Tag Archives: plantar plate dysfunction

How to manage a plantar plate tear?

Around each joint in the body is what is known as a joint capsule. This capsule is what supports the bones either side of the joint together and keep the fluid in the joint which lubricates it in place. Portions of this joint capsule are thicker and stronger. These thicker and stronger areas would be the ligaments that give stability to the joint. In the joints on the base of the toes in the foot, the metatarsophalangeal joints, the thickened bottom part of that joint capsule is commonly referred to as the plantar plate. This really needs to be thicker and stronger because we place such a lot of force through it whenever running and walking and it has to be able to take it. Occasionally that force may be so great it can strain that plantar plate or ligament and it will become painful. When this happens, the medical name is plantar plate dysfunction and in some cases it might go on to a tiny tear in the plate, therefore will get termed as a plantar plate tear.

Often the symptoms for this are pain under the joint whenever walking or on palpation, with the pain being more established toward the front edge of the joint. It in most cases only affects one joint but sometimes several may be affected. The toe can be slightly raised as the plantar plate is unable to retain the toe down due to the injury to its integrity with the strain or rupture. Usually the diagnosis is pretty obvious, however, if not an ultrasound examination is commonly done to determine it. The treatment typically consists of taping the toe to hold it in a downward position so that the plantar plate is relaxed to give it an opportunity to heal. A metatarsal pad may also be used in the footwear to keep weightbearing from the affected area. If these methods do not help, then a surgical repair of the plantar plate tear are usually necesary.

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.