Your plantar plate is the thick ligament in the ball of your foot that supports your metatarsophalangeal joints where your toes connect to your foot. If this ligament tears, the nearest toe can become unstable and shift out of its normal alignment, causing additional issues for your foot. In today’s blog, we take a closer look at why plantar plate injuries occur, what symptoms they present with and how the condition is commonly treated.

Causes And Symptoms Of Plantar Plate Tears

Plantar plate injuries tend to develop as a result of a combination of forces on the foot. Here’s a look at some of the most common contributing factors:

• Acute Force – Direct or intense pressure on the metatarsal heads can lead to the onset of a plantar plate tear. Athletes who participate in high-impact sports on hard surfaces, like runners or basketball players, may be at higher risk for plantar plate tears.
• Overuse – Even if the force is not excessive, if you regularly overstress your plantar plate, tears can develop.
• Sudden Impact – Direct impact to the base of your toes can also lead to a plantar plate tear. Stubbing your toe or dropping a heavy object on your foot can result in plantar plate tears.
• Repetitive Toe Bending – If you regularly partake in athletics or physical activities that involve a lot of pushing off with your foot or toe flexion, you may be at an elevated risk of plantar plate injuries.
• Related Toe Issues – Patients with underlying toe problems, like those with bunions or hammertoes, may be putting excessive stress on the plantar plate during normal movements.
• Age/Natural Degeneration – Older individuals may experience some natural weakening of their plantar plate, meaning less force is needed to cause an injury.

Symptoms of plantar plate tears can vary based on the size and location, but some of the most common symptoms include:

• Localized pain
• Swelling
• Bruising
• Difficulty walking
• Stiffness
• Numbness
• Toe misalignment

The earlier symptoms are identified and a treatment course is charted, the higher the likelihood that you can restore significant strength and function in the affected toe, so if you are experiencing any of the above symptoms, connect with a specialist like Dr. McDonald.

Diagnosing And Treating Plantar Plate Tears

A plantar plate tear can typically be uncovered following a physical examination and the assistance of some imaging tests like an X-ray or MRI scan. The most common location for this type of tear to develop is on the second toe, but imaging tests will pinpoint the precise location of the tear. For most mild to moderate tears, your provider will begin by recommending some conservative care techniques. Those will include a combination of RICE (rest, ice, compression and elevation), activity modifications, over-the-counter anti-inflammatory medications, footwear changes and the use of orthotic inserts. Protecting the area and gradually working to reintroduce stress can help a tear heal.

For significant tears or for patients with a severe toe deformity, surgical correction may be the best option. There are a few different ways the plantar plate can be addressed, and your doctor will walk you through your options. A plantar plate correction to reposition the toe and close the tear is common for newer tears, while older plantar plate tears may be best managed with a tendon transfer procedure. Both techniques are considered same-day procedures, meaning you’ll be discharged home on the same day as the operation. Most patients can perform some light walking by the 4-6 week mark post-op, and the majority of patients are back to most everyday activities by the 3-month mark, although complete recovery may take upwards of six months.

For more information about plantar plate tears or other conditions that affect your feet, reach out to Dr. McDonald and his team today at (860) 244-8889.