What is the plantar plate?
The plantar plate is a thick ligament-like structure located on the bottom surface of the metatarsophalangeal (MTP) joint in the foot. It attaches to the base of the toe and helps maintain stability and proper alignment of the joint. The plantar plate also serves to protect the joint against excessive pressure and stress during weight-bearing activities. Injuries to the plantar plate can lead to pain, instability, and deformity of the MTP joint.
How does the plantar plate tear?
The plantar plate tear is a common injury among athletes and individuals who engage in high-impact activities. It occurs when the ligament that connects the toes to the ball of the foot becomes stretched or torn. This can be caused by repetitive stress on the foot, such as running or jumping, or by a sudden injury, such as a fall or twist of the foot. Over time, the stress on the plantar plate can cause it to weaken, leading to a tear. Other factors that can contribute to a plantar plate tear include wearing shoes that do not fit properly, having a high arch or flat feet, and aging.
Symptoms of a plantar plate tear
Symptoms of a plantar plate tear include pain, swelling, and instability in the affected area. You may also notice that the affected toe is clawed like in the image below:
Treatment of plantar plate tears
The treatment options for a plantar plate tear depend on the severity of the condition. Generally, conservative measures are recommended first, and surgery may be considered if the tear is severe and does not respond to nonsurgical treatment. Some treatment options may include:
1. Rest and ice: Avoid standing or walking on the affected foot as much as possible, and apply ice packs to reduce inflammation.
2. Compression: Use bandages or compression socks to help reduce swelling and support the foot.
3. Nonsteroidal anti-inflammatory drugs (NSAIDs): Over-the-counter medications such as ibuprofen or naproxen can help relieve pain and inflammation.
4. Physical therapy: Exercises to strengthen the foot muscles and improve range of motion may be helpful.
5. Orthotics: Custom-made shoe inserts or pads may provide support and reduce pressure on the plantar plate.
6. Taping: Ribbon taping (below on left) can be applied to the 2nd toe to plantarflex the toe. The longer the toe is in the correct position, the quicker the plantar plate will be able to heal (in cases where the tear is small). A toe-fix device (below on right) can also be used to replicate the ribbon taping.
Surgical intervention
In severe cases, surgery may be necessary to repair or reconstruct the damaged plantar plate.
It is important to consult with your podiatrist for proper diagnosis and treatment recommendations. If you are experiencing pain under your forefoot or believe you may have torn your plantar plate, please feel free to come into our clinic at 4/89-97 New Canterbury Road, Petersham 2049 or call us on 9188 8432 to make a booking with one of our experienced podiatrists.
Thanks for reading and have a great day!
The team at Sole-Lution Podiatry