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Plantar Plate Injury

Have you been experiencing persistent foot pain? Is it interfering in your daily activities? It’s important to receive a proper diagnosis and treatment plan from the right medical professional. The sooner this happens, the sooner you’ll be pain-free and back on your feet, enjoying all your favorite activities. Read on as we discuss everything you should know about plantar plate injury.

Almost every day, our feet take us wherever we want to go. They allow us to engage in a multitude of physical activities, including walking, running, pivoting at a moment’s notice — in addition to a host of other complex movements. Most of the time, our feet perform quietly in the background, effortlessly and efficiently performing all these tasks without complaint. It’s only when a person begins to experience persistent foot pain that they realize just how important a healthy set of feet is to their ability to successfully go about their day.

The Plantar Plate – Where is it and What is its Function?

The exterior bump just beneath the toes is called the ball of the foot. On each foot inside the bump, you can find disc-shaped fibrous ligaments called plantar plates. Each of a person’s 10 toes has a corresponding plantar plate. The purpose of each individual plate is to protect both the toes and the metatarsals (the bones that reside in the upper portion of each foot just below the toes) from too much pressure. Plantar plates are particularly important in providing protection during strenuous activities. These include running, or any other activity that exerts tremendous pressure on a person’s foot.

Symptoms of a Plantar Plate Injury

If a person has a plantar plate (tear) injury, they will most likely begin to notice pain both underneath and on top of the area of their 2nd toe (the one nearest the big toe) and their 4th toe.

The more activity a person engages in, the more likely their pain will increase. They may also notice swelling around the area, as well as some redness of the skin. If the person attempts to raise their toes, they may experience an instant and notable increase in their pain levels. In more advanced cases, the toes may begin to cross over each other. They may also begin to separate and form into a “v” shape. Over time and without treatment, the tear responsible for the person’s painful symptoms may cause them to limp. This can happen especially after they attempt a more strenuous activity.

What Causes a Plantar Plate to Tear?

Excessive pressure from strenuous movements such as running can cause a person to experience one or more torn plantar plates. However, other activities such as walking barefoot on hard surfaces, or frequently wearing high heels and/or ill-fitting shoes can cause a plantar plate tear as well. Other people may experience a plantar plate tear due to:

  • An untreated hammertoe or bunion.
  • Overpronation of the feet during walking or running.
  • Hypermobility (abnormal, excessive range of movement in a joint).
  • A short first metatarsal bone (the one residing below the big toe) and/or an unusually long 2nd metatarsal bone.

Diagnosis of Plantar Plate Injuries

If you’ve been experiencing chronic foot pain, your first step should be to seek professional medical help, in order to receive the right diagnosis. During your clinical exam, your physician will attempt to rule out any other causes behind your foot pain such as a physical deformity, a neuroma, or other foot condition. They will likely perform some non-invasive tests to help determine the right diagnosis as well. 

In some cases, when a diagnosis is unclear, a physician may order tests such as an X-ray and/or ultrasound of the affected area. Your physician may also request an MRI to look for ligament tearing. 

Treatment For a Plantar Plate Injury

The recommended treatment for a plantar plate injury typically depends upon the severity of the injury. The good news is that as long as the injury is caught early and isn’t too severe, a patient will likely respond very well to conservative treatments and will be able to avoid surgery.

In the case of an acute (recent) injury, a physician may first prescribe the RICE method of treatment. RICE stands for Rest, Ice, and Compression, and Elevation of the injured area. The doctor may also prescribe anti-inflammatory or oral steroid medication to help relieve pain.

Resting the injured area is particularly important in both acute and chronic cases. A physician is also likely to recommend either wearing a boot or taping and/or padding the injured area. This is in order to provide additional strength and support for injured tissues. A doctor may also prescribe non-invasive treatments such as EPAT (Extracorporeal Pulse Activation Technology). This helps to increase blood flow to the injured area, in order to aid in the healing process. 

A physician may also decide to prescribe orthotic footwear for the patient to wear. The orthotic footwear is custom-designed and provides essential support for internal tissues inside the ball of the foot.

Surgery is generally only recommended as a last resort for cases where a patient doesn’t respond well to more conservative methods of treatment, or if they have some type of physical deformity that requires surgical correction. 

Healing Time

Even patients that don’t require surgery may need to exercise a notable amount of patience in order to allow their plantar plate injury to heal properly.

Some will respond to conservative treatments fairly quickly and will be able to resume their normal activity levels within a month. However, other patients will require additional time, perhaps even 3-4 months, before their injury heals completely. It can be challenging to limit one’s physical activity level for such a seemingly lengthy period. But giving the body the time it needs to fully heal is well worth the time and effort.

Contact Us

If you or someone you know, lives in the Middletown, NY, Warwick, NY, or Milford, PA areas, and is currently experiencing foot pain, we can help! Dr. Frankel, the founder of Frankel Foot & Ankle, uses his extensive experience to diagnose and provide effective treatments for plantar plate injuries for patients throughout the tri-state area of New Jersey, New York, and Pennsylvania. Contact us today! Learn more information on how to start the healing process, so you can get back on your feet and fully participate in life again.