Gout,Diseases Gout,Gout Joint - Turf Toe
Gout Remedy Natural Gout Treatment Treat Gouts Naturally
 

Turf Toe

Turf toe gets no respect. Let's take a closer look at the causes of turf toe and see how to treat it more effectively.

Turf toe is actually a form of hallux limitus. Hallux limitus is classically described as pain and progressive decrease in the range of motion of the first metatarsal phalangeal joint (MPJ). The onset of hallux limitus is due to the following:

Functional hallux limitus - biomechanical function that results in metatarsus primus elevatus and subsequent repetitive jamming of the first MPJ.


Try Goutezol for 60 Days

People Said About Goutezol Gout Remedy
"I've been suffering from gout for over 3 years. I tried many different remedies. After taking your product for 20 days I felt the difference. I'm ordering 3 more bottles to make sure I'm not going to have attack any time soon." Bill, FL
gout treatment


  Direct physical injury - injury to the articular cartilage or subchondral bone. These injuries may be due impaction injuries or hyperextension/flexion of the first MPJ.

Other conditions - synovitis, crystal deposition diseases such as gout, systemic arthritis, external physical influences such as Dupytren's contracture, etc.

But before we go any further, we need to understand that the terms turf toe and hallux limitus aren't really synonymous. The fundamental difference between the two terms is the patient population that they affect. Turf toe is a term used in athletic circles referring to any injury of the great toe joint. Consequently, discussions about turf toe will focus on the first two causes of hallux limitus mentioned above; functional hallux limitus and direct physical injury. On the other hand, when we discuss hallux limitus, we're actually referring to a broader, 'non-athletic' patient population and need to include all three causes of hallux limitus.

Think of turf toe (hallux limitus) as an isolated case of osteoarthritis limited to the first MPJ. Whether the injury is acute or due to repetitive loading, the result is a load that is applied to the subchondral bone that is greater than what the bone can tolerate. As the injury progresses, a series of micro fractures will develop in the subchondral bone. The typical soft spongy character of the metaphyseal bone changes to become brittle and hard. The result is that the articular cartilage looses its' underlying support and becomes susceptible to damage. Juxtachondral eburnation, osteophytes, lipping, spurring; call them what you like, but what you see on your x-ray is the slow progressive destruction of the joint.

What's the actual physical change that takes place in the joint with turf toe? As an easy analogy, consider the changes that takes place when an apple falls from a height and is damaged. The skin of the apple appears intact but the underlying pulp is damaged. In the case of turf toe (hallux limitus), think of the skin of the apple as the cartilage of the joint and the damaged pulp of the apple is the subchondral bone. Mild cases of turf toe (hallux limitus), result in little damage to the subchondral bone and will merely exhibit signs of inflammatory change within the joint. Most authors would refer to these cases as stage one turf toe (hallux limitus). More severe cases result in damage to the joint surface, the subchondral bone or both. These are the stage two and three cases of turf toe (hallux limitus) that show visible change on x-ray. As the subchondral bone becomes increasingly damaged, it will create an uneven supporting surface for the cartilage. An increase in activity results in uneven loading of the joint due to the compression injury of the subchondral bone.

Is the onset of turf toe always the same? Turf toe that is the result of functional hallux limitus is going to be insidious in onset. Functional hallux limitus will usually be seen in younger athletes as they attempt to increase their activity. It may not occur during the first athletic season, or the second, but when it does begin to cause pain, the onset will be more frequent and more severe, varying with activity. This profile of onset is simply due to the fact that the athlete is recreating the injury with every step.

Turf toe caused by a direct injury to the joint may or may not be obvious. Athletes may not remember an incident of pain since they're often distracted by the event or game in which they're involved. The onset of direct injury to the joint may be abrupt, but also may be insidious becoming increasingly more painful as the season progresses. The joint pain will subside with rest only to recur with increased activity. It's not unusual to see symptoms of turf toe resolve in the off season only to recur with renewed exercise.

Treatment of turf toe varies with the type of healthcare provider and includes the use of rest, shoe modifications, orthotics, steroid injections and surgery. The success of non-surgical care will vary with the degree of injury, the rate at which the injury is healing and how much osteoarthritis has occurred. We see varying degrees of success with orthotics that promote plantarflexion of the first ray, effectively treating metatarsus primus elevatus and peroneus longus dysfunction. Simple arch supports can make a significant difference in the symptoms of turf toe. Should our patient not respond to conservative care in a reasonable time period, we are not reluctant to suggest surgical revision to address the problem whether it be revisions of the joint defect, shortening of a long first metatarsal or structural revision of metatarsus primus elevatus. As mentioned before, the clinical appearance of dorsal lipping or visible radiographic changes are suggestive of moderately advanced osteoarthritis, a condition that is only repaired by joint revision or replacement.

 
100% Natural and Safe Remedy

People Said About Goutezol Gout Treatment
"My big toe was in horrible pain, so i went to emergency room. Dr diagnosed gout in my foot and gave me pain killers. I did some googling and found goutezol. I like that it's natural with no chemicals in it. Ive been taking it for about 6 months and so far no attack, and my doc confirmed lower uric acid in my blood. thank you!" Jeff, NY
gout treatment


When treating turf toe be sure to recognize the fact that there is no nerve innervation in articular cartilage. Pain associated with stage one turf toe (hallux limitus) is either synovial pain or bone pain. If we recognize that painful stage one turf toe (hallux limitus) may be due to bone pain, we then realize that turf toe should be treated aggressively to insure the long term viability of the joint.

Nomenclature:

First MPJ - the big toe joint Metatarsus primus elevatus - a functional or structural position of the first metatarsal First metatarsal - the foot bone making up the proximal portion of the big toe joint Hallux - the great toe




Anatomy:

The great toe joint, or first metatarsal joint consists of two bones. The proximal bone is the first metatarsal and the distal is called the proximal phalanx or hallux. These two bone move against each other in an up and down motion through what we refer to as the sagital plane. Biomechanics: The motion of the great toe joint is dependant upon the plantarflexion of the first metatasal. If the first metatarsal is limitied in its' ability to plantarflex, the joint will jam resulting in funtional hallux limitus, which as we know is one of the causes of turf toe.




Symptoms:

Turf toe that is the result of functional hallux limitus is going to be insidious in onset. Functional hallux limitus will usually be seen in younger athletes as they attempt to increase their activity. It may not occur during the first athletic season, or the second, but when it does begin to cause pain, the onset will be more frequent and more severe, varying with activity. This profile of onset is simply due to the fact that the athlete is recreating the injury with every step. Turf toe caused by a direct injury to the joint may or may not be obvious. Athletes may not remember an incident of pain since they're often distracted by the event or game in which they're involved. The onset of direct injury to the joint may be abrupt, but also may be insidious becoming increasingly more painful as the season progresses. The joint pain will subside with rest only to recur with increased activity. It's not unusual to see symptoms of turf toe resolve in the off season only to recur with renewed exercise.




Differential Diagnosis:

The differential diagnosis of turf toe includes; Arthitis Fracture Gout Joint infection Joint or bone tumor Synovitis

References:

Lombardi, C.M., Silhanek, A.D., Connolly, F.G., Dennis, L.N., Keslonsky, A.J. First Metatarsophalangeal Arthrodesis for Treatment of Hallux Rigidus: A Retrospective Study. J. Foot Surg. 40:3, 137-143, 2001

Unger, K., Rahimi, F., Bareither, D., Muehleman, C. The Relationship Between Articular Cartilage Degeneration and Bone Changes of the First Metatarsophalangeal Joint. J. Foot Surg. 39:1 24-33, 2000

Ronconi, P., Monachino, P., Baleanu, P.M.,Favilli, G. Distal Oblique Osteotomy of the First Metatarsal for the Correction of Hallux Limitus and Rigidus Deformity. J. Foot Surg. 39:3, 154-160, 2000

About the author: Jeffrey A. Oster, DPM, C.Ped is a board certified foot and ankle surgeon. Dr. Oster is also board certified in pedorthics. Dr. Oster is medical director of Myfootshop.com and is in active practice in Granville, Ohio.

 
 
     
 
 





Learn More about Natural Gout Remedy

Gout is a condition that results when crystals of uric acid are deposited body tissues, and is characterized by an overload of this acid. It causes joints to become inflamed and is often very painful. Chronic gout can lead to deposits of hard lumps in and around the joints. As a result, patients with gout can experience decreased kidney function and kidney stones, which are also very...


This is the second article of a series about this diet. Please see Natural Gout Treatment - The Rules Of A Gout Diet That Had A Lot Of Success, for the first article. This study, based on the Zone diet, did have a positive effect on markers of insulin resistance: triglycerides, total cholesterol, LDL cholesterol ( bad cholesterol) fell. HDL cholesterol ( good cholesterol) did...


You may or may not have heard about the MSM and gout connection, but MSM is being used for many conditions. Many of them are conditions that affect the joints much like gout does. MSM stands for Methyl Sulfonyl Methane - a natural sulfur compound. Though this is much like traditional sulfur, you will be glad to know that the smell normally associated with sulfur is not present when you use this...


Foods that cause gout are rich in a chemical called purines. These foods include organ meats such as liver, brain, kidneys and sweetbreads. Other foods include anchovies, herring, dried peas and beans. The purines get converted to uric acid but if they accumulate in excess they will cause gout. The uric acid crystals, which form will irritate the lining of joints such as the one in the big...


Gout is a painful inflammation of joints caused by accumulation of uric acid crystals. Uric acid is a normal chemical formed by the breakdown of purines, which in turn are an important component of the human body. Many foods contain purines especially seafood and meat. Unless a patient has a family history or is taking medication that can cause gout such as some diuretics it may be hard to...


removing uric acid | medication for kidney stones | how to perform uric acid test | allopurinol and kidney stones | gout of the foot | kidney stone relief | colchicine metabolites | high purine foods | risk factors of kidney stones | how does colchicine affect microtubules | uric acid kidney stone prevention | gout seizures | gout nutrition |







 
 
 
 
 
 
 
(c) 2018 uricacidlevels.info
Contact Us | About Us | Privacy Policy | RSS Feed | Gout,Diseases Gout,Gout Joint