Cincinnati quarterback Joe Burrow is expected to undergo surgery for his turf toe injury. He sustained the injury in the Bengals’ win over Jacksonville on Sunday. Below, our physical therapists share what this injury means, recovery options, and what his rehab might look like.
What happened?
Burrow sustained a hyperextension injury of his left big toe, commonly called turf toe. These injuries are graded on a 1–3 scale, with Grade 3 being the most severe, and that’s what Burrow has. A Grade-3 injury typically involves a complete tear of the plantar plate, a portion of the joint capsule on the bottom of the big toe, along with the surrounding ligaments. The result is joint instability and major limitations for an athlete.
What does turf toe limit a quarterback in doing?
We asked one of our physical therapists, Sean Trait, PT, DPT, what specific challenges turf toe creates for a quarterback. Sean explained that push-off is where the biggest limitations show up. During drop backs, most of the weight is carried on the toes, so a toe injury makes it harder to set and drive off the foot. In the pocket, mobility and elusiveness suffer, making it difficult to shift, cut, or extend plays under pressure. Even throwing mechanics can be affected, since foot drive during follow-through relies on a strong toe push-off. Sean also noted that beyond the physical impact, many athletes self-limit due to pain or fear of aggravating the injury.
What are the recovery options?
Mild turf toe can often be managed with rest, inserts that limit toe extension, and physical therapy. But in Burrow’s case, with a full tear, he’s electing to undergo surgery. He’ll likely receive advanced treatments available to pro athletes, such as anti-gravity treadmill work or blood flow restriction training to maintain leg strength while protecting the toe.
What does physical therapy look like after surgery?
Initially, PT will focus on protecting the surgical repair, controlling pain, and gradually restoring motion to the big toe joint. As healing progresses, therapy will target loading the calf and foot muscles, followed by balance, and plyometric exercises. In physical therapy, we often incorporate blood flow restriction training early on and then advance to heavier loading, sprint drills, and throwing mechanics once the joint can tolerate it.
Why do NFL players “heal” quicker, and when will Burrow play again?
Timelines for turf toe depend heavily on severity. As Mark Powell, PT, DPT and former NCAA Division I kicker, explained: “You can think of a mild sprain like a mild ankle sprain: uncomfortable but usually quick to recover, sometimes just a couple weeks. A Grade 3 or surgical case is very different. You’re usually looking at several months of rehab, especially in a sport that demands repeated, forceful push-off through the big toe.”
On why NFL players sometimes return sooner than expected, Powell said: “It’s both access and risk. They have the best nutrition, sleep tracking, and rehab — their recovery is literally their job. But we also need to remember those humans are <1% of athletes. Saquon Barkley took every bit of a year to recover from an ACL tear, and we know what kind of athlete he is. There’s also a financial side: unless contracts are guaranteed, missing time could mean missing big money. Teams sometimes weigh whether an ‘80%’ starter is better than the backup at 100%, and athletes are sometimes dosed with heavy painkillers to play through injuries.”
And for Burrow specifically? Powell added: “I think he could play again this season but likely will not if the team is not in a position to be competitive in the playoffs. The higher-ups see him as an investment, and there’s no benefit in risking injury again this season if they’re not going to be competing for a Super Bowl.”