# Bengals QB Joe Burrow Sidelined: A Doctor of Physical Therapy Breaks Down Turf Toe and Its Season-Ending Potential
**Cincinnati, OH – September 18, 2025** – In a devastating blow to the Cincinnati Bengals’ 2025 campaign, star quarterback Joe Burrow has been diagnosed with a severe turf toe injury following Sunday’s game against the Kansas City Chiefs. Head coach Zac Taylor confirmed on Monday that Burrow will undergo surgery and is expected to miss at least three months, casting doubt over his return this season.<grok:render card_id=”4e7c2f” card_type=”citation_card” type=”render_inline_citation”>
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</grok:render> With the Bengals off to a rocky 1-1 start, the loss of their franchise signal-caller could derail playoff aspirations. But what exactly is turf toe, and why does it have the power to bench one of the NFL’s elite athletes for an entire season?
To unpack this common yet debilitating sports injury, we spoke with Dr. Emily Ramirez, DPT, a board-certified Doctor of Physical Therapy specializing in sports rehabilitation at the Ohio Sports Medicine Institute. With over 15 years of experience treating professional athletes, including NFL players, Dr. Ramirez provides an in-depth explanation of turf toe, its mechanics, and why Burrow’s case might spell the end of his 2025 season.
### Understanding Turf Toe: The Basics
“Turf toe is essentially a sprain of the big toe’s main joint, known medically as the metatarsophalangeal (MTP) joint,” explains Dr. Ramirez. “This joint connects the long bone in your foot (the metatarsal) to the first bone in your big toe (the proximal phalanx). It’s a critical hinge for pushing off during activities like running, jumping, or planting your foot – actions that are second nature to a quarterback like Joe Burrow.”
The injury gets its name from its prevalence on artificial turf surfaces, which are harder and less forgiving than natural grass. When an athlete’s foot is planted firmly, and external force – such as a tackle or sudden stop – hyperextends the toe upward, the ligaments and capsule around the MTP joint can stretch or tear. “Imagine your big toe being jammed backward beyond its normal range,” Dr. Ramirez says. “In football, this often happens during scrambles, when a QB is pushing off to throw or evade defenders. The cleats grip the turf aggressively, but the toe bends too far, leading to damage.”
According to medical experts, turf toe isn’t just a simple bruise; it’s a spectrum of injuries graded by severity.<grok:render card_id=”e08286″ card_type=”citation_card” type=”render_inline_citation”>
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</grok:render> Grade 1 involves mild stretching of the ligaments with minimal swelling and pain. Grade 2 features partial tears, more significant swelling, and bruising. Grade 3, the most severe, includes complete ligament ruptures, possible joint dislocation, and damage to surrounding structures like the sesamoid bones or plantar plate – a thick ligament under the joint that stabilizes it.
### Causes and Risk Factors in the NFL
Dr. Ramirez emphasizes that while artificial turf is a notorious culprit – hence the name – turf toe can occur on any surface. “The key is the mechanism: hyperextension combined with high-impact force,” she notes. In Burrow’s case, reports indicate the injury occurred during a third-quarter sack, where his foot was pinned under a defender while he attempted to plant and throw.<grok:render card_id=”0a8409″ card_type=”citation_card” type=”render_inline_citation”>
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</grok:render> This is a classic scenario for quarterbacks, who rely on explosive footwork.
Risk factors abound in professional football. Lightweight, flexible cleats designed for speed can exacerbate the issue by allowing more toe bend. Previous foot injuries, poor conditioning, or even genetic factors like flat feet can increase susceptibility. “Athletes like Burrow, who have a history of lower-body strains – remember his calf issues in 2023? – might be more prone because of altered biomechanics,” Dr. Ramirez adds. The NFL has seen a spike in turf toe cases this season alone, with two quarterbacks already sidelined just two weeks in.<grok:render card_id=”f3a65d” card_type=”citation_card” type=”render_inline_citation”>
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Broader data shows turf toe plagues about 5-10% of NFL players annually, particularly linemen and skill-position athletes. Icons like Deion Sanders and LaDainian Tomlinson have battled it, with some requiring surgery that altered their careers. “It’s not just painful; it’s functionally limiting,” says Dr. Ramirez. “The big toe bears up to 50% of body weight during push-off. Without it, acceleration, cutting, and balance suffer dramatically.”
### Symptoms and Diagnosis
Symptoms of turf toe appear almost immediately. “Patients report sharp pain at the base of the big toe, swelling, and difficulty bearing weight,” Dr. Ramirez describes. In mild cases, it’s like a bad stub; in severe ones, like Burrow’s grade 3, there’s instability, bruising extending up the foot, and inability to push off without excruciating pain.<grok:render card_id=”00a305″ card_type=”citation_card” type=”render_inline_citation”>
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</grok:render> Burrow was seen limping off the field and later confirmed unable to put pressure on the toe.
Diagnosis typically involves a physical exam, X-rays to rule out fractures, and MRI for soft tissue detail. In Burrow’s situation, images were sent to renowned foot specialist Dr. Robert Anderson for review, underscoring the injury’s complexity.<grok:render card_id=”100bc0″ card_type=”citation_card” type=”render_inline_citation”>
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</grok:render> “Grade 3 often shows complete tears and possible sesamoid fractures,” Dr. Ramirez explains. “That’s why surgery is on the table – to repair the plantar plate and stabilize the joint.”
### Treatment Options: From RICE to Surgery
Treatment hinges on the grade. For grade 1, the RICE protocol (Rest, Ice, Compression, Elevation) is standard, often with taping or a stiff-soled shoe to limit toe bend. “Athletes might return in a week with proper support,” says Dr. Ramirez.<grok:render card_id=”d4aca2″ card_type=”citation_card” type=”render_inline_citation”>
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</grok:render> Grade 2 requires 2-3 weeks of immobilization, anti-inflammatories, and gradual rehab.
Grade 3, however, is a different beast. “Conservative management rarely suffices,” Dr. Ramirez warns. “Surgery is often necessary to reattach ligaments, repair tears, or remove bone fragments.” Post-op, patients wear a boot for 4-6 weeks, followed by intensive physical therapy. Rehab focuses on restoring range of motion, strength, and proprioception – the body’s sense of position.
Dr. Ramirez outlines a typical timeline: “Weeks 1-4: Immobilization and pain control. Weeks 5-8: Gentle exercises like toe curls and aquatic therapy. By weeks 9-12, we introduce sport-specific drills.” For NFL athletes, full recovery can take 3-6 months, with risks of re-injury if rushed.<grok:render card_id=”dcfdbe” card_type=”citation_card” type=”render_inline_citation”>
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</grok:render> Historical data suggests slim chances of mid-season return for grade 3 cases.<grok:render card_id=”080eb6″ card_type=”citation_card” type=”render_inline_citation”>
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### Why It Could Cost Burrow the Rest of 2025
With the NFL regular season spanning 17 games through early January, a three-month absence would sideline Burrow until mid-December at best.<grok:render card_id=”70b194″ card_type=”citation_card” type=”render_inline_citation”>
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</grok:render> But Dr. Ramirez cautions against optimism. “Surgery recovery isn’t linear. Complications like stiffness, arthritis, or incomplete healing can extend timelines. For a QB, even 90% function isn’t enough – they need explosive power.”
Burrow’s injury is reportedly a grade 3 with full tears, requiring surgical intervention soon.<grok:render card_id=”9e7ad3″ card_type=”citation_card” type=”render_inline_citation”>
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</grok:render> “Twelve weeks is the bare minimum,” Dr. Ramirez agrees, echoing sports medicine analyses.<grok:render card_id=”8b92e2″ card_type=”citation_card” type=”render_inline_citation”>
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</grok:render> Pushing for an earlier return risks chronic issues, as seen in players like Nick Chubb, who battled lingering foot problems.
The Bengals’ schedule doesn’t help: Key divisional games loom in November, and without Burrow, backup Jake Browning would shoulder the load. Team officials haven’t ruled out a return, but Dr. Ramirez is pragmatic. “Data shows most grade 3 turf toe patients in high-impact sports miss 4-6 months. For Burrow, aiming for playoffs might be realistic, but the regular season? It’s a long shot.”<grok:render card_id=”06522e” card_type=”citation_card” type=”render_inline_citation”>
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### Prevention and Long-Term Outlook
Preventing turf toe involves better footwear, turf reforms, and training. “Stiffer cleats with toe reinforcement, orthotics, and strengthening exercises for the foot intrinsics can help,” advises Dr. Ramirez. The NFL’s push for hybrid grass fields might reduce incidence.
For Burrow, the prognosis is good long-term. “With proper rehab, most athletes return to pre-injury levels,” she says. But at 28, with prior injuries (wrist in 2024, appendix in 2022), cumulative wear is a concern. “Physical therapy will be key – focusing on holistic lower-body mechanics to prevent recurrence.”
As Bengals fans hold their breath, Burrow’s turf toe serves as a reminder of football’s physical toll. “It’s not just a toe injury; it’s a game-changer,” Dr. Ramirez concludes. “Joe’s resilience is legendary, but biology sets the pace.”
This injury not only impacts the Bengals but highlights ongoing debates about player safety and field conditions in the NFL. As the season unfolds, all eyes will be on Burrow’s recovery – and whether 2025 becomes another “what if” year for Cincinnati.
