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Critical Reviews™ in Biomedical Engineering

ISSN Print: 0278-940X
ISSN Online: 1943-619X

Critical Reviews™ in Biomedical Engineering

DOI: 10.1615/CritRevBiomedEng.v40.i1.30
pages 43-61

Etiology and Biomechanics of First Metatarsophalangeal Joint Sprains (turf toe) in Athletes

Rebecca E. Frimenko
Center for Applied Biomechanics, University of Virginia
W. Brent Lievers
Center for Applied Biomechanics, University of Virgina
Michael J. Coughlin
Coughlin Clinic at Saint Alphonsus, Boise, ID
Robert B. Anderson
Foot and Ankle Service, Department of Orthopaedic Surgery, Carolinas Medical Center, OrthoCarolina, Charlotte, North Carolina
Jeff R. Crandall
Center for Applied Biomechanics, University of Virginia
Richard W. Kent
Center for Applied Biomechanics, University of Virginia

ABSTRACT

Sprains of the first metatarsophalangeal (MTP) joint, referred to colloquially as "turf toe," are a debilitating sports injury because the hallux is pivotal to an athletes' ability to accelerate and cut. Severe sprains may require weeks to full recovery, and injuries requiring surgery may prevent an athlete from full athletic participation for months. Whereas the diagnosis and treatment of turf toe are well documented in the literature, less is known about the biomechanics of this joint and the mechanical properties of the structures that compose it. Nevertheless, this information is vital to those, such as equipment designers, who attempt to develop athletic footwear and surfaces intended to reduce the likelihood of injury. To that end, this review summarizes the literature on the anatomy of the first MTP joint, on biomechanical studies of the first MTP joint, and on the incidence, mechanisms, and treatment of turf toe. Furthermore, gaps in the literature are identified and opportunities for future research are discussed. Only through a thorough synthesis of the anatomic, biomechanical, and clinical knowledge regarding first MTP joint sprains can appropriate countermeasures be designed to reduce the prevalence and severity of these injuries.