Sadly, I speak from personal experience here. In fact, I’m writing this with right leg raised, the second toe being the one giving me the voice of experience at the moment. Two dogs, one my own (see below) and one her best friend, were milling under foot in the kitchen and I tripped over one of them and broke my toe.

Atop Mt. Dickey after hiking Welch and dickey with Nancy July 13, 2011 asking Junie what she's thinking

I didn’t know this at the time, of course. I was too busy hopping around and swearing and yelling to my husband, “Check the dog. Make sure she’s okay!” (She was fine.)

Please note, I’m not a medical doctor. I’m just someone who’s had multiple injuries and surgeries and is old enough to have collected a lot of advice on the subject. I’ve also taken a Wilderness First Aid course and hiked a lot, meaning I’ve dealt with a few things on the trail.

What to Do Immediately

After injuring your toe, once you can think straight, sit down. Inspect your foot to make sure no bone is poking through, you’re not bleeding, etc. If the area is just red, you’re probably in better shape than if it immediately turns purple/red and swells, as mine did. Note which part seems to swell first or look worst; that’s usually the most injured part and the bit that will heal last. You may not be able to tell which part hurts most when the whole top of your foot is yelling at you.

Raise your foot. This helps decrease the swelling. Decreasing the swelling decreases the pain and, ultimately, speeds healing.

Ice it. Ice for no more than ten minutes and probably fewer. I’ve found that toes tend to hurt from the icing because they’re little and have less circulation and less bone than, say a knee. I never make it to ten minutes, but the toe is quite cold to the touch and reddish, which is all you need anyway. You do not want to cause frostbite, so be careful to stop icing long before ten minutes if the toe starts to feel tingly or burned.

The point of icing is to draw fresh blood with all of its healing elements to the site. Icing also numbs the pain and reduces inflammation.

If you can tolerate them, take an anti-inflammatory. You might try herbal remedies like Arnica, which you can take internally (little pills that go under your tongue to dissolve) or externally (cream or gel you rub on) or both, which I do.

Other anti-inflammatories include ibuprofen, in all its brands, or aspirin. Be sure to take with food, to protect your stomach lining.

Drink some water. It helps calm the nervous system and slows the body’s adrenaline reaction to injury and pain. It also just makes me feel better.

Rest. Oh, this is the hardest one of all. The more you elevate, ice and rest, the faster you’ll heal.

You may have heard of the easy-to-remember mantra for sprains/injuries, R-I-C-E. It’s a good one. The letters stand for REST, ICE, COMPRESS and ELEVATE. The least important of these is compress. In fact, you can skip it altogether, in my humble opinion, especially for a toe. How the devil do you compress a toe?

After The First Day

Lots of folks say don’t bother icing after 24 hours. Baloney! Ice is your friend. Ice as often as you can, but never more than 10 minutes per hour.

Raise your foot whenever possible: sitting in meetings, talking on the telephone, working on the computer, eating dinner, watching television.

Rest. The R-word. Do it. The more you rest early on, the less time you have to rest later.

Buddy Taping

And here’s another thing to do: buddy-tape your toe to the next one to act as a kind of splint. It helps keep the bone in line and helps keep the bruised and battered toe from bouncing around and re-injuring itself. I didn’t do this the first day because my foot hurt too much to fool with it.

I started out taping my injured second toe to the big toe because I thought the bigger toe would provide more stability, but it never seemed comfortable. I buddy-taped to the third toe and it was much comfier. Just came back from getting the toe X-rayed and the alignment of the fractured bone is fine, so all worked well though the buddy is smaller than the hurt toe.

Here’s a picture of a serious buddy tape set-up, with a bit of foam or cotton wool padding between to buddy tape a toe from online source

You don’t need wads of taping, I learned from the doctor today. Just a line of tape, that kind of silky medical tape is good, as you see in the picture.  In my case, the broken joint is the most distal (furthest out) so I’ve not taped over that (ouch!) but rather on the joint below it, closer in to my foot.

my broken toe taped to next toe July 28,2011

If the toe hurts more after buddy taping, don’t tape it.

Get Religion

Be religious in your care for the first two weeks. This kind of care sounds easy to do, but it’s not. You forget. You have other things to do. It’s only a toe, you say to yourself; what’s the big deal?

Heard of turf toe? It’s what football players call a soft tissue injury to their big toes—dancers commonly get it, too, but you notice we don’t call it stage toe—and it can keep players off the field or the dance floor for weeks at a time. So do everything you can do to stop limping around for weeks at a time as the injury lingers because you didn’t care for it properly.

Try acupuncture. I just went for some yesterday, 10 days after the injury, when I realized it probably wasn’t just a sprain. Acupuncture, to me, is something magical like electricity. I have only the vaguest idea how it works, I just know it does. I’ve been going for years for sports injuries, flu, pain management, and to boost my immune system for general well being.

I got an oil from my Chinese acupuncturist that’s applied externally and turns cool. I just put a drop of this on my toe and gently, gently massage it in. I’d tell you the Chinese name of the oil but I can’t begin to pronounce it much less spell it. I suspect any acupuncturist can give you some.

Earlier this summer, I injured my big toe by dropping a small table on it. (See what I mean by I’ve got toe experience?) After 10 days, it was nearly healed, which is how I knew it wasn’t broken.

To X-Ray or Not to X-Ray

Obviously, if a bone is poking through the skin or the toe is askew, get thee to a doctor.

Me, personally, I’d rather avoid a trip to the doctor if I can help it. They will recommend one do all the things I mentioned above and not do anything if the toe is cleanly broken or if it’s sprained, other than what we’ve already discussed.

Otherwise, I prefer to do all the good stuff above and wait. For my big toe, this saved me a doctor’s visit because it was just about fine in ten days. In the case of my second toe, I went today because, while much of the swelling and discoloration was gone, the last little joint was still swollen and red and hurt.

The X-ray told me it was fractured, which made me feel less like a wimp for getting my family to walk the dog and run up and down stairs for me, and gave me a sense for how long it might take to heal—4 to 6 weeks. Dang. That’s a long time!

online image of all five toes of left foot in X ray

The doctor also gave me a flat post-op shoe to wear which is nice in the house because it keeps the toe from getting bent on the push-off of each step I take. (A friend also recommended wearing clogs, which are firm beds and act like a splint, too. I’m going to try this out.) The post-op shoe is not so nice outdoors because my other shoes are a different height by a lot or a little so it makes me walk off-kilter, which isn’t pleasant and is bad for the back.

Here’s another reason I’m glad I didn’t rush in to my doc when the toe was all swollen and purple: doctors touch hurt toes. X-ray techs have to actually move and tape the smashed toe away from the others to get a proper X-ray.

Injured toes do not like this. I’d have kicked somebody who tried these things a week ago. Today I was able to be relatively pleasant.

Please respond to the poll on how long it took your toe to heal — see column to left of this article. Thanks!