Orthopedic Surgeon Explains Joe Burrow’s Grade 3 Turf Toe Injury

By: Alejandro Posada, MD

What’s Turf Toe?

Turf toe is an injury to the joint at the base of the big toe, also known as the first metatarsophalangeal joint. It connects the big toe to the long bone in the foot. Ligaments, or bands of soft tissue that connect bones and provide stability, can be stretched or torn when the toe is forced to bend too far upward.

This type of injury is common in athletes who play on artificial turf, where the toe can catch and extend beyond its normal range of motion.

The Three Grades of Turf Toe

• Mild (Grade 1): The ligaments are stretched but not torn. Symptoms are usually mild, and healing can occur in a few weeks with rest, ice, compression, and elevation.
• Moderate (Grade 2): Partial tearing of the ligaments may occur, often requiring a walking boot and several weeks of recovery.
• Severe (Grade 3): Complete ligament tears or even small bone fractures. These cases typically require a cast, months of recovery, and sometimes surgery.

Joe Burrow’s Case

Joe Burrow has been diagnosed with a Grade 3 turf toe injury and will undergo surgery.

Depending on the exact damage, his surgeon may perform one or more of the following procedures:

• Soft tissue repair: Stitching the torn ligaments back together.
• Joint implants: Replacing damaged cartilage with artificial implants. This procedure is not usually performed on athletes.
• Arthrodesis (fusion): Permanently joining the bones of the joint, often done when other treatments fail. This procedure is not usually performed on athletes.

Recovery and Return to Play

Surgical repair takes longer to heal than mild or moderate cases. Recovery usually lasts several months, depending on the athlete’s progress in rehabilitation. Burrow’s timeline to return will depend on how well his body responds to treatment and physical therapy.

Image: All-Pro Reels, CC BY-SA 2.0, via Wikimedia Commons