The big toe joint is a complex structure. Multiple tendons, ligaments, nerves, and vascular structures course across this joint. Injuries here are notoriously painful and can be challenging to heal. Forced extension of the big toe joint can lead to damage to the connective tissues, tendons, or ligaments that resist that motion on the bottom of the joint. If you recall a minor injury of this type and have significant pain the day after, you have likely stretched or torn some of the structures mentioned.
Challenges in healing injuries like these have to do with a combination of how slowly the body heals tendon, ligament, and connective tissues and the tendency we all have to keep walking on an injured foot due to the inconvenience of immobilization. Every evening, while we rest, our body works hard to repair damage. Skin and muscle can heal exceptionally quickly, for example. The structures damaged in a Turf Toe injury, however, often require a month to fully repair. Each day the injury is walked on a patient may actually be undoing the healing from the night before. Some patients have pain for years due to this. The gold standard for conservative treatment of this injury is complete non-weight bearing for a full month. A full evaluation from a podiatrist is recommended, however. If the structures in the toe are damaged severely enough, surgery may be required to heal the toe. Often an MRI can help your doctor to determine whether tissues were merely strained, or whether ruptures occurred. This will allow him to better advise you as to which treatment plan will be best for the specifics of your injury.