The metatarsophalangeal (MTP) joint is where the first long bone in your foot connects with the first bone in your toe. Ligaments, fibrous tissues, tendons and two tiny bones called sesamoids help to support the MTP joint and form what’s known as the plantar complex.
Trauma to the plantar complex can damage or tear the tendons that help to support your big toe joint, causing significant discomfort. In today’s blog, we take a closer look at the different grades of big toe tendon tears and how the condition is treated.
Big Toe Tendon Tears
A sprain or tear of the big toe tendon is typically classified as a turf toe injury, although turf toe can affect any part of the plantar complex. Your turf toe injury will be graded based on its severity, which will also dictate your treatment protocol. Turf toe injuries are typically classified into one of three different grades:
Grade 1 – This involves a mild stretching of the soft tissues that make up the plantar complex.
Grade 2 – A Grade 2 turf toe injury is categorized by partial tearing of the plantar complex, and it presents with more discomfort.
Grade 3 – A Grade 3 injury to your plantar complex involves a complete tendon tear.
You can learn about some of the more common symptoms of a big toe tendon tear in greater detail in this blog, but here’s a look at some of the more common symptoms associated with a plantar complex disruption. The higher the grade, the more severe these symptoms tend to be:
- Pain
- Soreness
- Swelling
- Bruising
- Difficult moving the toe
- Abnormal walking gait
Treating Big Toe Tendon Tears
As we mentioned above, treatment will be determined based on the severity of your plantar complex disruption, so it is imperative to connect with a foot and ankle specialist if you are experiencing the above symptoms and have reason to believe that you may have suffered a turf toe injury. Your provider will begin by asking about your symptoms and conducting a physical exam to see how your toe looks and how it responds to certain movements. They may also order imaging tests like an X-ray to rule out a possible fracture or an MRI to get a better look at the soft tissues in the plantar complex.
For Grade 1 or Grade 2 turf toe injuries, you may be able to help the area heal with certain non-operative treatment methods. RICE is one of the standard protocols, which stands for Rest, Ice, Compression and Elevation. It’s also imperative the you practice activity avoidance. Any activities that result in pushing off of your forefoot, like running or jumping, will put additional stress on the plantar complex. It’s important that you avoid these strenuous activities and gradually increase the amount of strain that you put on the toe as healing begins to progress. Physical therapy can also help to strengthen the supportive soft tissues in the area. Total recovery typically takes a couple of weeks depending on the severity and the level of activity you’ll be returning to.
Grade 3 tears require more hands-on care, although that doesn’t mean that surgery is definite. Grade 3 tears will typically require weeks of immobilization in a protective boot to provide an ideal environment for healing. Once enough healing has occurred, you’ll begin physical therapy and eventually work to return to normal activities. Recovery typically takes anywhere from 2-4 months.
If immobilization is not yielding the right healing pattern, a surgical procedure may be recommended. During the operation, the surgeon will work to reattach the tendon and stabilize the MTP joint. Full recovery following surgery can take anywhere from 3-6 months.