Sand Toe is a sprain of the big toe. It is more common in situations like sand volleyball where the surface is unstable. The shifting sand makes it more likely for running, jumping, and explosive change of directions to bend the big toe forward.
The big toe, or first metatarsal phalangeal joint, is composed of several bones, ligaments, and muscle attachments. The forced flexion of the joint causes damage to ligaments, muscles, and soft tissue around the joint. Fractures can happen and need to be properly evaluated.
Any person with this injury will tell you they were surprised by how much they use their toe toe during the day. Every step places pressure across the big toe. It is difficult to avoid walking during the day, which creates daily stress into the injured ligaments. This daily strain is a complicating factor for the slow resolution of the injury and progression of recovery.
The first step is to decrease the pain and swelling. Protect the area with taping, splint, modified shoe wear, or even better shoe choices. Crutches or a protective boot might be needed in severe cases. Rest whenever possible. Try to avoid walking whenever possible, especially for the first few weeks. Ice the toe to decrease pain and inflammation. Ice for 15-20 minutes and then take the ice off for 20. Repeat this process multiple times a day. The more rounds of ice you apply a day the greater your ability to decrease the pain and inflammation. Elevate your foot to decrease swelling!
Therapeutic procedures in the office utilized to decrease the pain and inflammation include ice, electric, ultrasound, and cold laser. Foot and toe strengthening exercises and stretches maybe given later based on improvement. Individuals with a history of sand toe or turf toe sprains should consider focusing on strengthening the foot to decrease additional injuries.
Cold laser is a useful therapeutic modality to decrease pain and inflammation. The cold laser frequency starts a process inside the body to decrease pain and inflammation. It brings more blood to the area to further speed the flow of healing nutrients. Laser therapy can decrease scar tissue formation which may contribute to the chronic nature of sprains. The laser energy triggers tissue repair and cell growth differently than other therapeutic treatments, which is why we like to include it in treatments for sand or turf toe.
Expect mild sprains to last 1-3 months. The pain intensity
will decrease over that time, but pain will return with increased
activity. Quickly reducing the pain and inflammation decreases
the overall duration of the injury. Act quickly and aggressively.
Moderate to severe sprains can take longer to heal, and care
should be give to reduce the likelihood of chronic toe sprains.