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edge
Mar 5, 2010, 3:35 PM
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After a series of web searches, I am underwhelmed at the amount of information available regarding treatment of "turf toe."
I have been dealing with this since last November, and gave my biggest piggy 6-8 weeks of rest and protection from abuse. Although somewhat better, it still gets sore. Web searches caution coming back too soon, but since a huge percentage of climbing involves weighting that particular digit, what else am I to do?
I also need to start running to prep for the upcoming season. Buddy taping? I dunno.
I felt some relief using Topricin, but don't know if it is doing anything other than acting as a topical analgesic.
Anyone have other thoughts?
(This post was edited by edge on Mar 5, 2010, 3:37 PM)
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scottek67
Mar 5, 2010, 3:57 PM
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amputation is the only cure.  when looking for medical advice on the web or on this site you should always go for the first reply. green troll.
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scottek67
Mar 5, 2010, 4:09 PM
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edge
Mar 5, 2010, 8:43 PM
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Some more background info:
I went to see my primary care physician about a month after this reared it's ugly head, and told him I thought it was turf toe. He replied that he thought so too. I told him I had done some research on line and it seemed that 6 weeks rest was recommended. He said, "yup." I asked is there anyone else I can see who knows specifically about this injury and he told me that he didn't think there was anyone local, and anyway my insurance company would frown on that sort of second guessing for something as easy to diagnose as turf toe.
I was hoping that one of the physical therapist types who grace this forum might have some first hand experience, or else someone else who has dealt with it could recommend excessive sex as a cure. (I am pretty sure if it were prescribed I could get my wife on board with that.)
So far, MDs and web searches have provided nada.
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onceahardman
Mar 5, 2010, 11:20 PM
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edge...
First MTP injuries really suck. See Gail's never-ending chronicle. You need to very carefully continue to re-assess, and not be concerned with a concrete time-frame. All that matters is symptom response.
This:
In reply to: Self-care Rest—Do not try to run or play sports until you can walk without pain. Do not return to your sport until you can run, jump, and push off from your injured foot without pain. Ice—Apply ice or cold pack to your toe for 15 to 20 minutes, 4 times a day for 2 to 3 days or until the pain goes away. Wrap the ice or cold pack in a towel. Do not apply ice directly to your skin. Compression—Wrap an elastic compression bandage around your big toe. It is important not to cut off blood circulation to your toe or any body part when using such wraps, do not make them very tight. Put several wraps around the big toe and then include the rest of the forefoot within the bandage. This will limit swelling and support your toe. Elevation—Keep the injured foot raised above the level of your heart for 48 hours (such as up on a pillow). This will help drain fluid and reduce swelling. Stiff-soled shoes or rigid orthotics—Wear stiff-soled shoes or rigid orthotic inserts in your shoes to keep your toe from hyperextending.
is from here:
http://www.med.nyu.edu/....html?ChunkIID=11485
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fishman
Jun 2, 2010, 2:19 AM
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I have been experiencing symptoms in line with turf toe as well. Of course rest is important for it, but I'm not sure climbing aggrevates it. I took a month off climbing and it was worse during that period than when I started getting back in the gym. I work on my feet carrying heavy stuff all day, so its virtually impossible to rest it fully. I tried icing, didnt seem to help. The only thing that I have found that helps, and it has helped alot is taking an anti inflammatory, such as ibuprofin. I find that if I take 400-800mg first thing in the morning, it feels about 80% for at least a couple hours. Climbing on it only hurts when I whack it on something.
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edge
Jun 2, 2010, 6:39 PM
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Well, I saw the podiatrist last week, and then had x-rays taken immediately afterward. At the time all he told me was to get a stiff soled walking shoe with a rocker sole so the toe wouldn't bend, and to take Aleve.
He then told me to move the toe so it wouldn't "freeze up." So what is it, move it or immobilize it?
He couldn't say for sure until he saw the x-rays.
Friday morning is my follow up visit. I will post up the results then, but I am not optimistic after the length of time that I have been dealing with this that RICE is having any effect.
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gblauer
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Jun 2, 2010, 7:52 PM
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Edge...I bought some carbon fiber inserts (xblades) specifically made for turf toe from Indiana Brace (Clyde Peach). The prevent your big toe from flexing when you walk. Mitch has also fabricated some carbon fiber inserts for my clmibing shoes. The inserts stiffen the shoe dramatically and it reduces the pressure on my big toe joints. I can climb 7-10 pitches in a day and then my toes are toast. I start using my knees!
I use the xblades in my everyday shoes and I am finding good relief. I need modifications in the xblade, as I need an aperature for my sesamoid bones. But, overall, I am much happier with the xblades than I was without any insert at all. My feet hurt a whole lot less. They are really expensive $250 for a pair, so Mitch is going to make me several more pair, using the xblades as a model. It's a pain to keep moving them from shoe to shoe.
I am only taking aleve when I have to (feet are sending shooting pains). I have also looked into the rocker shoes, but, I just can't get there yet. They are sooo fugly.
Finally, I am headed for toe fusion at some point. NOt now. I have aleady given up 6 months of my life this year. I will wait until I can no longer walk. Today, I have pain every step I take, but, it's so much better with the xblades. PM me if you want to chat on the phone.
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edge
Jun 2, 2010, 8:58 PM
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gblauer wrote: PM me if you want to chat on the phone.
Thanks, Gail! I may do that after my Friday meeting with the foot doc. While I wouldn't wish your experience on anyone, I will no doubt have questions to ask from someone who sent that particular route before me...
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edge
Jun 4, 2010, 2:02 PM
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Well, I just got back from the foot doc.
He basically told me that the x-ray showed advanced osteoarthritis, and the pain could be reduced by surgery or titanium joint replacement. The operation would not help me walking, running, or climbing, just with the pain.
While the thought of becoming just-that-much-more titanium sounds appealing, I guess I will just have to sack up and learn to embrace the pain. I mean, I am 48 years old and given my previous lifestyle I only give myself 5 years more, 9 tops.
Signed respectfully,
Sacking It Up in NH
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crankmas
Jun 4, 2010, 3:32 PM
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I have the same problem, you need to stretch your calf muscles, I do it in the deep end of the pool but there are other techniques, it has disabled me before and screwed up scheduled climbing days, the stretching has helped considerably.
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edge
Jun 4, 2010, 3:54 PM
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crankmas wrote: I have the same problem, you need to stretch your calf muscles, I do it in the deep end of the pool but there are other techniques, it has disabled me before and screwed up scheduled climbing days, the stretching has helped considerably.
So, stretching my calf muscles will help with osteoarthritis in my toes? Who knew?
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edge
Jul 23, 2010, 1:55 AM
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edge wrote: Well, I just got back from the foot doc. He basically told me that the x-ray showed advanced osteoarthritis, and the pain could be reduced by surgery or titanium joint replacement. The operation would not help me walking, running, or climbing, just with the pain. While the thought of becoming just-that-much-more titanium sounds appealing, I guess I will just have to sack up and learn to embrace the pain. I mean, I am 48 years old and given my previous lifestyle I only give myself 5 years more, 9 tops. Signed respectfully, Sacking It Up in NH
Status Update:
In a "why not?" effort, I have now had 3 sessions of acupuncture with very positive results. The pain has decreased by 50% (rough guess), and range of motion has seen similar improvement.
These sessions have been once a week for the last three weeks, with one more scheduled for next week. I will most likely continue to schedule appointments on a regular basis thereafter.
Each session lasts 45 minutes, and involves a dozen or so accupuncture needles, as well as concentrated heat in the form of burning mugwort incense. I am truly amazed at the difference.
Two days ago I ran full tilt down a 1 mile hike of moderate steepness with relatively little pain, something that would have been unthinkable only a month ago.
More updates to follow... 
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bill413
Jul 23, 2010, 3:31 AM
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This is excellent news. Well, it's not titanium cyborg, but still....
I'm glad you found something that helps.
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onceahardman
Jul 23, 2010, 10:40 PM
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edge...I'm really happy with your success with acupuncture. I have seen and heard of amazing results in many cases.
You said this a while up-thread:
In reply to: He then told me to move the toe so it wouldn't "freeze up." So what is it, move it or immobilize it?
That question is best asked of the person making the statement...but...
In general, move it. But don't stretch it. Many, many (most) people don't understand the difference between range of motion and stretching. Just move the joint within it's available range, without stretching the passive restraints (ie ligaments).
Joints are built to move. They don't do well when immobilized. As long as you can do ROM without making it worse, you should do ROM.
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