In the second quarter of the Bengals’ Week 2 win over the Jacksonville Jaguars on September 14, 2025, Joe Burrow was sacked by defensive tackle Arik Armstead. He was hit low, needed attention on the field, and limped to the locker room. By the end of the game, he was on crutches with a boot on his left foot.
The next day, the diagnosis was confirmed: a Grade 3 turf toe. Burrow would need surgery and was expected to miss at least three months.
Five days after the injury, he had the procedure in Birmingham, Alabama, at Andrews Sports Medicine and Orthopedic Center, performed by foot and ankle specialist Dr. Norman Waldrop.
Seventy-four days after the injury, he was throwing two touchdown passes on Thanksgiving night in Baltimore.
Now, with the 2025 season over and an offseason ahead, it is worth looking back at what turf toe actually is, why the most severe version is so difficult to come back from, and what Burrow’s recovery could mean for 2026.
What is turf toe?
Turf toe is the common name for a sprain of the joint at the base of the big toe, called the first metatarsophalangeal joint, or MTP joint. It is where the long bone of the foot meets the first bone of the big toe.
On the underside of that joint sits a thick, fibrous band of tissue called the plantar plate, supported by several ligaments. Together, they stop the big toe from bending too far upward.
That joint is under enormous demand. Every time an athlete pushes off to sprint, jump or change direction, the big toe is the last part of the foot to leave the ground. It acts as a lever, and it can be exposed to forces of roughly 70 to 100 percent of body weight.
Turf toe happens when that lever is pushed too far. The foot is planted, the toe is stuck flat on the ground, and the body’s weight drives forward over it. The toe is forced into hyperextension, bending upward beyond its normal limit, and the structures underneath the joint are stretched or torn.
The name comes from artificial turf, which has less give than natural grass and makes this kind of injury more common.
What makes a Grade 3 different?
Turf toe is graded on a scale of one to three:
- Grade 1: The plantar complex is stretched, with mild tenderness and swelling.
- Grade 2: The plantar complex is partially torn, with more swelling, bruising and painful, limited movement.
- Grade 3: The plantar complex is completely torn, with severe pain and swelling and difficulty moving the toe at all.
The difference between grades is significant. Just one week before Burrow’s injury, 49ers quarterback Brock Purdy also suffered turf toe, but a less severe version that was expected to keep him out for only a week or two.
Burrow’s injury was at the other end of the scale. With the supporting structures completely torn, the joint can lose its stability, and surgery is usually recommended to restore it.
That comes at a cost. One 2021 study found that athletes who needed surgery for turf toe lost an average of 221 days. For an injury to a single toe, that may sound surprising, but it reflects how much the rest of the body depends on that joint.
What did the surgery involve?
In general, surgery for a Grade 3 turf toe aims to repair the torn plantar plate and surrounding ligaments, restoring the stability of the joint so it can once again tolerate the forces of pushing off.
Timing also matters. Surgeons generally prefer to repair this injury early, ideally within about five to ten days, before the tissue begins to scar and retract. Burrow’s surgery took place five days after the injury, on September 19.
What did the road back look like?
While every rehabilitation program is individualized, recovery from a surgically repaired Grade 3 turf toe generally follows a progression like this:
Weeks 0 to 2
Protect the repair
The early focus is on protecting the surgical repair and controlling swelling. That usually means a boot and no weight through the foot for roughly the first two weeks. Upper body work and conditioning that does not load the foot can continue.
Weeks 2 to 6
Protected movement
Weight bearing is gradually introduced while the foot stays protected in the boot. The big toe is not allowed to bend fully upward during this period, typically for around six weeks, because that is the exact motion that stresses the repair. Gentle, controlled movement of the toe can begin, along with strengthening of the foot and ankle.
Weeks 6 to 8
Restore motion and strength
As the repair heals, the athlete transitions out of the boot. The focus shifts to restoring the toe’s ability to bend upward, normalizing walking, and building strength with exercises like calf raises, balance work and progressive loading of the foot. One of the challenges here is finding the right balance: enough motion to perform, without aggravating the joint.
Weeks 8 and beyond
Return to football
The final stage reintroduces the demands of the position: running, dropbacks, rolling out, planting and throwing on the move.
Burrow reached this point remarkably quickly. On November 10, just 57 days after the injury, the Bengals opened his 21-day practice window, and he returned to practice in a limited capacity. By November 19, he was a full participant. Eight days later, he was back in the lineup.
Why the plate in his cleat?
When Burrow returned, he did so with a steel plate in his left cleat.
This is a common strategy after turf toe. A stiff plate under the forefoot limits how far the big toe can bend upward, which reduces stress on the repaired tissue during push-off and planting. In simple terms, the shoe takes over part of the job the plantar plate normally does.
The trade-off is that a stiffer shoe can change how the foot feels and moves. For a quarterback, however, protecting the toe is likely worth a small change in feel, especially so soon after surgery.
How did he look?
Burrow made his return on Thanksgiving night against the Ravens, and the Bengals won 32 to 14.
He completed 24 of 46 passes for 261 yards and two touchdowns. By his own admission, he needed the first half to shake off the rust before looking much more comfortable after halftime.
The toe was tested. According to Next Gen Stats, Burrow attempted eight throws on the run that night, completing six of the throws he made while moving at 8 miles per hour or more for 55 yards and a touchdown.
More importantly, it held up. Burrow played every remaining game of the season, finishing with a three-touchdown performance against the Browns on January 4. The Bengals finished with six wins and 11 losses and missed the playoffs, but Burrow ended the year on the field.
What does this mean for 2026?
The research on turf toe surgery is encouraging, but it comes with a caveat. Up to 90 percent of athletes who have surgery are able to return to their sport, but as many as 73 percent may notice some decline in performance.
One of the longer-term concerns after a severe turf toe is stiffness in the joint, particularly the loss of the toe’s ability to bend upward. For a quarterback who relies on movement in and out of the pocket, that is worth watching.
The good news is that Burrow now has something he did not have last fall: a full offseason. Rather than racing a calendar, he can continue to build strength and motion in the toe without the pressure of an active season.
The things to watch as the Bengals move toward training camp are whether he continues to wear the plate, how freely he moves outside the pocket, and whether the toe tolerates the volume of a full season.
For now, the toe has passed its biggest test. Burrow came back ahead of schedule, started six straight games, and finished the season healthy.
