Plantar plate injuries tips and tricks
This week the NK Active podcast is talking all about one of our favourite topics…plantar plate injuries! The chances are that you most probably don’t even know what the plantar plate is and the injuries associated with it, but it is most probably one of the most common conditions that we see here in clinic. And it’s the one condition that we have people drive for multiple hours to come see us. We also help manage people remotely from all parts of the world.
What is the plantar plate?
Plantar plate is a technical term used to describe ligament tissue that holds two bones of your toe together. We usually find that plantar plate is common on all of our toes, but the one that frequently we see injured is the second toe. This can often occur through trauma or sometimes repetitive injury. And that might be through dancing, or running, or any any sport that kind of forces you to repeatedly land or go up onto your tiptoes.
Patients often report kind of a dull ache under the toe. And you tend to find that they can also report that it feels like that they’re walking on a pebble, there’s a lump underneath their toe that they can’t quite get rid of or or move or change at all. We can find that sometimes aggravating factors, things that can cause it to become worse or more uncomfortable, can be simple things like wearing high heeled shoes, it can be dancing, it can be brought on by certain activities, or it could be a certain pair of shoes or footwear that aggravate.
Have you ever been affected by a plantar plate injury? Or have you ever experienced foot pain and not even realised that the plantar plate is the issue? Listen to todays episode as Charlie and Nick walk [boom boom] you through some simple tips and tricks for dealing with Plantar Plate problems.
Listen now via the Spotify button below or if you prefer you can click here to listen on your preferred podcasting platform… https://kite.link/nk-active
And of course if you have any concerns about your own lower limb health, or if you feel that you would like to discuss anything with a member of our team please do contact us to book a consultation here at the NK Active clinic.
I have a plantar plate tear with a slight hammer toe. How do i know if I absolutely need surgery. I’ve had 2 opinions so far. A podiatrist and Ortho and they’ve both suggested surgery. I’m very active and a moderate runner . I’m hoping to get back to my usual activities. Please any advice would be greatly appreciated
Hi Elaine, many thanks for the comment. Surgery is always a personal view of when you need it, we tend to take the approach if you can do the activties you want to do and you are happy then maybe hold off on the surgery. However it is your our decision to have surgery or not, most patietns we see if we can get them back to running and off load the plantar plate and improve the strength, then they tend to leave suergery. Thanks Nick
Dear Nick!, sorry to be a pain!, I just stumbled upon this thread of your reply and I am seeking guidance on strategies for off-loading the plantar plate and enhancing strength in cases of its tear, like in this case.
What approaches or exercises would you recommend for effective management?, since two clinicians have recommended surgical intervention?
Hi Irvine, thanks for the message. It is a case-by-case basis. However off loading is key ever with orthoses, tape, shoes or carbon rocker. Then start building strength through toes, ankle and lower limb. Once strength has built to the ability of doing lesser toe plantar flexion exercises with our black tone loop, we move to calf raises, then add weight, then move to hopping then return to activity. I think with the rehab you have to push it harder than you think. I spoke about it more in detail in this blog https://www.running-physio.com/plantar-plate3/ Thanks Nick
Hi Nick,
I had a fall 4 months ago and have only just had an MRI. I am hoping you can help with a question please!
Do we have a plantar plate on our big toe? The MRI found mine to be “diminutive” which worries me as he wants to operate but I have also read that these ligaments are only found in the lesser toes.
Thanks in advance.
Hi Jo, Many thanks for the message, yes we do have a plantar plate of the 1st toe, it commonly gets called a turf toe injury. Surgery depends on the person and many factors. Surgery is more common on the 1st toe for plantar plate injuries than lesser toe injuries. Thanks Nick
Hi Nick, I’ve watched a lot of YouTube videos.
With 2nd MTP plantar plate sprain that has not appealed on MRI, if offloading and ribbon taping are done diligently, is there a chance this will heal on its own? I have no hammertoe or swaying toe.
I’m also thinking of EPAT and PRP.
Lastly, is capsulitis treated the same as plantar plate?
Yes Jason there is a chance, personally forget about PRP and EPAT, focus on the strength work and why it become irroated in the first place, you may find using a rocker shoe, you dont need to tape as often. Think of it as off laoding as stage one to reduce symptoms, but the strength work is the key long term treatment. Yes, capsulitis is the same non-surgical treatment as plantar plate. Happy to have an appointment with you face to face or over video if you are not local. thanks Nick