Why do I have pain under my forefoot?
Recently in the clinic I have seen an increased amount of people suffering from pain underneath their forefoot, in particular plantar plate injuries
No matter your fitness level, forefoot pain can prevent you from doing the activities you enjoy, whether that be walking your dog or going for a 10km jog. At Complete Podiatry we love helping our clients continue to do the things they love doing.
What is a plantar plate?
A plantar plate is a ligamentous structure which connects your toes to your foot, stabilising the position of your toes.
These structures prevent the toe from clawing or overextending, which is especially important for protecting our toes as we walk and remain active
What does a plantar plate injury feel like?
Everyone’s experience with pain is different, and with plantar plate the severity or type of pain can variate from person to person, but generally symptoms can include
- Pain under your forefoot, specifically where your toes join your foot
- Swelling and pain may occur on the top of the affected joint
- Numbness in the tips of toes
- Sharp pain during forefoot loading (rising onto toes)
What causes a plantar plate injury?
Injury or tears to the plantar plate can either be caused by a sudden trauma which overloads the plantar plate or can be caused by degeneration to the plantar plate over a long period.
The most common location of a plantar plate injury is in the 2nd toe.
How to treat a plantar plate injury?
The first thing our podiatrists will help you with is managing your pain.
This can be achieved through methods such as rest and icing the location of the pain.
Rest or activity modification will give the damaged structure some time to heal.
Icing can reduce inflammation, swelling and pain in the area.
The next most important step with a plantar plate injury is identifying the cause, our podiatrists will review your biomechanics (the way you move) and take complete medical history.
Once we have done this we will develop a comprehensive management plan, to help you heal. Working together to resolve and prevent the injury from returning.
Based upon our assessment, treatment recommendations within your comprehensive management plan may include.
- Plantar Plate Taping
- Shockwave Therapy
- Customised Orthoses
- Changes in Footwear
- Strength & Stretching exercises
What is the best footwear for someone with a plantar plate injury?
With a plantar plate injury we want to decrease the pressure under the damaged tissue to help in the healing of the plantar plate injury.
One of the best ways to do this is by changing shoes.
The qualities in a shoe that help to offload the plantar plate area include.
1. A rocker forefoot
A rocker forefoot helps reduce reliance and pressure on the ball of your foot.
2. A stiff sole shoe
Being in a stiff sole shoe will decrease the bending stress at your forefoot.
3. More cushioned shoe
Having more cushion will reduce ground impact forces.
4. Good fixtures
Have good fixtures such as laces will help the shoe grip onto your foot holding it securely.
Is there footwear which will aggrevate my condition?
Just like some shoes can assist the healing of your plantar injury, some shoes have qualities that can make your injury worse.
Increase pressure under the forefoot, because you have to grip your toes to hold onto them.
2. High heels shoes
Overload the forefoot, putting the toes in an extended position leading to more pressure on the plantar plates.
3. Ballet flats
Offer very low cushioning and therefore protection from ground impact forces.
At Complete Podiatry we often see clients with plantar plate injuries.
This injury can prevent you from doing all the activities you enjoy and love. If you are sick of your forefoot pain then my challenge to you is to be proactive about your health.
Working together we can get you back to having an awesome active life.
Yours in helping to build amazing lives from the feet up,
Podiatrist at Complete Podiatry