The plantar plate is a thick ligament on the bottom of the foot between the base of the toe and the metatarsal that keeps the toe in joint. The plantar plate keeps the toe in line and prevents it from over extending or drifting.
Plantar plate ruptures happen most commonly in the second toe. They are a progressive form of capsulitis, which is an inflammation of the plantar plate tissue. As capsulitis progresses, the plantar plate can tear, causing persistent pain and swelling.
Symptoms of a plantar plate tear can include:
- A dull ache or sharp pain in the ball of the foot.
- The feeling that there is not enough cushion between the foot bone and the ground.
- Possible swelling and/or redness on the foot near the toe.
- Pain worsening when flexing the toe upwards.
- In more advanced injuries, the toe may shift upwards or to one side, resulting in “crossover toe.”
Plantar plate rupture can be caused by a specific and sudden injury to the toe and joint (acute) or repeated overuse (chronic) such as walking, running or jumping. Certain conditions, such as a severe bunion, a second toe that is longer than the big toe, or flat feet, can also make a person more prone to plantar plate injuries. Plantar plate injuries are typically more common in women in their 30’s and 40’s.
Like most foot injuries, the earlier we can treat you, the better. Treatment of a plantar plate rupture can vary according to the degree of injury, but can include:
- Anti-inflammatory medication, ice and rest.
- Footwear modifications.
- Custom orthotics
- A walking surgical boot or shoe to keep weight completely off the ball of the foot.
- Surgery to repair the ligament, if the rupture is severe.
When it comes to plantar plate conditions, an ounce of prevention really is worth a pound of cure! Examining and diagnosing abnormal foot mechanics early on can help prevent plantar plate injuries.
– Dr. Frank, 541-385-7129