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San Diego Chargers' LaDainian Tomlinson Slowed By Turf Toe

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San Diego Chargers' LaDainian Tomlinson Slowed By Turf Toe Powered By Docstoc
					The San Diego Chargers star running back, LaDainian Tomlinson, has been hampered
all season by an early turf toe injury. This injury can be devastating and has ended
many NFL careers. What is turf toe really? How can we avoid this pain in the toe?

What is turf toe?

Turf toe is a condition of pain in the base of the big toe. This usually caused from
either traumatically jamming the toe, or pushing off repeatedly when running or
jumping. The most common complaints are pain, stiffness and swelling. The pain can
be so severe that pushing off in football is virtually impossible.

This injury is especially common among athletes who play on artificial turf, hence the
name. The hard surface combined with running, jumping and cutting in football and
soccer, make turf toe a frequent injury. Some also blame the choice of athletic
footwear. The more flexible shoes, especially used in competition, provide less
support to the forefoot joints, possibly contributing to the incidence of turf toe.

How does turf toe occur?

When a player sustains this kind of toe injury they are actually tearing the capsule that
surrounds the joint at the base of the big toe. Tearing this joint capsule can be
extremely painful. Furthermore, tear of the joint capsule can lead to significant
instability and even dislocation of the joint at the base of the toe. This may lead to
accelerated cartilage wear and arthritis of the big toe known as Hallux limitis or
rigidus. This wear-and-tear arthritis can end a promising career prematurely.

How is turf toe diagnosed?

Diagnosis is based primarily on the physical examination of the patient. X-rays may
be taken to ensure there is no fracture or evidence of arthritis. Occasionally an MRI is
needed to evaluate the surrounding tendons or to rule out an occult stress fracture.

What is the treatment of turf toe?

Treatment of toe injuries usually consist of trying to control the inflammation of the
joint capsule.
Treatment protocol can include:
1. Rest
2. Ice
3. Elevation
4. Taping or padding to off-weight the toe joint
5. Anti-inflammatories
6. And in chronic cases steroid injections to the joint may be helpful
7. Long term use of a functional foot orthotics to balance the forefoot in the cleats is
quite helpful.

Athletes diagnosed with turf toe should avoid stress to the joint for three to four
weeks to allow the joint capsule to heal. Once returning to activities, functional
orthotics can be used to limit the motion of the big toe and prevent further damage to
the joint capsule.

Will turf toe return?

Unfortunately, turf toe can return, often more severe than the initial injury, and
rehabilitation may be very slow. LaDainian Tomlinson has been slowed by his injury
all season and most likely will not be 100% until he can rest at the end of the season.
Most athletes have trouble when they try to come back to sports too soon after
sustaining a turf toe injury. Surgery is rarely needed for treatment of turf toe unless
this has been a chronic injury and spurs are present in the joint limiting motion. If a
bone spur has formed, and severely limits the motion of the toe joint, surgery to
remove the spur may be helpful.

Prevention and early treatment is really the key! If you are experiencing pain in the
joint after running in practice, your shoes should be evaluated for a functional orthotic
to balance your biomechanics and hopefully avoid significant turf toe.

				
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