CINCINNATI — What is turf toe? And does it really require surgery?
The entire Bengals fan base has likely been googling these questions since star quarterback Joe Burrow went down in Cincinnati's home opener against the Jacksonville Jaguars Sunday afternoon.
What is turf toe?
Turf toe is a fairly common sports injury in which a person sprains the main joint of their big toe. Specifically, the American Academy of Orthopaedic Surgeons (AAOS) says it relates to an injury of any soft tissue structure in the plantar complex.
While the name sounds fairly insignificant, the injury can range in severity. That's because turf toe can describe a stretching of the plantar complex that can be addressed with some rest and ice OR it can describe a complete tear that could require surgery.
How does turf toe happen?
The AAOS said turf toe typically happens as a person is pushing off the ground in an attempt to sprint or run, and a force "pushes the big toe into hyperextension," meaning the toe gets stuck flat on the ground.
As the name suggests, turf toe is often associated with playing on turf surfaces (like the field at Paycor Stadium). Though it can happen on any surface, the Cleveland Clinic said artificial turf is a harder surface than natural grass, meaning it's less forgiving when a toe is pushed too hard or forced down onto the ground.
In Burrow's case, the injury happened as he attempted to run away from the Jaguars' defensive linemen. As the pocket collapsed around him, Burrow tried to escape from defensive tackle Arik Armstead, who grabbed onto Burrow's foot as he pushed forward in a sprint position.
Bengals say QB Joe Burrow has a left toe injury and his return today is questionable. pic.twitter.com/i9TE5l8dY1
— Adam Schefter (@AdamSchefter) September 14, 2025
Why is Burrow's injury more severe than others?
Many NFL players have dealt with turf toe injuries. In fact, San Francisco 49ers quarterback Brock Purdy is currently slated to be out for at least another week due to the turf toe he sustained in Week 1 of the season.
However, Purdy's injury is believed to be a moderate variant of turf toe. Initial reports say Burrow had a Grade 3 (or severe) turf toe injury.
AAOS describes a Grade 3 injury as a complete tear of the plantar complex, "causing severe tenderness, severe swelling and bruising."
While some Grade 3 tears do not require surgery and instead are treated with immobilization for several weeks, AAOS says doctors recommend surgery if the Grade 3 injury includes:
- A severe tear
- Fracture of the sesamoid bone (a round bone found near the joint)
- Unusual up-and-down motion of the joint
- Loose bony chip in the joint
- Damage to the cartilage of the joint
- New or worsening bunion
Reports say the Bengals attempted to get multiple opinions on his injury, but all responded that it would require surgery.
When can Burrow return to action?
According to ESPN's Adam Schefter, the surgery will require Burrow to be sidelined for a "minimum of three months." That would mean Burrow returns in mid-December if all goes according to plan.
The good news is that both the American Academy of Orthopaedic Surgeons and the Cleveland Clinic said most people with turf toe injuries do not deal with long-term problems after recovering from the injury. At most, some athletes can deal with stiffness or problems with push-off strength.
