Welcome to “Peak Pages” from Peak Podiatry Subiaco.

As we enter spring it’s getting a little easier to get up in the morning and get out exercising. Well done to all that ran in the recent City to Surf, along with other fun run events such the “Run for Gold” and “Perth Half Marathon” which are proudly sponsored by Peak.
Good luck to all those participating in finals in coming weeks.

Injury Spotlight – “Turf toe”
One of the more painful injury presentations to the forefoot is injury to the big toe joint itself, known as “turf toe”. Common in athletes, avid gardeners and the general population alike. This condition has received the spotlight in the past by plaguing Fremantle Dockers ruckman Aaron Sandilands.
Turf toe is a sprain of the base of the big toe where the big toe meets the foot, called the first Metatarsophalangeal joint. or MPJ. It describes a mechanism of injury usually involving forced or sustained hyper-extension of the MPJ.

Clinical features:

There is localised pain and swelling at the 1st MPJ with “bending” the toe. It is worse with weight bearing and there may be pain with passive range of movement. Discomfort results in an inability to “push off” the big toe.

Grading of injury:

  1. Localised swelling with some redness
  2. Partial tear of plantar structures
  3. Complete disruption of plantar structures, significant swelling, and instability of joint. Often associated with surrounding structure damage such as Flexor tendon injury.

The severity of the injury will determine the time before return to sport and the degree of intervention required for treatment. Mild grade one symptoms can often be symptomatically managed well with conservative treatment and settle in 2-4 weeks. More significant injury and and persistent synovitis possibly 6-8 weeks with surgical recovery 10-12 weeks

Predisposing factors:

  • Sporting actions that require repeated forced hyper-extension under load
  • Lack of ankle range of motion
  • Lack of first MPJ range of motion
  • Flexible footwear

Differential Diagnosis: (boney, ligamentous or cartilage injury)

  • Plantar plate tear
  • Flexor Hallucis Longus or brevis tendon injury
  • Sesamoid injury
  • Chondral injury (boney injury such as avulsion fracture)


  • Ice
  • Taping is very effective
  • Off-loading the joint with padding
  • Footwear with “stiffer” misdole in the short term
  • Possibly Carbon plate to stiffen the shank of a shoe to reduce flexion of the 1st MPJ short term
  • Cam walker for higher grade injury
  • Surgical intervention if indicated

Strapping during symptomatic stages and on return to activity is an important treatment modality. See our YOUTUBE link here for taping techniques.
Peak has a series of taping videos for your reference to assist with self taping at home.


GOLD Fever.
Its been busy few months since July. World cup soccer, Tour de France and the the Glascow Commonwealth Games. So many great achievements and so enjoyable to watch.

There are a vast team of people behind each of these athletes, all of whom take great joy in their success and great pride in the fact that maybe the role we play in some small way helps them get there.

We were very grateful to Casey Eastham (Hockey) and Kim Mickle (Javelin) who came in for the post games check up and also proudly showed off Glascow Gold!