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Toe Sprain

Definition

A toe sprain is caused by a partial tear of the ligaments that support a toe. Ligaments are strong bands of tissue that connect bones to each other.

Causes

Toe sprains may be caused by:

Stubbing your toe into something when walking barefoot
Stopping suddenly when running, causing a toe to jam into the end of your shoe
Landing awkwardly from a jump, causing a toe to jam into the end of your shoe

The Toes (Phalanges) of the Foot

Risk Factors

Factors that increase your risk of getting a toe sprain include:

Sports such as:
- Football
- Soccer
- Rugby
- Basketball
- Running
Dancing
Poor coordination
Rough ground

Symptoms

Symptoms include:

Pain and tenderness in the toe
Pain when moving the toe
Swelling and bruising of the toe

Diagnosis

The doctor will ask about your symptoms and how you injured your toe. Your toe will be examined to assess the stability of the joint and the severity of the injury.

Images may need to be taken of your toe. This can be done with:

Toe sprains are graded according to ligament damage. The more ligaments damaged, the more severe the injury.

Grade 1

Some microtearing of ligament tissue

Grade 2

Partial tearing of ligament tissue
Mild instability of the joint

Grade 3

Severe or complete tearing of ligament tissue
Significant instability of the joint

Treatment

Treatment includes:

Self-care

Rest—Avoid using the injured toe.
Ice—Apply ice or a cold pack to your toe for 15 to 20 minutes. Do this 4 times a day for 2 to 3 days or until the pain goes away. Wrap the ice or cold pack in a towel. Do not apply the ice directly to your skin.
Compression—If the injured toe is the big toe, wrap a 2-inch elastic compression bandage around it. Put several wraps around the big toe and then include the rest of the forefoot within the bandage. This will limit swelling of your big toe. Other toes cannot be effectively compressed with a bandage. It is important not to cut off blood circulation to your toe or any body part when using such wraps. Do not make them very tight.
Elevation—Keep the injured foot raised above the level of your heart for 48 hours. You can use a pillow. This will help drain fluid and reduce swelling.
Protection—Wear a shoe with a stiff sole to help protect the injured toe.

Medication

The following drugs may help reduce swelling and pain:

Ibuprofen, such as Motrin or Advil
Naproxen, such as Aleve or Naprosyn
Acetaminophen, such as Tylenol
Aspirin

Topical pain medicines, such as creams, patches, can also be applied to the skin.

Prevention

Often, toe sprains cannot be prevented. However, to reduce your risk of getting a sprained toe, wear stiff-soled athletic shoes when playing sports.

Proper treatment of toe sprains can help prevent long-term complications or problems with the toe joint, such as misalignment and immobility.

RESOURCES:

American Academy of Physical Medicine and Rehabilitation
http://www.aapmr.org

American Orthopaedic Society for Sports Medicine
http://www.sportsmed.org

CANADIAN RESOURCES:

British Columbia Association of Podiatrists
http://www.foothealth.ca

Canadian Podiatric Medical Association
http://www.podiatrycanada.org

References:

Adult foot health. The American Orthopedic Foot & Ankle Society website. Available at: http://www.aofas.org/footcaremd/overview/Pages/Adult-Foot-Health.aspx . Accessed March 20, 2013.

Churchill SR, Donley BG. Managing injuries of the great toe. The Physician and Sportsmedicine. 1998;26:29.

Mullen JE. O'Malley MJ. Sprains—residual instability of subtalar, Lisfranc joints, and turf toe. Clinics in Sports Medicine. 2004;23(1):97-121.

Pommering TL. Ankle and foot injuries in pediatric and adult athletes. Prim Care. 2005; 32(1):133-161.

Renstrom P. Sports Injuries: Basic Principles of Prevention and Care. Boston, MA: Blackwell Scientific Publications; 1993.

Sports injuries. National Institute of Arthritis, Musculoskeletal and Skin Diseases website. Available at: http://www.niams.nih.gov/Health_Info/Sports_Injuries/default.asp . Published April 2009. Accessed March 20, 2013.

10/26/2010 DynaMed's Systematic Literature Surveillance https://dynamed.ebscohost.com/about/about-us: Massey T, Derry S, Moore R, McQuay H. Topical NSAIDs for acute pain in adults. Cochrane Database Syst Rev. 2010;(6):CD007402.

Last reviewed September 2012 by Michael Woods, MD

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.

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