A sprained toe is a common injury that can happen for many reasons and affect people of all ages. Sprained toes are often tender and painful, but it is still possible to move them.
The toes contain joints that enable a person to walk, run, jump, and do other activities. Bands of tissues called ligaments surround each toe joint. Ligaments connect the bones in the toes and allow these digits to move.
As with other joints in the body, twisting, overstretching, or injuring these ligaments can cause injury. Damaging or tearing the ligament is known as a sprain.
Broken toes and sprained toes often have similar causes and symptoms. However, a broken toe does not involve overstretching or damaging ligaments. Instead, a toe bone becomes cracked or fractured.
It is advisable to see a doctor to check whether the toe is sprained or broken. The doctor may conduct a physical examination, ask questions about what caused the injury, and potentially order medical tests, such as X-rays.
Most of the time, people can treat a sprained toe at home.
A sprain can affect any of the toe joints. The four smaller toes each have three joints, while the big toe has two.
The symptoms of a sprained toe typically include:
- pain in the toe, especially when walking
- difficulty moving the toe
- throbbing or tenderness
The extent of the pain, swelling, and other symptoms will depend on the severity of the sprain. The American Academy of Orthopaedic Surgeons categorize sprains into three grades. These include:
- Grade 1: Mild sprain. A mild sprain involves stretching of the ligament and possibly some microscopic tears. Symptoms usually include some tenderness and mild swelling.
- Grade 2: Moderate sprain. The ligament has a partial tear. The swelling and tenderness may be more noticeable and painful than in a grade 1 sprain.
- Grade 3: Severe sprain. The injury may have completely torn the ligament. Swelling, pain, and tenderness are significant.
A sprained toe often results from injuries and accidents that bend the toe too far or stretch it beyond its natural range. These accidents may include:
- stubbing the toe on the ground, which could overextend the toe under the foot
- getting the toe caught on something while walking or running, which could cause it to overextend or twist
- tripping while walking or running, which could bend the toe downward or below the foot
A sprained toe is also a common sports injury.
Turf toe usually happens when a person bends their toes too far upward, such as when pushing off to run or climb. In combination with the pressure of pushing off, this hyperextension of the MTP joint can cause a sprain.
This type of sprain gets its name because it often happens in sports, such as football, where the player is on artificial turf. Artificial turf is often harder than natural grass. According to some estimates, up to 45% of professional football players experience turf toe.
However, anyone can get turf toe, including people who do not exercise on artificial turf. People who push off hard to start running on a track could potentially develop turf toe. Likewise, individuals who practice martial arts barefoot on mats with grip can also develop turf toe.
Sprains vs. fractures
There is an overlap between the causes of a sprained toe and those of a fractured toe.
Some accidents will usually only cause broken toes, not sprained toes. For example, dropping a heavy object on the toes could fracture a toe bone, but it is unlikely to affect the ligaments.
However, a toe can either break or become sprained if a person trips and falls, sustains a sports injury, or overextends their toe.
Hitting the toe on a hard object, such as a wall or piece of furniture, may also cause either injury, depending on whether the force of the impact hits the bone or stretches the toe's ligament.
In these cases, it may be hard to tell the difference between a sprain and a break without a medical test, such as an X-ray.
If there is severe pain, swelling, and bruising, a doctor should examine the toe to rule out a fracture and provide treatment if necessary.
In most cases, a toe sprain will get better with proper home care. Mild sprains that have not torn the ligament usually respond well to standard home treatment, such as the RICE technique. This treatment involves:
- Rest. Avoid doing the activity that caused the sprain, such as running or playing sports. If it hurts to walk on the sprained toe, try to stay off the foot until it feels better.
- Ice. Using ice packs can help reduce swelling and pain.
- Compression. Taping the sprained toe to an adjacent healthy toe can be helpful. Use medical tape to "buddy wrap" the toes together, making sure that the wrap is firm but not too tight. Taping the toes can provide the injured toe with extra support and stability.
- Elevation. Putting the foot up on a footrest or elevating it off the floor may relieve some of the swelling and pain, and it might aid healing.
Many people also find relief using pain relievers. Nonsteroidal anti-inflammatory drugs, such as ibuprofen and naproxen, can help relieve pain and reduce swelling and inflammation. People with health conditions should ask a doctor before taking any medications.
A severe sprain may need extra help to heal. A doctor may recommend a walking boot, which is a stiff boot that protects the toe as it heals. A walking boot allows a person to walk on their injured foot with extra stability.
Some people may also need crutches for a sprained toe. Crutches can help a person keep their weight entirely off the foot, allowing the ligaments to heal.
It is not always possible to prevent all accidents and sprains. However, taking simple foot care measures and extra precautions can lower the chances of getting a sprained toe. A person can help prevent a sprained toe and other foot injuries by:
- Wearing properly fitted footwear for sports and other physical activity. The American Academy of Podiatric Sports Medicine suggest replacing athletic shoes every 350–550 miles or before they start to show noticeable wear. Worn shoes lose some of their stability and shock absorption, which can put more stress on the feet and toes during activity.
- Avoiding going barefoot. Going without shoes, especially outside, can leave the toes more vulnerable to injury. If a person trips or falls while barefoot, their toes have no protection.
- Stretching thoroughly before and after physical activity. A person should gently stretch the muscles in the legs, feet, and toes as part of a warmup. They should then stretch again after the exercise when the muscles are warm.
A doctor should evaluate any severe pain, swelling, or changes in a toe's appearance. People should not assume that there is nothing that they can do to improve the symptoms of an injured toe. Ignoring the symptoms could cause the problem to become worse and may delay healing.