A commonly misunderstood injury of the foot is turf toe. This condition is an acute, traumatic bursitis of the first toe-metatarsal joint associated with tendonitis. This condition is a common result of playing on artificial turf.

During normal running conditions, the athlete uses his big toe in a gripping action to dig downward in order to propel him into a forward motion. However, on the artificial turf, he is unable to get the necessary gripping action, thereby causing a sliding or displacement of the big toe-metatarsal joint.

If this imbalance continues, it will cause undue stress to the first toe joint and can lead to strained or broken toe and tear of ligaments around the big toe joint, as well as trauma to the second metatarsal bones at the mid-foot articulation.

This abnormal motion is a form of pronation, or inward rolling, of the foot that could lead to further complications involving the ankle, knee, hip and lower back. This condition can also occur on a playing field of natural grass when the athlete has a flat or low-arch foot, which is a mechanically weak foot.

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Early in the season, the athlete may complain of muscle stiffness in the legs, hips and lower back, which may be an accumulation of microtrauma. This can cause a lack of efficiency, rendering the body less able to protect itself from overuse and injury.

It is of the utmost importance for good communication between player, coach and trainer so that they can recognize the possibility of injuries and the need for prevention.

Treatment is directed towards balancing the biomechanically weak foot for improved efficiency and performance, thereby lessening the chance of injury.

Dr. Robert F. Weiss, a Sport Podiatrist, was a member of the Medical Advisory Committee of the 1984 & 1988 Olympic Marathon Trials.