones are taken out, the toe flexors lose necessary leverage and can't function. When this happens, the big toe will either bend up like a claw or slant severely toward the second toe. Thus, surgeons usually try to avoid taking both sesamoids out.

When a sesamoid bone is fractured in a sudden injury, surgery may be done to remove the broken pieces. To remove the sesamoid on the inside edge of the foot, an incision is made along the side of the big toe. The soft tissue is separated, taking care not to damage the nerve that runs along the inside edge of the big toe. The soft tissues enclosing the sesamoid are opened, and bone is removed. The tissues next to the sesamoid are stitched up. Then the soft tissues are laid back in place, and the skin is sewed together.

Surgery is similar for the sesamoid closer to the middle of the foot. The only difference is that the surgeon makes the incision either on the bottom of the big toe or in the web space between the big toe and the second toe.

Scraping

For patients diagnosed with stubborn plantar keratosis, surgeons generally perform surgery to scrape off the extra tissue. Your surgeon may decide to shave off only the affected part of the bone. The bottom half of the sesamoid is cut off, and the rough edges of the remaining part of the bone are filed with a special tool to leave a smooth shell. This surgery is easier on the body than procedures that completely remove the sesamoid.

Bone Graft

When patients continue to have problems with nonunion stress fractures, a bone graft may help the parts of the bone heal together. Surgeons mostly use this type of surgery for high performance athletes to keep the fulcrum point intact. The surgeon makes an incision along the inside edge of the main joint of the big toe. This exposes the sesamoid bone. The surgeon gathers small bits of bone from a nearby part of the big toe bone. The bone fragments are then packed into the unhealed area of the sesamoid. The soft tissue surrounding the sesamoid is stitched closed. Then the soft tissues are laid back in place, and the skin is sutured together.

Rehabilitation

What should I expect after treatment?

Nonsurgical Rehabilitation

Patients with sesamoid problems may benefit from four to six physical therapy treatments. Your therapist can offer ideas of pads or cushions that help take pressure off the sesamoid bones.

Treatments directed to the painful area help control pain and swelling. Examples include ultrasound, moist heat, and soft-tissue massage. Therapy sessions sometimes include iontophoresis, which uses a mild electrical current to push anti-inflammatory medicine to the sore area.

If simple modifications are made to your shoes you may be allowed to resume normal walking immediately. But you should probably cut back on more vigorous activities for several weeks to allow the inflammation and pain to subside. More aggressive treatment may require you to use crutches for several weeks to keep weight off the foot.

After Surgery

After a surgical procedure to shave or remove bone, patients are generally placed in either a rigid-soled shoe or a cast for two to three weeks. Most are instructed to use crutches and to limit the weight they put on the foot during this period.

Treatment is more cautious after bone graft surgery. Patients usually wear a cast for up to four weeks. Then they wear a short walking cast for another two months, at which time active exercises can start.

About 12 weeks after surgery, surgeons begin computed tomography (CT) scans on a regular basis to keep track of how the bone graft is healing. The CT scan uses X-rays that are interpreted by a powerful computer to create images that appear as slices through the body. With a CT scan the surgeon can see the bones of the sesamoid better to determine if it is healing.

http://www.orthogate.org/patient-education/foot/sesamoid-problems.html

http://www.drblakeshealingsole.com/2012/05/sesamoid-fracture-followup-email.html

 


Read more: Foot Disorders Forum - Sesamoiditis http://ehealthforum.com/health/sesamoiditis-t319849.html#ixzz2aMO1z1nX
 

Author(s):
David Zuckerman, DPM, FACFAS, Lee Cohen, DPM, FACFAS, and Sharon Monter, DPM
These authors discuss the use of ESWT to treat a professional football player who previously failed various conservative modalities for chronic sesamoiditis.
 



Sesamoiditis is inflammation and/or degeneration of the flexor digitorum brevis tendon as it passes through the sesamoid bones in the foot. Sometimes, there is a stress fracture involved and/or a tear of the tendon and/or capsule structures. Foot structure and type can contribute to this pathology.
Standard evaluation consists of X-ray, MRI or utlrasound depending upon the presentation and the response to non-surgical treatment. The differential diagnosis may include a stress fracture of the sesamoid bone, tear of the flexor digitorum brevis tendon, capsulitis, tear of the intersesamoid ligament, and/or hallux limitus with biomechical involvement.
 

Typical treatments include physical therapy, local steroid injections, padding, NSAIDs, orthoses, non-weightbearing or, in cases of failed conservative treatment, surgical excision of the tibial sesamoid. Complications arising from surgical excision may include infection, nerve damage, tendon tear, hallux abducto valgus deformity and/or other biomechanical events.
 

We have used ESWT for chronic tendinopathies and sesamoiditis for many years and have achieved excellent resolution of the pain without the need for surgical excision or any type of surgical repair.

In this particular case study, a professional football player had failed conservative therapy for chronic sesamoiditis. Failed conservative therapies included orthoses, taping, stretching, heel cups and deep tissue massage. His last episode of sesamoiditis was six weeks in duration and he was unable to play football without pain.
Upon the physical exam, the patient had pain with deep palpation of the tibial sesamoid and ambulation. The neuro-vascular status was intact. There were no signs of infections
 

We decided to try ESWT. We did not use an anesthetic nerve block for the ESWT treatment. We used the Dornier Epos Ultra (Dornier Medtech) to identify the flexor tendon at the level of the tibial sesamoid bone. We treated all hypoechoic areas at 0.21mj/cm2. The total joules applied were 960 joules. We performed two ESWT sessions with the sessions being two weeks apart.
After the first session, the patient was 50 percent better. After the second session, the patient had complete resolution of pain. The patient was subsequently able to return to the field at full capacity.
 

Final Notes
Chronic sesamoiditis is a very difficult problem to resolve, whether it is in a professional football player or anyone with this very painful pathology. It is important not only to determine time frames for ESWT treatment but the history of the complaint. Was the problem off and on for years? What were the responses to treatments aimed at the inflammation? One would typically confirm the diagnosis with either MRI and/or diagnostic ultrasound.
ESWT is a time-tested modality that clinicians can use to treat plantar fasciosis, Achilles tendinosis, posterior tendinosis and chronic sesamoidititis. I have found that clinicians have long used ESWT to treat non-unions so one may also consider this modality for non-union of the sesamoid bone. We believe that ESWT can be very effective in the treatment of chronic sesamoiditis with very little downtime and very rare complications. A study on the use of ESWT on a large pool of patients with chronic sesamoiditis would be a very exciting venture to be undertaken at one of the podiatry schools.
Author(s):
By Mark A. Caselli, DPM and Mohsen Khoshneviszadeh
 


Foot injuries are one of the most common injuries for athletes. Specifically, among all the joints and bones of the foot, the first metatarsophalangeal joint with its sesamoid complex is the most commonly affected. It is usually clear when an athletic injury involves the first metatarsophalangeal joint complex. However, identifying the specific injured structures and arriving at a precise diagnosis can be difficult.


Acute or chronic injures to the sesamoid bones or their associated tendon and joint capsule apparatus may cause pain, limping and difficulty wearing shoes, all aggravated by even a simple activity like walking. The resultant clinical impact makes both acute (traumatic) and overuse injuries major causes of competitive and recreational athletic disability.
 

Two hallucal sesamoids are situated under the first metatarsal head. The medial (tibial) sesamoid tends to be larger, oval-shaped and presents in a bipartite or multipartite form in 10 to 33 percent of feet. The lateral (fibular) sesamoid is smaller and rounder. Each sesamoid has an articular surface of hyaline cartilage, allowing it to articulate with the plantar aspect of the distal first metatarsal. While sesamoids elsewhere in the body occur variably, the hallucal sesamoids are virtually constant. These sesamoids function as an integral part of the first MPJ.

The hallucal sesamoids play an important role in great toe function as they absorb weightbearing pressure, reduce friction and protect tendons. The functional complexity and anatomic location of these small bones make them vulnerable to injury from shear and loading forces.
 

During running, more than half the weightbearing force travels through the great toe complex. Forces up to three times the athlete’s body weight may be transmitted across the sesamoids. The medial sesamoid bears most of this force and thus is more prone to injury than the lateral sesamoid. Injury to the hallucal sesamoids can cause incapacitating pain. Although you usually can diagnose traumatic injuries easily, you may overlook other pathologic conditions caused by overuse.
 

Careful physical and radiographic examinations (including bone scans) may be necessary to determine the structures damaged, extent of damage and the optimal treatment plan. Sesamoidal injures are divided into acute and chronic injures. Acute injuries are traumatic fracture/dislocations of the sesamoids and sesamoidal apparatus caused by trauma to the first MPJ complex. Chronic injuries of the sesamoids can be divided into three groups: Stress fractures, osteochondritis and sesamoiditis.
 

How To Detect And Treat Acute Injuries
 

Fracture dislocation of the sesamoids and sesamoidal apparatus is relatively rare. It usually results from a high-impact force like a fall, an injury which the pathological force of hyperextension of the MPJ causes.
 

The hallux is dorsiflexed, causing stretching of the plantar joint capsule. This causes distal distraction of the sesamoids due to their strong attachments to the plantar base of the proximal phalanx. As pathologic dorsiflexion continues, the capsule ruptures from its insertion at the plantar metatarsal neck. The hallux, with the sesamoids attached to the base of the proximal phalanx, dislocates dorsally to override the metatarsal head. The metatarsal head is then driven plantarly. The pathologic dorsiflexion may dislocate the sesamoids dorsally with the intersesamoidal ligament still intact. It also may result in either rupture of the intersesamoidal ligament or a transverse fracture of one of the sesamoids.
 

Jahss classified two types of first MPJ dislocation. Type I is a dorsal dislocation of the proximal phalanx and sesamoids on the first metatarsal head with the intersesamoidal ligament still intact. You cannot reduce this type of dislocation by closed means because of the intact intersesamoidal ligament. However, you can often use closed means to reduce the two groups of Type II dislocations. Type IIA is a dorsal dislocation of the proximal phalanx and sesamoids on the first metatarsal head with rupture of the intersesamoidal ligament, which results in wide separation of the sesamoids. Type IIB shows a transverse fracture of one of the sesamoids.
 

What About Sesamoid Stress Fractures?

Stress fractures occur when an athlete applies abnormal repetitive stress to normal bone or applies normal repetitive stress to a weakened bone. Fractures are more common in long-distance runners. Stress fractures account for 40 percent of all sesamoid injuries. These patients will complain of increasing pain and have point tenderness of the involved sesamoid. Keep in mind the pain usually develops gradually and is exacerbated by faster running or walking up and down stairs.
It’s important to differentiate sesamoid stress fractures from bipartite or multipartite sesamoids. Employing bone scans or CT scans may be necessary for early confirmation of an abnormal bony sesamoid process, as plain radiographs will not be abnormal until approximately three weeks after the injury has occurred.

As far as treatment goes, you would emphasize rest and use a 1/4- to 3/8-inch weight dispersion felt padding or a specially modified foot orthosis with a sesamoid “cutout” that decreases stress on the sesamoid while transferring weight along the shaft of the first metatarsal. Using a rigid soled shoe is also helpful. If the fracture has not united after six months of treatment and symptoms are sufficiently severe, you should consider surgical treatment. This may include performing open reduction with internal fixation of the fractured sesamoid or excising the involved sesamoid.
 

What To Look For In Osteochondritis Of The Sesamoids
 

Osteochondritis or avascular necrosis of the sesamoids may occur as a primary disorder, possibly related to recurrent stress, or as a secondary problem following a stress fracture and subsequent fragmentation. Be aware sesamoidal osteochondritis is less commonly a complication of traumatic fracture and more often the result of chronic stress. In either case, resulting avascular necrosis may lead to fragmentation and collapse of the sesamoid. You should treat such lesions conservatively for at least six months with splinting and activity modification.
Use functional orthoses and paddings similar to those you would use for sesamoid fractures. It may be necessary to fabricate a custom shoe with a protective toe box roomy enough to permit splinting of the toe. You also may emphasize other modalities such as icing, physical therapy and non-steroidal anti-inflammatory medications if necessary. If the symptoms continue to be disabling, you may use bone grafting from the adjacent first metatarsal. If the sesamoids are too fragmented for bone grafting, partial or complete excision may be a last resort.


 

How To Relieve Sesamoiditis

Sesamoiditis is a clinical diagnosis usually related to repetitive stress to the hallucal sesamoids. It occurs more frequently in the high arch or cavus foot type. In diagnosing sesamoiditis, keep in mind that it is marked by point tenderness on one or both of the sesamoids in the absence of radiographic evidence of a specific bony abnormality such as stress fracture or avascular necrosis.
At times, it’s tough to differentiate between a symptomatic and fractured partite sesamoid. In such cases, you may find contralateral X-rays or previous X-rays of the same foot valuable. Bipartite sesamoids have smoother edges and usually occur bilaterally.
Treatment options for curing or controlling sesamoiditis include temporary rest, icing, non-steroid anti-inflammatory drugs, physical therapy, splinting or foot orthoses. In severe cases, up to three weeks of rest and casting may be necessary to reduce symptoms in order to achieve pain-free foot function
---------------------------------------------------------------------------------------------------------------------

Turf Toe comes under the Sesamoid section

https://fbcdn-sphotos-e-a.akamaihd.net/hphotos-ak-prn2/970761_396562980459950_812423210_n.jpg

https://fbcdn-profile-a.akamaihd.net/hprofile-ak-ash3/211074_376289569153958_1204251212_q.jpg

The question asked was about Turf Toe.The simplest definition of turf toe is that it is a sprain of the main joint of the big toe. Here is some more detailed information gleaned for you. Turf toe is not a term you want to use when talking to a head football coach about his star running back or the ballerina before her diva debut. “Turf toe” is the common term used to describe ...a sprain of the ligaments around the big toe joint. Although it’s commonly associated with football players who play on artificial turf, it affects athletes in other sports including soccer, basketball, wrestling, gymnastics, and dance. It’s a condition that’s caused by jamming the big toe or repeatedly pushing off the big toe forcefully as in running and jumping.

Here is information about turf toe -- what causes it, how to prevent it, and how it's treated -- to help you stay in the game.

What Causes Turf Toe?

Turf toe is a sprain to the ligaments around the big toe joint, which works primarily as a hinge to permit up and down motion. Just behind the big toe joint in the ball of your foot are two pea-shaped bones embedded in the tendon that moves your big toe. Called sesamoids, these bones work like a pulley for the tendon and provide leverage when you walk or run. They also absorb the weight that presses on the ball of the foot. In Irish Dance, going up on to your toes in soft shoes can put excessive strain on the toe joint. Unlike Pointe Shoes for Ballet, Irish Dance Shoes do not have any support to take that strain in a soft shoe. The Jigs are a bit more supportive but as long as you do not sink into the toe of the shoe and that the sides of the shoe keep you from sliding down.

When you are walking or running, you start each subsequent step by raising your heel and letting your body weight come forward onto the ball of your foot. At a certain point you propel yourself forward by "pushing off" of your big toe and allowing your weight to shift to the other foot. If the toe for some reason stays flat on the ground and doesn't lift to push off, you run the risk of suddenly injuring the area around the joint. Or if you are tackled or fall forward and the toe stays flat, the effect is the same as if you were sitting and bending your big toe back by hand beyond its normal limit, causing hyperextension of the toe. That hyperextension, repeated over time or with enough sudden force, can -- cause a sprain in the ligaments that surround the joint.

Typically with turf toe, the injury is sudden. It is most commonly seen in athletes playing on artificial surfaces, which are harder than grass surfaces and to which cleats are more likely to stick. It can also happen on a grass surface, especially if the shoe being worn doesn't provide adequate support for the foot. Often the injury occurs in athletes wearing flexible soccer-style shoes that let the foot bend too far forward.

What Are the Symptoms of Turf Toe?

The most common symptoms of turf toe include pain, swelling, and limited joint movement at the base of one big toe. The symptoms develop slowly and gradually get worse over time if it’s caused by repetitive injury. If it’s caused by a sudden forceful motion, the injury can be painful immediately and worsen within 24 hours. Sometimes when the injury occurs, a "pop" can be felt. Usually the entire joint is involved, and toe movement is limited.

How Is Turf Toe Diagnosed?

To diagnose turf toe, the doctor will ask you to explain as much as you can about how you injured your foot and may ask you about your occupation, your participation in sports, the type of shoes you wear, and your history of foot problems. The doctor will then examine your foot, noting the pattern and location of any swelling and comparing the injured foot to the uninjured one. The doctor will likely ask for an X-ray to rule out any other damage or fracture. In certain circumstances, the doctor may ask for other imaging tests such as a bone scan, CT scan, or MRI.

The diagnosis will then be made based on the results of the physical examination and imaging tests.

How Is Turf Toe Treated?

The basic treatment for treating turf toe, initially, is a combination of rest, ice, compression, and elevation (remember the acronym R.I.C.E).This basic treatment approach is to give the injury ample time to heal, which means the foot will need to be rested and the joint protected 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 tape or strap it to the toe next to it to relieve the stress on it. Another way to protect the joint is to immobilize the foot in a cast or special walking boot that keeps it from moving. The doctor may also ask you to use crutches so that no weight is placed on the injured joint. In severe cases, an orthopaedic surgeon may suggest a surgical intervention.

It typically takes two to three weeks for the pain to subside. After the immobilization of the joint ends, some patients require physical therapy in order to re-establish range of motion, strength, and conditioning of the injured toe.

Can Turf Toe Be Prevented?

One goal of treatment should be to evaluate why the injury occurred and to take steps to keep it from reoccurring.

One way to prevent turf toe is to wear shoes with better support to help keep the toe joint from excessive bending and force with pushing off. You may also want to consider using specially designed inserts that your doctor or physical therapist can prescribe for you.

A physical therapist or a specialist in sports medicine can also work with you on correcting any problems in your gait that can lead to injury and on developing training techniques to help reduce the chance of injury.

 

 



Images:
www.oandplibrary.org
www.sanluispodiatrygroup.com