I woke up Friday morning with an unusual swell… no, no, not there… on my left foot. To be precise, it’s the balljoint where the big toe bends called the capsular ligament. Mobility of the big toe was limited and the ligament was swollen. The pain was of course, quite excruciating. I haven’t felt this much pain since I tore my MCL (Medial Collateral Ligament) in 2008.


I was a little baffled as to the cause of the sudden injury overnight as I have not been playing my usual weekly futsal sessions for 2 weeks due to the CNY holidays. Was I sleep-poledancing? Did I bump it when I was sleeping? So many thoughts and presumptions. None made sense. The matter a fact was that it was painful to walk and affected area was tender. Felt a lot like a bad sprain.

One of the causes of turf toe, pivoting off foot.

What’s that a-gout?

My other suspect was that all the rich food (and multiple sessions of seafood, including crab) over the holidays has somehow raised my uric acid levels in my joints, causing gout.

Info from Wikipedia:

Gout (also known as podagra when it involves the big toe) is a medical condition usually characterized by recurrent attacks of acute inflammatory arthritis—a red, tender, hot, swollen joint. The metatarsal-phalangeal joint at the base of the big toe is the most commonly affected (~50% of cases). Gout is caused by having higher-than-normal levels of uric acid in your body. Your body may make too much uric acid, or have a hard time getting rid of uric acid. If too much uric acid builds up in the fluid around the joints (synovial fluid), uric acid crystals form. These crystals cause the joint to swell up and become inflamed. Not everyone with high uric acid levels in the blood has gout. Dietary causes account for about 12% of gout, and include a strong association with the consumption of alcohol, fructose-sweetened drinks, meat, and seafood.

Gout, a 1799 caricature by James Gillray

Plantar what?

Funnily enough though, I don’t drink and I don’t take red meat in my diet. Although still suspect, seemed quite unlikely to be gout-related. A visit to a general clinic was a little inconclusive. Doc did say it is highly unlikely to be gout and that no blood test was necessary. Also, he mentioned a condition called plantar fasciitis which is a painful inflammatory process of the plantar fascia. So, not gout! I told doc that I refuse to take any painkillers, and so he gave me non-steroid anti-inflammatory pills to take for a few days. All he said was to monitor my condition over the next week.

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Turf’s up, dude!

I researched further online later and found a couple of possibities – metatarsalgia (pain in the ball joint) and the closest being turf toe, a common athletic injury. Turf toe is seen at different levels of competition, and even affects professional athletes. Although not considered a serious injury, it can be annoying and take a long time to heal.

Below is an illustration of the affected area of the foot.

Turf toe happens when the great toe is hyperextended (the big toe is excessively bent upwards) thus over stretching the tendon underneath the big toe usually at the level of first metatarsal-phalangeal joint (where the big toe bends).

Athletes who do a lot of running and pivoting on the foot like in football/futsal are likely to be afflicted. It usually occurs on harder artificial turf, hence the name of the condition. From the info I gather, I could be out for a couple of weeks. Remedies include a pair of shoes with better support/padding, anti-inflammatory drugs, physiotheraphy and cessation of activities (boo!!!).

I’m looking for a podiatrist who will be able to solve my foot problem. Apparently there are only a handful of foot specialists in Malaysia. If you do know of any to recommend, please do drop me a message. Until then, I’ll see you on the limp side.

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