Many patients have never heard of plantar plate tears, even if they suffer from the syndrome. Some patients only learn they have the condition when they are seen in our clinics in DeSoto, Sunnyvale or Dallas for foot pain, and finally have a diagnosis.
If a patient appears in one of our clinics complaining of pain in the ball of the foot that worsens when they press down or put weight on it, we usually add plantar plate injury to the list of possibilities.
The plantar plate is a ligament-like structure that’s designed to keep the toes from splaying (spreading out wide). Untreated plantar plate injury can lead to hammertoe. Plantar plate tears are most often found in middle-aged women who have a tendency to over-pronate, or roll the foot inward as they walk.
Experts say that plantar plate problems are under-reported.
Plantar plate rupture may not sound familiar but its many ramifications are well known, including hammertoe, bursitis, crossover toe, and metatarsalgia. The end result is an unstable and painful gait.
The condition seems to be more common in women than in men, and has been thought to be caused or worsened by wearing high heels. It’s usually Caucasian women who present with this ailment, or younger males who engage in vigorous physical activities such as distance running.
Our staff can perform a few simple tests to confirm the diagnosis, and will also ask you to describe when you first noticed the pain, and what you were doing at the time. X-rays may be needed to check for arthritis in the bones of the foot and toes. An MRI is sometimes helpful to view tissue damage.
Conservative Management to Ease Symptoms — or Surgery
How can you tell if you have this affliction? Here are some of the signs:
- You have pain in the ball of your foot
- You feel like you’re walking on the bones of your foot
- Your toe starts to shift upward and may hitch a ride on the neighboring toe (it’s usually the second toe riding on the big toe)
- You may have swelling and redness on the foot above the second toe.
We usually treat plantar plate injuries by focusing on symptomatic relief. Anti-inflammatory drugs (NSAIDs) may ease the pain of walking. There are orthotic devices to pad or strap the toe in place. We may also recommend a change of footwear and perhaps modifying your activity.
Other possibilities include physical therapy to strengthen and stretch the muscles, or cortisone injections— which are used sparingly and can only relieve the pain, not correct the root cause.
Surgery is another option for patients whose condition has deteriorated. The operation is fairly straightforward, and involves stitching the ligament back into its proper position, which is supporting the toes. If the injury has persisted for a while, there may be secondary damages which require a more complicated approach. Only the doctor can tell you what kind of treatment would be best for your situation.
Listen to Your Feet!
Many of us take our feet for granted. If they hurt, we blame a job that keeps us standing all day, or our shoes. But nothing can bring our activity schedule to a screeching halt like aching feet.
We advise our patients in DeSoto, Sunnyvale and Dallas to pay attention to what their feet are saying. Is a toe starting to curl upward? Do you feel like there’s a ball of yarn inside your shoe? Are your feet rolling inward as you walk? Any of these symptoms can seem trivial, until we realize that they are signs of a serious foot condition.
Call the clinic and make an appointment if you notice anything unusual, or if you feel any pain. The best way to stop a big problem is to tackle it while it’s still a small problem.