The Running Doctor: Turf toe commonly misunderstood

Patrick Mahomes, quarterback for the Kansas City Chiefs of the National Football League, first injured his toe against the Cleveland Browns in the Divisional Rounds of the postseason. He did go on to play in the Super Bowl with a limp.

A commonly misunderstood injury of the foot is “turf toe”. This condition is an acute, traumatic bursitis of the first toe-metatarsal joint associated with tendonitis. This condition is a common result of playing on artificial turf.

In Mahomes case, it was a more serious injury where there was a need for surgery to repair the injured toe. This is known medically as a plantar plate tear. During normal running conditions, the athlete uses his big toe in a gripping action to dig downward in order to propel him into a forward motion. However, on the artificial turf, he is unable to get that needed gripping action, thereby causing a sliding or displacement of the big toe-metatarsal joint. If this imbalance continues, it will cause undue stress to the first toe joint and can lead to greater imbalance on the first and second metatarsal bones at the midfoot articulation.

This abnormal motion is a form of pronation, or inward rolling of the foot which could lead to further complications involving the ankle, knee, hip, and lower back. This condition can also occur on a playing field of natural grass when the athlete has a flat or low-arch foot, which is a Mechanically weak foot.

Early in the season, the athlete may complain of muscle stiffness in that legs, hips, and lower back which may be an accumulation of micro trauma (unnoticed trauma) which can cause a lack of efficiency, rendering the body less able to protect itself from overuse~ and injury. It is of the~ utmost importance for good player-coach-trainer communication so that they can recognize the possibility of injuries and the need for prevention.

Treatment is directed towards balancing the biomechanically weak foot with an orthotic~ foot insert for improved efficiency and performance, thereby lessening the~ chance of injury.

Dr. Robert F. Weiss is a podiatrist. He was a former member of the Medical Advisory Committee of the Olympic Marathon Trials. Dr. Weiss is a veteran of 35 Marathons. For more information go to www.facebook.com/drrobertweiss