Just two weeks into the 2025 NFL season, two different quarterbacks have already been sidelined with turf toe injuries. The San Francisco 49ers’ Brock Purdy was the first to go down, playing all of Week 1 but missing Week 2 with the issue. The Cincinnati Bengals’ Joe Burrow followed suit with an even more serious variation, exiting Week 2 and quickly making plans for surgery.
Why is it that Burrow and Purdy are on different timelines? And why is turf toe such a serious concern for both signal-callers? Come to think of it, what does “turf toe” even mean? These are all valid questions considering how much the injuries are set to affect the 2025 season, putting added strain on a couple of would-be playoff contenders.
So we checked in with two medical experts: Marty Jaramillo, CBS Sports HQ’s injury analyst who spent more than 30 years as a physical therapist; and a practicing orthopedic physician assistant and strength and conditioning specialist. Combining their insight, we’ve got answers to all the basic questions surrounding turf toe, its causes and effects:
What is turf toe?
Turf toe is an injury at the bottom of the foot where the big toe meets the main bone on the inside of the foot. There are ligaments and bands of tissue on the bottom of the foot that provide stability and keep this big toe joint in proper alignment. This joint takes on stress when trying to pivot or push off the foot. These forces are significantly increased during athletic competition or pushing against resistance. When the forces are too much to bear, that’s when “turf toe,” or a hyperextension of the big toe, occurs.
How do turf toe injuries occur?
If the ligaments and bands on the bottom of the big toe joint can’t resist the forces applied to them, that’s where “turf toe” occurs. These injuries can take place after a cumulative amount of repetitive trauma, or thanks to one specific event in which the body — or, in this case, the big toe joint — can’t handle the external load it is trying to overcome.
Why is it called turf toe?
The name stems from the earliest days of athletes playing on artificial turf, when “it was just artificial turf on concrete,” an unforgiving surface that “put tremendous stress on big toes at push-off,” according to Jaramillo. Turf isn’t necessarily a primary cause of the injury anymore, per Jaramillo, but the moniker has stuck since it was first used in the 1970s.
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How is turf toe typically treated?
Minor turf toe injuries would be considered sprains and can be treated conservatively. Treatment would involve ice, rest, and rehabilitation, while allowing the tissues time to heal. However, significant stress can result in a partial or total tear of these ligaments and tissues. Surgery is “rare,” per Jaramillo, but it is used to “reattach damaged soft tissue to restore the joint’s stability and function,” and the subsequent rehabilitation usually lasts several months.
Why can’t players just play through it?
If appropriate treatment isn’t initiated, the big toe joint can become unstable, leading to prolonged pain. And in time it can also progress to arthritis of the big toe. More than that, those who’ve endured the injury describe it as “extremely painful,” one of the main reasons being that you need motion in the big toe during every step, and to a greater extent while playing sports. Jaramillo estimates “60-70% of our body weight is supported by the big toe,” making any movement, especially active motion like running and push-offs, impossible to enact without piercing pain.
What does this mean for Brock Purdy and Joe Burrow?
We already have the reported recovery times for both quarterbacks: an estimated two to five weeks for Purdy and an estimated three months for Burrow. That jibes with our medical experts’ commentary on the variations of turf toe injuries.
Purdy’s more abbreviated absence confirms he’s battling a strain, though his ambiguous return timeline speaks to the unpredictability of how his joint will respond to certain amounts of rest.
Burrow, meanwhile, was tabbed for surgery almost immediately after reports first surfaced regarding his injury, signaling a significant tear of ligaments and tissue. A three-month rehab timeframe would mean a potential mid-December return for Burrow, which Jaramillo anticipates … but only if Cincinnati has reason to put the quarterback back on the field.
“If the Bengals are in playoff contention,” he says, “I expect him to be ready for the tail end of the season wearing a customized insole with a still plate to support the big toe and push-off.”
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