Plantar Plate Injuries
There are many reasons pain in the bottom of your forefoot can develop; neuroma, a fracture, bursitis, fat pad atrophy, the list goes on and on.
One of the more common causes, however, is a Plantar Plate Injury.
The Plantar Plate
The plantar plate is an important part of the joint that connects the toes to the foot. It is a thick ligament type structure that connects the plantar fascia into the base of our toe bones.
The plantar plate has evolved to protect the head of the metatarsal (the long bones in the front of the foot) from pressure and prevent over extension of our toes. It also plays a role in preventing our toes from clawing up when we walk.
Risk of Injury
Injuries to this part of the foot are most common in middle aged, overweight women who have regularly worn high heeled, unstable shoes with little to no cushioning. Plantar plate injuries are associated with bunions and hammertoes.
The plantar plate can also be injured in sports involving a lot of twisting movements where the athlete spends a lot of time on the balls of their feet, like Netball for example.
Symptoms of a plantar plate injury tend to be either a slow development or sudden increase in pain under the ball of the foot (commonly the 2nd toe joint) followed by swelling and possible redness in this area. It can feel like you are walking on the bone in your feet all of a sudden!
If you notice a sudden clawing, splaying, or change in the shape of the toe associated with this pain, you can assume the plantar plate is damaged. Long term this can result in stiffening of the affected clawed toe, corns and even ulceration in susceptible individuals.
Treatment for Plantar Plate Injury
When I treat a plantar plate injury I usually recommend the following steps:
- Use ice and anti-inflammatories to help control your pain
- Rest from sporting activities
- Apply a strapping to help realign the toe and reduce the strain on the plantar plate
- Wear stable, well cushioned shoes like trainers to protect the forefoot
- Apply padding into the shoe to offload the painful joint
- Refer for diagnostic ultrasound and/ or X-ray if there is any doubt as to the diagnosis or if other damage is suspected
- Foot orthoses can be very useful in changing the force loading of the front part of the foot.
Treatment for this type of foot injury can take 3-4 months or more due to the load bearing nature of the structures involved. Occasionally surgery may be the best option to repair the plantar plate if conservative options are not effective.
Plantar plate injuries can be a significant life changing event due to the pain and changes in foot shape that occur with it.
If you or someone you know has a sudden increase in pain in the ball of the foot and changes to the shape of the affected toe, contact the Podiatrists at Complete Podiatry or call 8330 0004 quickly to make sure it doesn’t become a lifelong problem.
Yours in helping build amazing lives from the feet up.
Director of Complete Podiatry