Stubbed Toe

What is a Stubbed toe?

This is a foot injury that is common in both children and adults. Most times having a stubbed toe is not serious and after the pain goes away you can usually carry on as you normally would. There are times when your stubbed toe can be a serious injury that will need to be treated. Your little pinky toe is the toe that is most commonly injured with the big toe being the next most stubbed toe. A stubbed toe occurs when your foot is jammed into a solid object. Most times they will heal quickly, usually within a few days.

Symptoms of a Stubbed toe

• Immediate pain
• Swelling
• Bruising on the toe or extend onto the foot
• Can be difficult to put weight on the foot
• Toe can become black and blue over the next few days
• Bruising under the nail
• Stiffness

Why does a stubbed toe hurt?

A person’s toes are densely populated by nerve endings that relay sensory feedback to their central nervous system, like pain sensations. Your brain is programmed to give top priority to sensory input from your feet because they are in touch with the ground. Your feet play a critical role in helping to prevent harm to your body. Unlike other areas of your body your toes have little muscle or fatty tissue to absorb the force of an impact. These are the reasons that a person experiences excruciating pain when you stub your toe.

Causes

A stubbed toe is often the result of walking barefoot , wearing open toed shoes, or wearing sandals, and colliding with a curb, a piece of furniture, or anything hard. Many times people stub their toe when they get up in the middle of the night and do not turn on the light, resulting in hitting furniture or some other object with their foot.

Diagnosis

When stubbing your toe it could be fractured or stubbing it may also cause other injuries like a contusion, tendon injury, ligament sprain, dislocation, or other soft tissue injuries. All of these other injuries are caused by the identical thing that causes a toe fracture. To determine if your stubbed toe is fractured or has another soft tissue injury your doctor will usually order x-ray to make the right diagnosis. In children, stubbed toe injuries can cause in an injury that is more serious, especially if it is their big toe they stubbed. Stubbing their big toe can result in developing osteomyelitis or an open fracture. Osteomyelitis is an infection that can happen if treatment is delayed for an open fracture.

Check your stubbed toe

Make sure that you inspect your toe immediately after stubbing it to make sure that the skin is intact because any break in the skin could invite an infection. In addition to looking for a skin break you should also check to see if it has a misaligned or bent appearance, if it is bleeding, has a misplaced or broken nail, or any heavy discoloration and/or swelling. Even if you did not see any skin breaks or anything abnormal when the injury happened you should check your toe over the next few days to see if there are any changes.

How to treat a stubbed toe?

When stubbing your toe most take a “wait and see” approach because most injuries with a stubbed toe will often resolve without any treatment. The primary treatment is to take as much rest as possible. You should also apply an ice pack to help reduce the swelling and pain. Apply it for 15 – 20 minutes at a time several times a day. You can also massage your stubbed toe with an ice cube for ten to fifteen minutes every couple of hours. Do not use this treatment if you have a problem with circulation or diabetes. Massaging with an ice cube could limit the blood circulation which is not a good thing. You should not use heat on a stubbed toe because anything hot will dilate the blood vessels that are torn immediately. This can cause a buildup of fluid in your stubbed toe.

You should avoid putting pressure on the toe as much as possible. When you are sitting, elevate the foot of the stubbed toe to also help reduce swelling. If you leave your foot hanging down the blood runs into and can increase the swelling. To help with the pain and swelling you can take over-the-counter pain medication. If there is a break in the skin clean the area and apply an antibacterial cream, then cover with a bandage. After stubbing your toe you should try to avoid wearing shoes that are tight-fitting until any swelling or pain goes away. Wear sandals or other open toed shoes or shoes that are wide enough to not put pressure on your stubbed toe.

Sometimes when you stub your toe it can cause your nail to break or tear off. If your nail is still partially attached you should cover it with an adhesive bandage in order to give the toenail to reattach itself. If it falls off within a few days make sure that you cover it to help prevent an infection. If the nail does not reattach itself gently clip it off so it does not catch itself on something and gets pulled off.

After checking your stubbed toe it is important to immobilize it. When you stub your toe, muscles or ligaments could be strained or sprained and any excess movement could make the injury worse and prevent adequate healing. You should immobilize your stubbed toe with a splint to prevent allow the tissues to heal on their own and to prevent movement. You can do this at home by using medical tape to secure the stubbed toe to the one next to it. If you think it might be broken do not do this because you could do more harm than good.

When you are diagnosed with a broken toe you should see a podiatrist. Depending on how severe the fracture is the foot doctor may implement one of the following treatments:

• Securing your stubbed toe to another toe
• Splinting your broken toe
• Surgery to reset a severe fracture
• Assigning corrective and protective footwear

When your stubbed toe is broken, to completely heal, it can take six to eight weeks.

Complications

With a stubbed toe the two complications that are most likely to happen are osteoarthritis or infection. The infection could start when the skin which is closer to your stubbed toe is broken open. If you have an ingrown toenail in the toe that you stub it could cause an ingrown toenail infection. This could make it necessary for antibiotics and/or debridement.

If the person is immuno-compromised, like a person with diabetes, they are more at risk to develop an infection even after minor injuries like a stubbed toe that has broken skin. This could lead to a bone infection or an ulcer on their foot. Osteoarthritis is often referred to as a wear and tear medical condition. The reason is that osteoarthritis will typically develop over time with the breakdown of cartilage in the joints. Osteoarthritis could also develop months or even years after an injury. Developing osteoarthritis in your big toe is often caused by dropping a heavy object on your big toe or stubbing it. You can also suffer from stiffness but this can be prevented if you keep moving the stubbed toe gently.

How to tell if a stubbed toe is broken?

There are several signs or symptoms that can indicate that your stubbed toe is actually broken, which can include:

• Pain that continues for several hours or the pain returns when you put pressure on the toe
• Swelling that lasts for a few days
• Discoloration that lasts for several days
• Bleeding under the toenail
• An abnormal appearance of the stubbed toe
• An audible sound at the time the injuries

The symptoms listed do not always mean that a toe fracture has happened but you should still visit your physician. If a fractured toe is not treated it could result in complications, which could be more pain, and time-consuming or costly treatment. One thing to note is that if you stub your toe and it is broken you can still walk on it and you may not be in any pain following the injury. Because of the swelling wearing shoes and walking may start to become difficult.

When to see a doctor?

If you are still experiencing symptoms after several days, it is best to contact your physician. When seeing your physician they will want an explanation of how you stubbed your toe and what symptoms you have experienced when it happened and afterward. Sometimes when you stub your toe you could develop a subungual hematoma, which is a collection of blood under your toenail. If it is a large injury you should visit your physician for treatment. The physician will make a little hole in your toenail and drain the blood that has collected there.

Exercises to help with the stiffness

If you know that your toe is not broken there are different exercises that you can do to help keep your stubbed toe from becoming stiff. One important thing to remember is that you should begin to exercise your stubbed toe very gently and if it starts to hurt stop. Start off with gentle, simple range-of-motion exercises. These can help to relieve some of the swelling and pain by improving the circulation in the stubbed toe and foot. Gently bend the stubbed toe with your fingers and hold it for ten seconds. Slowly straighten your stubbed toe back out and relax for ten seconds. Start out doing this five times and work your way up to doing it ten times. You should do this three times a day.

Other exercises that you can do can include:

• Towel pick-up and stretch: to do this exercise you sit on a chair and toss a towel on the floor in front of you. Pick it up with your toes, making sure that you are keeping your heel flat on the floor. Drop it and repeat ten to twenty times. You can also sit on the floor and stretch your injured foot out in front of you. Slip the towel around the ball of your foot and then grasp the ends of it with both hands. While pulling the towel toward you make sure that you are keeping your knee straight. Hold your foot in that position for ten to twenty seconds and then relax your foot. Repeat three times.
• Heel raises: stand up and hold onto a countertop or chair. Shift your weight onto the counter or chair and slowly raise yourself up onto your toes. Hold that position for five seconds and then lower yourself to the floor slowly. Repeat five times and work up to ten times. Do three sets a day. When starting this exercise do it using both feet but when it becomes less painful try doing it only on the foot with the stubbed toe.
• Toe raises: stand up and distribute your weight over both feet evenly. Keep your feet flat and rock backward. Shift your weight onto your heels and then raise your toes off of the floor. Hold that position for five seconds. Repeat ten times and do three sets.

When exercising your stubbed toe you can alternate between these exercises. You can also do other non-weight-bearing exercises like swimming as this type of exercise will put less pressure on your stubbed toe. If you have been diagnosed with a broken toe do not do any exercises without your physician’s permission.