Journal List > J Korean Foot Ankle Soc > v.19(3) > 1043349

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Park and Grindstaff: Overuse Capsuloligamentous Injury of the First Metatarsophalangeal Joint: A Case Report
Case Report

J Korean Foot Ankle Soc 2015;19(3):128-131.

Published online: 10 September 2015

DOI: https://doi.org/10.14193/jkfas.2015.19.3.128

Overuse Capsuloligamentous Injury of the First Metatarsophalangeal Joint: A Case Report

Jihong Park, Terry L. Grindstaff*

Athletic Training Laboratory, Department of Sports Medicine, College of Physical Education, Kyung Hee University, Yongin, Korea

*Department of Physical Therapy, School of Pharmacy and Health Professions, Creighton University, Omaha, NE, USA

Corresponding Author: Jihong Park Athletic Training Laboratory, Department of Sports Medicine, College of Physical Education, Kyung Hee University, 1732 Deogyeong-daero, Giheung-gu, Yongin 17104, Korea Tel: 82-31-201-2721, Fax: 82-31-204-8117, E-mail: jihong.park@khu.ac.kr

Received 15 June 2015       Revised 8 July 2015       Accepted 24 July 2015

Copyright © 2015 Korean Foot and Ankle Society

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Capsuloligamentous injury at the first metatarsophalangeal (MTP) joint is a common traumatic injury during physical activity, particularly on artificial turf. Mechanism of injury include excessive flexion, extension, or valgus stress. We report a non-operatively treated capsuloligamentous injury at the first MTP joint, which did not occur traumatically but developed by a stress-related mechanism in a collegiate rower.

Keywords: First metatarsophalangeal joint, Turf toe, Overuse injury, Rower

References

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Figure 1.
The anteroposterior radiograph of the left foot revealed no abnormality at the first metatarsophalangeal joint.
jkfas-19-128f1.tif
Table 1.
Summary of Therapeutic Interventions
Treatment Parameter, dosage, and duration
NSAIDs Ibuprofen 400 mg after each meal
Cryotherapy Cold-water immersion (10oC∼12oC) up to malleolus for 15 minutes or ice massage to the 1st MTP joint for 20 minutes
Thermotherapy Pulsed ultrasound for 4∼5 minutes
Duty cycle: 50%∼80%; Frequency: 3 MHz; Intensity: 1.2 W/cm2
Treatment area: around the 1st MTP joint
Electrotherapy High-voltage pulsed stimulation (pain modulation) for 20 minutes
Pulse frequency: 200∼250 pps; phase duration: < 80 microseconds
Active electrode (―): on the top of the 1st MTP joint
Dispersive electrode (+): on the quadriceps muscle valley
Iontophoresis Drug ions used: dexamethasone
Current: 3∼4 mA; total charge: 40 mA/min
Active electrode (―): on top of the 1st MTP joint
Dispersive electrode (+): on the gastrocnemius muscle valley
Stretching Active (assisted) big toe extension/flexion (15∼20s×4∼5 repetitions) within pain free ROM
Ankle dorsiflexion with knee extended or bended (15∼20s×4∼5 repetitions)
Strengthening Towel crunches (1 m) curling (10∼15 repetitions)
Active heel raises (10∼12 repetitions both single and two-legged)
Joint mobilization 1st MTP joint: moved concave surface (proximal 1st phalanx) on the concave surface (head of the 1st metatarsal);
Direction: AP and PA (grade I and II)
Tarsometatarsal joint: moved concave surface (base of the 1st metatarsal) on the convex surface (medial cuneiform);
AP and PA (grade I and II)

NSAIDs: non-steroidal anti-inflammatory drugs, MTP: metatarsophalangeal, pps: pulse per second, ROM: range of motion, AP: anteroposterior, PA: posteroanterior.

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