A commonly misunderstood injury of the foot is "turf toe".

This condition is an acute, traumatic bursitis of the first toe-metatarsal joint associated with tendonitis, this condition is a common result of playing on artificial turf. During normal running conditions, the athlete uses his big toe in a gripping action to dig downward in order to propel him into a forward motion. However, on the artificial turf, he is unable to get that needed gripping action, thereby causing a sliding or displacement of the big toe-metatarsal joint.

If this imbalance continues, it will cause undue stress to the first toe joint and can lead to greater imbalance on the first and second metatarsal bones at the midfoot articulation.

This abnormal motion is a form of pronation, or inward rolling, of the foot which could lead to further complications involving the ankle, knee, hip and lower back. This condition can also occur on a playing field of natural grass when the athlete has a flat or low-arch foot, which is a mechanically weak foot.

Early in the season the athlete may complain of muscle stiffness in that legs, hips and lower back which may be an accumulation of micro trauma (unnoticed trauma) which can cause a lack of efficiency, rendering the body less able to protect itself from overuse and injury. It is of the utmost importance for good player-coach-trainer communication so that they can recognize the possibility of injuries and the need for prevention.

Treatment is directed towards balancing the biomechanically weak foot with an orthotic foot insert for improved efficiency and performance, thereby lessening the chance of injury.

Dr.Robert F. Weiss is a podiatrist specializing in foot and ankle surgery,

He was a member of the Medical Advisory Committee of the 1984 and

1988 Olympic Marathon Trials. Weiss is a veteran of 35 Marathons & has a practice in Darien, affiliated with Stamford Hospital and member of Stamford Health Medical Group-Foot & Ankle Institute.

For info visit his Web site at www.stamfordhealthmedicalgroup.org