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Turf toe – how carbon fiber promotes healing with every step

As Patrick Mahomes trains for The Super Bowl, a carbon fiber technology is there to assist in healingfootball

Twenty five year old Patrick Mahomes has lead The Kansas City Chiefs through an exciting year and is scheduled to the meet The Tampa Bay Buccaneers in The Super Bowl on February 7th.  Behind the scenes, practice and preparation for the big game are in high gear.  A large component of this preparation for The Super Bowl is injury management and injury prevention.  Mahomes sustained a turf toe injury during the divisional playoff game against The Cleveland Browns on January 17th.  What is turf toe and how is turf toe treated?  Lets take a closer look.

The term turf toe was originally used by K D Bowers and RB Martin  in 1976. (1)  Bowers and Martin described an extension injury to the great toe joint that resulted in injury to the plantar plate of the joint.  The plantar plate is a dense fibrous pad that acts as an anchor for the majority of the ligaments that support range of motion of the joint.  Turf toe injuries are classified in three degrees of severity:

  • Grade I – sprain of the plantar plate
  • Grade II – partial tear of the plantar plate
  • Grade III – complete tear of the plantar plate

In addition to injury to the plantar plate, intra-articular damage can be sustained during the injury resulting in damage to the cartilage in the great toe joint.  While partial thickness tears of the plantar plate can heal in time, partial to full thickness injuries of the cartilage within the great toe joint can be more difficult to heal.

Diagnosis of turf toe injuries

The great toe joint is a complex joint that include the articulation of four separate bone and a number of different ligaments.  Diagnosis of turf toe injuries can be made based on the history of the injury and clinical assessment.  Definitive diagnosis of turf toe requires and MRI to evaluate both soft tissue and bone injuries.

Treatment of turf toe injuries

Conservative care of turf toe injuries is primarily focused on limitation of range of motion.  Limiting range of motion, particularly dorsiflexion (the same direction that caused the injury) is essential.  Turf Toe T-Straps are a quick and easy way to limit motion of the joint.  Specialized shoe insoles made of light weight, rigid materials represent a better, long term solution in the treatment of turf toe injuries.  Carbon graphite is an extremely thin yet rigid material that is used in a number of different styles of specialty insoles called turf toe plates.

Which turf toe plate is best for my turf toe injury?

Turf toe plates are designed to be specific to the injured athletes shoes and activities.  Carbon Graphite Spring Plates are the most universally accepted insole due to the fact that they fit well in both athletic shoes and dress shoes.  Carbon graphite turf toe plates are also designed in a slim line style to fit dress shoes.  These slim line designs are called Flat Turf Toe PlatesMolded Turf Toe Plates that are molded to provide arch support are also available and are often made of fiberglass/resin materials.

At the heart of all turf toe plates is a unique modification of the insole called a Morton’s extension.  A Morton’s extension is a semi-rigid to rigid extension that provides rigidity to the great toe joint.  The Morton’s extension prevents extension of the joint providing protection and rest for the plantar plate and joint cartilage.

Patrick Mahome’s carbon graphite insole

Carbon graphite insoles are used to promote early return to play in athletes who have sustained a turf toe injury.  Early return to activity with carbon graphite splinting can actually promote healing.  Images of Mahome’s insole show an insert of carbon graphite to the forefoot.  As Mahomes and The Chiefs prepare for The Super Bowl, you can bet that there will be a team of specialist tweaking and tuning that carbon graphite insole to provide optimal support while enabling Mahomes to return to play.  Who knows – could carbon fiber help win The Super Bowl?  We shall see.


1. Med Sci Sports. Summer 1976;8(2):81-3.


Dr. Jeffrey Oster
Jeffrey A. Oster, DPM

Medical Advisor