Rosi’s Blog

I dislocated a toe a few weeks ago. I was just grappling, going for a guard retrieval when I got my foot caught and heard something snap. Didn’t hurt at all, until I looked at it and my toe was sticking out at an angle that toes aren’t supposed to stick out at. I just lay on my back and looked at it for a minute, while everyone else went “urgh!”. Karl put it back in for me, and THEN it really started hurting.

It’s not the worst I’ve seen. I know a couple of instances where people have practically torn their big toe off by getting it caught in gaps in the mat - now they were nasty. It’s not even a particularly important toe - just one of those ones in the middle that are there to make up the numbers. But it’s bloody annoying just the same. It’s amazing how a little thing like that can get in the way of just about every aspect of training.

Fingers and toes are a grappler’s nightmare. Judoka and gi-BJJ players often seem to have hands or feet that are mostly held together by tape. Wrestling boots can prevent injury, but a lot of  grapplers (including me) dislike wearing them because of the loss of sensitivity.

From a sports therapist’s point of view, fingers and toes pose a tricky problem too. Because of the limited blood flow to the area, they can stay swollen and painful for a long time. Not much thought is generally given to rehabilitating a damaged toe, but left to itself it may remain painful and stiff, sometimes for years. When it comes to treating injuries, I learn most from personal experience. I think knowing how something feels first hand, and having worked on my own injuries gives an edge that you can’t get from books, courses, or even working on other people.  So this gave me a good opportunity to give some thought to what is often a neglected area.

So, here’s what I’m doing with mine. Some things just take time, but it’s usually possible to give them a nudge in the right direction.

Immediately after the injury: 

• RICE - rest, ice, compression, elevation. In particular, get ice on it in the first few minutes after the accident to reduce the swelling in the area. Keep icing it every few hours for the first 2-3 days.
• Strap it up to protect it initially, but don’t leave it strapped up. Every few hours, take all the strapping off and give the toe a gentle stretch to maintain range of movement.   

During the healing process (after 72 hours):

• Contrast bathing - alternating ice pack with warm water to increase blood flow to the area. This is one of the best ways to speed up healing in a damaged extremity.
• Mobilize, mobilize, mobilize - make sure you keep things moving gently.
• Dont’ leave it taped up if you don’t need to. One of the most common mistakes with an injured digit is to leave tape on constantly. This allows the scar tissue to stiffen up and you may lose range of movement.  (Of course, if it is fractured then you may have to immobilize it for protection. But that’s a different story). If you are going to tape it to protect it while training, then make sure you take the tape off when you finish to allow it to move normally.
• Anti-inflammatories. It’s important to be careful with these, as the potential side-effects can be very nasty indeed. Not being a medical doctor, I also can’t advise anyone else to take them. But that said, they can be damn good at getting a finger or toe that looks like a balloon back down to a sensible size.
• Ice after training, to take care of any excessive inflammation that may have been triggered off, and to reduce soreness the next day.
• Protection - look at methods of taping, or consider wearing wrestling boots.
• Rehabilitation - treat it like any other joint. Once the inflammation subsides, start working the muscles around the joint. With a finger or toe, start with gentle flexion / extension movements, at first with no resistance, and then just against a small amount of pressure.