- PODIATRY -

PLANTAR PLATE TEARS

Common Symptoms
Plantar Plate tears is generally described as swelling, pain and burning (paraesthesia) within the ball or top of the foot. Discomfort is generally more pronounced at the 2nd toe which may also visually appear to be splayed or elevated when compared to the unaffected toes.

How it occurs

As seen in the image, plantar plate is a thick ligament which protects the head of the metatarsal’s and prevents abnormal extension of the toes. Although, damage to this ligament is most common within the 2nd toe it can occur throughout any toes.

Plantar plate tear predominately occurs when there is excessive overload or stain placed on the ligament. Factors contributing to this include:

-          Trauma due to abnormal loading patterns whilst walking or running

-          Inappropriate footwear

-          Lesser toe deformities such as, hammer or claw toes

-          Long 2nd toe compared to 1st

-          Foot rolls in excessively (pronation)

What we may assess to obtain a diagnosis
Diagnosis is always subject to symptomatic complaint in conjunction with clinical testing performed by your podiatrist. Test performed may include touching (palpation) the painful area, joint range of motion to assess and an assessment of your walking or running (gait).

At The Running Room and Posh Pod, we are equipped with a pressure plate treadmill (Zebris) allowing us to comprehensively assess plantar pressures within the feet. Additionally, your podiatrist may send you for ultrasound or MRI imaging to assess the severity and/or degree of the deformity.

Management and how long does it take?
Subject to imaging findings plantar plate tears can be managed conservatively or surgical with management modalities and treatment time frames varying on a case-by-case basis. Treatment ranges between 2-6 weeks for acute cases and > 6 weeks for surgical cases.

Conservative modalities may include tape and padding techniques, footwear advice, ice, custom orthotics, and foot specific exercises where applicable. If conservative treatment fails, surgical or oral/injectable anti-inflammatory medication may be considered in collaboration with your general practitioner where an appropriate referral will be made. Post-operative treatment can be provided by your podiatrist and may include a combination foot specific exercise, footwear adjustments and/or custom orthotics.

Author: Maddie Parker

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