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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:

  • Excessive tension
  • Trauma

The Toes (Phalanges) of the Foot

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Risk Factors

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

  • Stubbing your toe into something when walking barefoot or while wearing sandals
  • 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
  • Sports such as:
    • Football
    • Soccer
    • Rugby
    • Basketball
    • Running
  • Wearing inappropriate footwear for an activity
  • 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

You will be asked 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

You will need time to heal, but strict rest is rarely necessary. RICE therapy is often advised:

  • Rest—Avoid using the injured toe. Go about your normal activities as much as you can tolerate.
  • Ice—Ice may help decrease swelling and pain in the first few days after the injury.
  • Compression—Compression of the toe with an elastic bandage may help to control swelling.
  • Elevation—Keep the injured foot raised above the level of your heart to help drain fluid and reduce swelling.

Consider wearing a shoe with a stiff sole to help protect the injured toe.

Medication

Non-steroidal anti-inflammatory drugs and over-the-counter pain medications may be advised.

Topical pain medications, 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 June 22, 2015.

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.

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 November 2013. Accessed June 22, 2015.

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



Last reviewed June 2015 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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