Tag Archives: metatarsalgia

Is it a plantar plate tear or metatarsalgia?

Metatarsalgia is a poor name for a very frequent condition in runners. This is a name which regrettably gets used a lot but is a pretty useless name and diagnosis. The phrase is much like, by way of example, declaring you have a painful knee. This sore knee could be due to any one of a variety of different things. Metatarsalgia means discomfort in the metatarsals or forefoot, so it can end up being as a result of multiple different disorders. For this reason the word can be so meaningless.

The reason for the pain might be a callus of the skin beneath the ball of the foot; it could be a pinched nerve that triggers sharp type discomfort; it may be a fat pad atrophy that produces issues with standing and walking; or perhaps it might be arthritis type conditions inside the joints in the forefoot. Each of these possible causes of metatarsalgia are usually quite different to each other with various symptoms and diverse reasons that simply functions to underscore precisely what a useless term it is make use of.

Probably the most common reason for discomfort in the forefoot is a problem called a plantar plate tear. This is a sprain of the ligament under the metattarsophalangeal joints in the ball of the foot which might progress to a little tear. The pain sensation is often over the joint on the bottom of the foot and just distal to the metatarsophalangeal joint. Normally it's the 2nd metatarsophalangeal joint, however it can impact all of the metatarsophalangeal joints. This problem is more common in people that run more. The problem begins as a slight ache which is often neglected, however it will progress until there is a treatment solution commenced as it doesn't heal on its own.

Typically the treatments for a plantar plate tear is by using strapping to hold the joint in a plantarflexed or downward posture to avoid it from bending up so the strain is given a rest. A rocker sole footwear or a shoe that is more rigid can also help do that. If this helps, it will tend to take a long time and persistence is required. If this is not going to work, after that a number of plantar plate tears should have a surgical procedure.

Taping for a Plantar Plate Tear

A plantar plate tear is a small tear or strain in the ligament that is under the lessor toe joints in the foot. It is usually related to overuse, especially in activities that require the toes to be bent back or dorsiflexed. The pain is typically just above the area distal to the joint on the bottom of the foot. As this problem is due to the toe bending to far backwards or upwards (dorsiflexing) when walking, taping is a good way to restrict that movement.

The best way for taping a plantar plate tear is to loop some tape around the toe to pull the toe downwards in a plantarflexed position. The ends of the tape go under the ball of the foot and by looping around the toe tit will hold it down. The idea being is that when we walk, and the heel comes up off the ground and the toe bends there is less load on the plantar plate as the toe is prevented from bending back. This way the plantar plate tear strapping can help the injury heal. This can take a while but is generally quite effective. Other methods can be used to help prevent the dorsiflexion across the joint that is painful, such as using a more rigid sole shoe that is not flexible as this will prevent too much movement at the joints. There are also stiff plates that can be used as insole to make the shoe stiffer. A foot orthotic device that has a cavity over the painful area can also be used to get weight of the painful area will also make it more comfortable to walk on. These sorts of approaches are generally quite useful, especially that taping. However, as we still have to walk around on the foot and not have total rest, it can take many months of this approach to get a result. Sometimes it does not work out that way or the problem is particularly painful. In those cases, surgery to repair the tear may be indicated.