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First MTP Joint Sprain (Turf Toe)
The first MTP joint is the second last joint before the end of the big toe. This injury is common in gymnastics or contact sports when the toe is forced past its normal range of movement, usually upwards or downwards. The injury is also more common in those sports played on non-slip surfaces and is subsequently called ‘turf toe syndrome’. Symptoms include immediate swelling and pain at the base of the big toe. Ice and rest may help to decrease symptoms.
Hallux Valgus (Bunions)
Hallux valgus occurs when the big toe is angled inwards at an unusually large angle. Hallux valgus may be present at birth or caused by untreated excessively flat feet. Symptoms include a pain, redness, swelling and/or callous on the outside of the base of the big toe. A callus may also form under the base of the second toe.
This injury is a chronic stiffness of the joint at the base of the big toe caused by chronic inflammation or arthritis. This may occur as a result of excessively flat feet or overuse of the big toe such as with long distance running. Symptoms include poor big toe mobility, especially with pulling the toe upwards (dorsiflexion), as well as pain and swelling at the base of the big toe. Rest, orthotics and training modification may be needed to correct or alleviate this condition.
Sensation is felt by transmission of nerve impulses via nerves to the brain. Morton’s neuroma involves compression of nerves that travel between the bones, usually in the third, fourth and fifth toes (the little toes). This condition may occur due to tight shoes or flat arches in the foot. Symptoms include pain, pins and needles and numbness radiating into the affected toes. Standing, especially up on the toes may aggravate symptoms. Ice may decrease acute pain, but longer-term solutions must be explored such as padding and orthotics.
Fractured 5th Metatarsal
This fracture is known commonly as a Jones’ fracture and usually occurs with overuse such as long distance running. The Jones’ fracture can also occur as a result of a bad ‘ankle sprain’. Symptoms will involve an acute pain at the base of the little toe. Treatment involves a plaster cast for up to eight weeks.
Early Injury Management
For approximately the first 72 hours following an injury, the RICE regime should be followed to ensure control of inflammation and pain relief.
R - Rest
I – Ice
C - Compression
E – Elevation
Rest from aggravating activity.
Ice should be applied in the first 72 hours or when inflammation persists. Ice should be applied for 15 to 20 minutes at a time. Ice should not be applied directly to the skin, but through a wet towel or cloth.
Compression can be achieved with an elastic bandage.
Elevation is used to help swelling to return to the heart through the blood stream.
The injured area should be elevated above the level of the heart.
Strengthening programs should only be commenced when:
Exercises should be 3 sets of 8-12 repetitions.