The plantar plate is a thick ligament structure beneath the metatarsophalangeal joints of the lesser toes. Your plantar plate protects the head of your metatarsal (long bones of the foot) from too much pressure, prevents the toes from spreading too far apart, and prevents overextension. Your plantar plate is necessary to support the joints during walking and activity. It’s not uncommon for individuals to experience a plantar plate tear. In fact, plantar plate tears are a common cause of pain in the ball of the foot.
Do you live in Warwick, NY, Milford, PA, Middletown, NY, or the surrounding area and believe that you may have a plantar plate tear? Read on to learn what a plantar plate tear is, its causes, symptoms, and treatment options available.
What is a Plantar Plate Tear?
Plantar plate tears are typically caused by microtrauma due to a sports injury or an imbalance. When one of these instances occurs, it can cause the connective tissue running through the sole of the foot to become inflamed, stretched, or torn. As a result, individuals with a plantar plate tear often experience pain in the ball of the foot, joint instability, crossover toes, or dislocations.
The most common site for a plantar plate tear is the second metatarsal phalangeal joint plantar plate. This is due to the fact that the second metatarsal is usually the longest. It typically bears the most force when a person is walking or running.
What Causes a Plantar Plate Tear?
A plantar plate tear may come on gradually but it can also occur suddenly. Let’s take a closer look at what causes plantar plate tears.
Gradual Plantar Plate Tear
Most plantar plate tears are a gradual process caused by an overload of pressure on the metatarsophalangeal joint. This excess pressure leads to strain, eventually resulting in pressure in the plantar plate area. The tear is what causes pain and instability. This is a common symptom for individuals living with this type of tear.
Sudden Plantar Plate Tear
While plantar plate tears typically occur gradually, someone can also get a tear suddenly. This may be due to a variety of factors including:
- Bunions: A bunion is a bony bump that forms on the joint at the base of the toe. A bunion puts pressure on the plantar plate, which pushes on the second toe and ultimately dislocates it.
- Biomechanical Abnormalities: A biomechanical abnormality means that the musculoskeletal structure and movement of the foot have been altered, resulting in abnormal movement patterns. Some people have abnormalities, such as a long second metatarsal or elevated first metatarsal that causes a tear in the plantar plate.
- Cortisone Injection: In some cases, receiving a cortisone injection can lead to a sudden plantar plate tear. This is because cortisone sometimes has a side effect of thinning and weakening the plantar plate ligament.
Symptoms
Plantar plate tears have very distinct symptoms that make it easier to identify the injury. If an individual has a plantar plate tear, one of the first things they’ll likely notice is persistent pain and swelling under the ball of the foot. This pain usually extends towards the toes as well. It’s possible that you might also notice swelling, redness, or both at the top of your foot.
Some people even experience a feeling as if they’re walking on the bones of the foot. In addition to this, it’s often noted that the foot has a “V” sign between the toes. This means that two toes have further separated from one another than what is normal for the average person due to the tear.
Treatment Options for Plantar Plate Tear
There are a few treatment options available for those with a plantar plate tear. Most methods include self-care but the tear may require surgery, depending on the severity of the issue. Here are a few treatment options to consider.
Self-Care
- Toe Strapping: Strapping the toes is a common treatment option for those with an injury. Toe strapping controls the position of your toe and allows time for your plantar plate tear to heal.
- Padding: Padding the foot is a great way to take pressure off of the injured area.
- Changing Footwear: Changing your footwear to shoes that provide better support may help take pressure off of the injured area and ultimately alleviate your symptoms.
- Avoid Certain Activities: Avoiding activities, such as running or anything that adds additional pressure to the injured area is important. This will ensure that you don’t aggravate the pain and allow the tear to heal properly.
- Anti-Inflammatory Medications: Taking anti-inflammatory medications can help reduce any swelling that you may experience due to the tear and can alleviate some pain.
Surgery Options
In some instances, surgery may be necessary to heal a plantar plate tear. Regardless of whether you have an acute or chronic tear, surgery may be an option for you. It’s important to note that the method of repair will depend on a variety of factors. This can include the extent of the injury, cause of injury, and how long you’ve had the tear.
- Acute Plantar Plate Tear Surgery: If you have an acute tear, it may be repaired by sewing the ligament back together in the correct position. This is called Primary Repair. It’s important to note that if your tear is more complex, this may require plastic surgery techniques to help get the tear back together.
- Chronic Plantar Plate Tear Surgery: A chronic plantar plate tear is a lot more complex than an acute tear. It will likely need extensive evaluation. This is because the secondary compensations for chronic tears are generally set, making repair more difficult. As a result, this may require ancillary procedures to balance the toe, especially in cases of a chronically dislocated toe or the person has a hammertoe.
Get Relief for Plantar Plate Tear with Frankel Foot & Ankle Center
A plantar plate tear can certainly be painful and disrupt daily life. If you’re living with a plantar plate tear, it’s important to note that healing takes time, with individuals typically being pain-free within 3-4 months. However, you can expect the initial symptoms of your tear to diminish a lot quicker. This will allow you to get back to regular activity without too much comfort. If you’re in Warwick, NY, Milford, PA, Middletown, NY, or the surrounding area and want relief for your tear, give Frankel Foot & Ankle Center a try. We offer innovative treatment plans and pain-free procedures to help you live a quality and comfortable life. Contact us today to learn more about how we can help you with your injury.