Time for a personal confession. Being the prototypical nerd, I read a story yesterday and thought that the creator of Spiderman had injured his toe. Luckily I didn’t bring it up at any comic book conventions. As it turns out, Sean Lee, a linebacker for the Dallas Cowboys sustained a season ending injury, not Stan Lee (real name Stanley Lieber, BTW) the creator of many of my childhood heroes and current recycled action movies. Sean reportedly sustained a turf toe injury, the subject of this week’s blog.
So what is a turf toe? The big toe joint is comprised of the first metatarsal, the big toe, two sesamoid bones that sit in the ball of the foot under the big toe joint, multiple tendons and ligaments connecting everything, and a soft tissue capsule that surrounds the entire structure. The joint is designed to bend up and down, and generally glides very nicely. A turf toe injury occurs when the joint is forcibly bent upwards in a quick and forceful manner, damaging the soft tissue structures at the bottom of the joint. This damage many include a tear of the big toe joint capsule, ligaments or even of the sesamoid bones themselves. This can happen in the course of a football game as the player impacts the ground with the big toe joint bent and force is applied either from his own or someone else’s body.
In my NYC podiatry practice, a turf toe injury requires a careful assessment. The first step is to evaluate the level of injury and determine what is damaged, by the use of in office X-ray or ultrasound, or by MRI. Depending on the severity of injury, treatment consists of shoegear and activity modification, immobilization in a fracture boot, or even foot surgery to repair the damaged structures. In most cases, these injuries will progress to a full recovery, and as with most other foot injuries, it will take as long as it needs to take, and usually longer than most patients want it to take.
So Sean, or Stan, the season may be over, but there is always next year. Meanwhile, feel free to come up north and enjoy the sights of NYC.
See you in the office.
Dr. Ernest L. Isaacson