Plantar Plate Tear Symptoms & Treatment

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What Is The Plantar Plate?

The plantar plate is a strong ligament located in the ball of the foot, connecting to the joints. Its primary role is to protect the heads of the metatarsal bones (the long bones in the foot) from excessive pressure, prevent the toes from spreading too far apart, and limit the overextension of the toes.
diagram of plantar plate on the Left foot with description of anatomy and indication of plantar plate tear

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How Does A Plantar Plate Tear?

When the plantar plate becomes overloaded or strained, it can lead to a tear. This injury most commonly occurs at the second toe, as the second metatarsal is often the longest. Factors that can contribute to a plantar plate tear include:
  • Over-pronation (excessive inward rolling of the feet)
  • The presence of a bunion or hammer toe
  • A long second metatarsal bone
  • Activities that place high pressure on the ball of the foot, such as dancing, running, or climbing stairs

Symptoms Of A Plantar Plate Tear

Persistent pain and swelling under the ball of the foot, extending toward the toes, is often an early indicator of a plantar plate tear. This pain can typically be triggered by bending the toe upward. Swelling may also appear on the top of the foot, sometimes accompanied by redness. Many individuals describe a sensation of “walking on the bones of the foot,” and a noticeable “V” sign may be present, where two toes separate more than usual due to the tear.

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Management Of A Plantar Plate Tear

Diagnosing a plantar plate tear can be challenging due to the complexity of the foot’s anatomy. This is why consulting an experienced podiatrist is essential. Plantar plate tears can range in severity from mild to a complete rupture. To accurately determine the extent of the injury, medical imaging may be used, allowing for the development of the most appropriate treatment plan.

Treatment Of A Plantar Plate Tear

Initially, treatment for a plantar plate tear will focus on relieving the painful symptoms. This may include:
  • Strapping the toes
  • Padding to offload the affected area
  • Temporarily modifying your footwear
  • Avoiding activities that worsen the pain
  • Using anti-inflammatory medications

After addressing the immediate pain, treatment will focus on any underlying factors, such as flat feet, bunions, or hammer toes. Your podiatrist will conduct a thorough assessment to determine the best way to reduce pressure on the forefoot and minimize stress on the injured area.

Plantar plate issues often develop gradually and are most effectively treated in the early stages. In many cases, using a custom soft full-length orthotic and wearing appropriate footwear can help prevent the condition from worsening.

In rare cases, surgery may be necessary to repair the plantar plate. For chronic cases, a resection osteotomy may be recommended as a treatment option.

Expected Outcome

Restoring the plantar plate can take time, but most patients are pain-free within 3-4 months. The initial symptoms typically improve more quickly, allowing most individuals to return to regular activities within a month.

Our podiatrists are experts in treating plantar plate tears. Book an appointment today for professional care.

Plantar Plate FAQ's

Bunions are one of the contributing factors to plantar plate tears. They increase pressure on the plantar plate, which can lead to the ligament thinning and stretching, sometimes causing dislocation.

Over-pronating (rolling your feet inward), bunions, hammertoes, and activities that place excessive pressure on the balls of your feet (such as running, dancing, or climbing stairs) can all contribute to the tearing of the plantar plate.

Recovering from a plantar plate tear can take time, but most patients report being pain-free within 3-4 months after the plantar plate is restored.

Depending on the severity of the tear, your podiatrist may recommend avoiding walking barefoot to prevent further aggravating the injury.

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