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August 12, 2018
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Why ‘turf’ toe?

Big toe sprains often occur in athletes such as football, soccer, and baseball players. Since these sports are played on grass or turf, the injury has been dubbed ‘turf toe.’

Causes

Injury occurs when the toe is either jammed inward or bent backward beyond the range of normal flexibility. This is a sudden event, not an overuse injury. A toe sprain is more likely in athletes who perform cutting and sprinting movements on artificial turf. Grass is the preferred surface as it provides a softer impact. Improper footwear can also contribute to these injuries. Athletes should always wear the proper shoes for their particular sport. If you are at risk for a re-injury or want to avoid a bad stub, opt for shoes stiffer through the forefoot and toes.

READ MORE: The Right Shoes for Your Activity

Signs & Symptoms

There has never lived a person who could sprain their big toe and not at least wince. Most people will know they have suffered an injury by the immediate pain shooting through their toe. Overextension and impact on the joint causes damage to ligaments which causes bruising and swelling. In severe cases, there could be damage to the bones at the joint, resulting in increased pain.

Complications

Turf toe not only results in a great deal of immediate pain but as the injury goes untreated, further damage could also be occurring. Joints become less flexible and you are more likely to develop arthritis. Hallux Rigidus, extreme limited mobility of the big toe, can lead to problems with balance and performance, leaving you at a high risk for re-injury. If your joint suffers further damage, a minor injury could turn into a chronic condition that impacts your game.

Diagnosis

Diagnosis is made by taking an account of the injury event and coupling it with a physical exam. Many podiatrists will take x-rays to rule out bone fractures or other, more serious injuries. It is important to visit your podiatrist early and not wait until symptoms recede and then reappear.

READ MORE: Types of Fractures

Treatment & Healing

Treatment for a sprained toe is RICE–rest, ice, compression, and elevation. If the bone is not damaged, then the only thing to do is wait for healing to occur. While recovering, you will want to switch to stiffer footwear that will protect the big toe from any unnatural movements. If you return to activity before your toe is fully healed, you risk re-injury and chronic pain and stiffness. Additional therapies such as laser therapy can help speed up healing time.

If you think you have sprained your toe, visit the FAAWC immediately. Faster diagnosis and treatment means less time sitting on the sidelines. Get back in the game faster with proper care.

Without the skeletal system, we would all be crawling around on the ground like an octopus out of the water. It’s good, therefore, that humans developed bones. In fact, the foot developed more bones than any other part of the body. Each foot has 26 bones, which is pretty awesome, but it’s also 52 different places injury can occur.

 

Bruising

Your bones are strong and can take a lot of force before succumbing to injury, but problems like a bone bruise can still cause big pain. Bruises sound minor compared to breaks, but a physically traumatic event still needed to occur to bruise a bone. The bone itself does not swell or discolor, but the sudden force causes micro-tissue tearing around the bone, and fluid and blood build up in that area. You will have swelling, tenderness, discoloration, stiffness, and pain. To diagnose a bone bruise, your podiatrist will examine the foot and ask about the injury event. Bone bruises do not show on x-rays, but your podiatrist may still take x-rays to rule out a fracture.

READ MORE: Why Your Toe Hurts...

 

Stress Fracture

Stress fractures are a type of repetitive use injury common in athletes and runners. With this type of fracture, the bone has cracked but not split completely apart. Stress fractures most often develop when people change the intensity of their workouts or the surface they are working out on. Running on a treadmill in the winter then switching to pavement in the summer puts excess force on bones, causing these hairline fractures. If you have weakened bones, you could develop a stress fracture just doing everyday activities. Stress fractures will show up on x-rays and can be treated with RICE­–rest, ice, compression, and elevation.

READ MORE: Don't Stress Over Stress Fractures

 

Acute Fracture

An acute fracture occurs in an instant from a traumatic event to the foot and breaks the bone apart. These fractures can range from simple breaks to gory compound fractures. Simple fractures, where the bones remain aligned, can be protected with a cast while they heal naturally.

Spiral fractures occur when the bone is twisted, causing the break to spiral around the bone. These may remain aligned and heal with prolonged immobilization, or they may require setting of the bones manually if they have been displaced.

Compound fractures occur when broken pieces of bone pierce the skin and extrude. These are the most severe and dangerous of all fractures as it leaves the patient oven to deep bone infections. Compound fractures require surgical repair, sometimes with the use of pins or rods to hold the bone together.

All acute fractures require a minimum healing time of 4-6 weeks and will be followed with physical therapy to strengthen muscles that were unused during the immobilization time.

READ MORE: Beware the Compound Fracture

 

Crush Injuries

Bones can also be crushed and shattered which can be very serious and requires major surgery. A comminuted fracture occurs when the bone breaks into three or more pieces. These fragments will need to be put back together and secured with pins, wires, screws, and plates. The goal is to help the bone heal back into its natural position. Some bones may be too injured to pin back together. In these cases, a substitute bone may be used. One option is to use a bone graft from your own body, usually taken from the hip or leg. Other options include donated cadaver bones and synthetic bones created in a lab or even with a 3D printer.

No matter what type of bone injury has occurred, you will need to see your podiatrist. From a bone bruise to a bone replacement, the foot and ankle surgeons at the FAAWC are the best at diagnosing and treating your bone injury. If you have pain in your foot or ankle and suspect a fracture, call us today!

 

Cycling is a great way to keep in shape while minimizing the impact on your feet and ankles, but that doesn’t mean there are no risks for your feet. All the energy you push through your legs is transferred directly into the bike through the bottoms of your feet. Arch pain, heel pain, and toe pain are all common complaints of cyclists. Luckily, just a few simple steps can help you avoid pain and injury and keep you going for miles to come.

Better Footwear

It should come as no surprise that your cycling shoes will affect your foot health. Shoes too tight or pointed in the toes can lead to issues such as bunions or hammertoes. There should be at least 1” of room between your toes and the front of the shoe. Just like all shoes, cycling shoes need to have arch support to avoid issues like plantar fasciitis. Sweat-wicking socks are strongly advised as sweaty feet can lead to fungal growth and athlete’s foot.

READ MORE: What is Plantar Fasciitis?

Seat Fitting

Your bike seat is at the proper height when your leg extends 80-90% of the way on the downward stroke of your pedal cycle. Knees should be directly under the hips in this extended position. Having your bicycle seat too low can put added pressure on the bottom of the foot and throw off the alignment of your hips and back. Improper seat height is usually felt in the knees, but pain can transfer downward to include calf pain and Achilles tightness. Seats that are too high put all the work on the toes to push the pedal down and back, straining the plantar fascia and leading to arch and heel pain.

Fitting Pedals

There are many types of pedals and each works for a different style of riding and cycling shoe. Your pedals should be fitted to the size of your shoe and position of the cleats. Small pedals can mean increased strain on a single part of the foot, exacerbating conditions such as Morton’s Neuroma. Wider or longer pedals will increase the surface area that your foot contacts, distributing pressure evenly.

READ MORE: Neuromas

Fitting Cleats

Cycling cleats should fit snug in the heel and wide around the forefoot. The cleat should place the ball of your foot (metatarsal arch) directly over the center of the pedal. Older-style clip-in pedals with toe cages are less adjustable and tend to place more of the forefoot over the pedal. Without proper alignment, your toes will end up doing all the pushing, putting extra strain on your plantar fascia.

Proper Pedaling

While riding a bike is easy, riding it properly is another story. Using the correct part of the foot during each push will help alleviate and prevent issues. Your forefoot (just behind the toes) should provide the majority of the energy for each push. There should be an angle of 20 degrees between your heel and the pedal, except during the forward part of your stroke when the angle decreases to less than 10 degrees. For leisure cycling, there should be even force used throughout the pedaling cycle. For competition racing, over 96% of your energy is expended on the downstroke.

READ MORE: Choosing The Right Shoes

Avoiding cycling injuries is easy when you maintain proper seat positioning, have the correct pedal and shoe size, and keep your pedaling stroke strong and even. If you have pain in your hips, knees, ankles, heels, or arches after a long ride (or especially after a short one!) come visit the FAAWC. We can help correct underlying conditions and suggest ways to protect your feet for miles to come.

Summer is fully upon us and things are heating up outside. When the sun beats down, it can cause major problems for your feet and result in serious burns. While sunburn is an obvious culprit, hot surfaces underfoot can leave you with first and second-degree burns on your feet.

The skin on your feet is thin and, unless you live your life in flip-flops, sees the sun less than your face, arms, and legs. Sunburn on the tops of feet can start in a matter of minutes after exposure. Sunscreen can wash off in the water or rub off on shoes and needs to be reapplied often.

First and second-degree sunburns on the tops of feet can make walking, wearing shoes, and every other activity incredibly painful. If you do get burned, be extra careful the next time. Severe sunburns may take up to six months to heal, during which time your skin is extra sensitive.

The bottoms of your feet may seem more resilient, but don’t be fooled. Hot surfaces underfoot can leave you with serious burns. Hot sand is responsible for thousands of emergency room visits each year and can really put a damper on an otherwise awesome beach vacation. Sand has a low specific heat, meaning it doesn’t take much energy to heat it up.

If you aren’t sure that your feet can take the heat, place the back of your hand against the ground and hold it there. If you can stand that temperature on your hand for more than 10 seconds, your feet will probably be fine. If you do get caught mid-sprint on a hot patch of sand, bury your feet. The layer beneath the top that has been baking in the sun is actually quite cool and can provide relief during the long haul to the water’s edge.

Wearing shoes is the best way to avoid burning. Flip-flops may protect from below, but the sides and tops of your feet are still exposed. Opt for fashionable FitKicks or versatile RocSocs that will take you straight into the water and keep your feet protected.

If you do get burned, use these helpful tips to relieve symptoms and start healing:

  • Cool feet with cold water soaks
  • Use burn moisturizers or aloe to soothe
  • Cold compresses can take down swelling and reduce itchy feelings
  • Keep hydrated as this will help cells heal faster
  • Avoid wearing shoes or socks that irritate the area until it is healed
  • Avoid itching, peeling, or bursting blisters as this can lead to pain and infection

Yoga is a combination of physical movements and mindfulness. This ancient practice was first mentioned in the Rig Veda, a text from Northern India written almost 5000 years ago. Today, there are dozens of styles and types of yoga to participate in, but they will all help your feet.

One of the biggest benefits of yoga is an increase in flexibility. Slow movements and pose holds work to gently stretch the muscles, tendons, and ligaments. Poses such as Downward Facing Dog will stretch the Achilles tendon and keep your calf muscles loose. A healthy and stretchy Achilles tendon can protect you from conditions such as tendonitis, heel pain, and more.

READ MORE: Your Achilles Tendon

Another benefit of yoga is an increase in balance. You most likely stand with more pressure on one leg or the other, which throws off your center of gravity. Poses such as the Mountain Pose teach you to be mindful of your center and have a more even stance. Increased balance not only protects you from potential falls and ankle sprains, but can also improve functional movement, making you a better athlete and protecting you from sports injuries.

While most yoga is done barefoot, we recommend a foot covering for several reasons. Although it is a slow form of exercise, it’s likely you’ll still work up a sweat. Sweaty feet on a slippery floor can mean a face plant instead of a proper pose. This is particularly important during Bikram yoga, commonly referred to as hot yoga. Another reason to wear foot coverings is to protect against fungus which can lead to athlete’s foot.

READ MORE: Fungus and Your Feet

There are many ways to enjoy yoga, from taking a local class to following a YouTube video tutorial. Try these poses if you want to keep your feet and ankles healthy:

Chair Pose

Mountain Pose

Downward Facing Dog

Tree Pose

Extended Triangle Pose

Warrior II Pose





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