When One Step Hurts: Understanding Turf Toe in Athletes

What do Joe Burrow, Brock Purdy, and Treylon Burks have in common? Beyond being high-profile NFL players, all three have been sidelined by a condition known as turf toe. Turf toe is an injury to the soft tissues surrounding the big toe joint. This joint is formed by two bones connected by ligaments, tendons, and other supporting structures. When excessive or abnormal force is placed on the joint, these soft tissues can become overstretched or torn, resulting in a turf toe injury. The severity of turf toe varies and directly influences both treatment and recovery time.

This injury is particularly common among athletes who engage in sprinting, sudden stops, and rapid changes in direction. During normal walking, the soft tissues surrounding the big toe joint withstand approximately 40-60% of body weight. With athletic activity, this load increases to two to three times body weight and can reach as much as eight times body weight during a running jump. Turf toe typically occurs when the toe remains planted on the ground as the heel lifts, forcing the big toe into hyperextension and placing excessive strain on the supporting soft tissues. This injury has become increasingly common in football players due to the widespread use of artificial turf, which provides less shock absorption than natural grass. Footwear also plays a role, as modern athletic shoes are designed for agility and speed, often at the expense of forefoot stability.

The symptoms of turf toe generally reflect the severity of the injury. At the time of injury, an individual may feel or hear a sudden “pop.” Swelling, bruising, and limited range of motion of the big toe are common findings. In more severe cases, particularly when a dislocation is present, the joint may feel unstable or loose.

To guide diagnosis, treatment, and prognosis, turf toe injuries are classified into three grades. Grade 1 injuries involve stretching of the soft tissues surrounding the big toe joint and are typically associated with localized tenderness and mild swelling. These injuries are usually managed with rest, ice, compression, elevation (RICE), and over-the-counter pain medication, with symptoms improving within one week. Grade 2 injuries involve a partial tear of the soft tissues and present with more widespread tenderness and painful, limited range of motion. Management includes RICE and immobilization, commonly with taping or a walking boot, and recovery generally occurs within two to three weeks. Grade 3 injuries are the most severe and involve a complete tear of the soft tissues or a dislocation of the joint. These injuries cause significant pain, swelling, and bruising and may require prolonged immobilization, physical therapy, and in some cases, surgical intervention. Recovery from a Grade 3 injury may take anywhere from two to six months.

With appropriate treatment, most turf toe injuries heal without long-term consequences. However, if left untreated, chronic pain, stiffness, and functional limitations can develop. Potential complications include decreased push-off strength, bunion formation, and deformity of the big toe joint. Because of these risks, prevention is especially important. Wearing supportive, stable footwear and performing proper warm-up exercises before athletic activity can help prepare the soft tissues for increased activity and reduce the likelihood of injury.

In summary, turf toe is a deceptively serious injury that can significantly impact athletic performance, even among elite NFL players. Understanding its causes, symptoms, and treatment options allows for earlier recognition and more effective management. With timely care and preventative strategies, athletes can reduce both recovery time and the risk of long-term complications.

References:

1. American Academy of Orthopaedic Surgeons. Turf Toe. OrthoInfo. Updated 2026. Accessed January 30, 2026. https://orthoinfo.aaos.org/en/diseases--conditions/turf-toe/

2. Cleveland Clinic. Turf Toe: What It Is, Causes, Symptoms & Treatment. Cleveland Clinic. Updated February 6, 2024. Accessed January 30, 2026. https://my.clevelandclinic.org/health/diseases/17590-turf-toe

3. Mass General Brigham. Turf Toe: Symptoms & Treatment. Mass General Brigham. Accessed January 30, 2026. https://www.massgeneralbrigham.org/en/patient-care/services-and-specialties/sports-medicine/conditions/foot-ankle/turf-toe

4. McCormick JJ, Anderson RB. Turf toe: anatomy, diagnosis, and treatment. Sports Health. 2010;2(6):487‑494. doi:10.1177/1941738110386681. PubMed Central article PMC3438874. Accessed January 30, 2026.

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