Sports affected include: football, soccer, lacrosse, field hockey, cross-country skiing, cross-country running, volleyball
Mechanism: hyperextension (excessive dorsiflexion) resulting in strain of the joint capsule at the first metatarsal-phalangeal joint
Risk factors:
(1) pivoting and pushing off with excessive force
(2) flexible footwear
(3) recurrent episodes of trauma
Clinical features affecting the base of the great toe:
(1) edema
(2) tenderness
(3) decreased range of motion
(4) pain in the toe on attempting to push off
(5) late effects include degenerative osteoarthritis and formation of osteophytes
Management:
(1) control of inflammation with icing and anti-inflammatory agents (NSAIDS)
(2) taping
(3) wearing of a more rigid shoe that limits excessive extension of the great toe
