Through chronic microtrauma, sports injury or dynamic imbalance, the connective tissue running through the sole of the foot can become inflamed, stretched or torn. These plate tears can result in pain in the ball of the foot, joint instability, crossover toes, or dislocations.
Symptoms may include pain, burning, tingling or numbness between the toes and on the ball of the foot associated with standing for long periods of time or increased activities.
Depending on the severity of the tear and the background of the patient, surgery may be considered as a treatment. Conservative treatment options are always recommended.
A larger, softer shoe with a more supportive insert and a roomy toe box can relieve the direct or indirect pressure and pain from plantar plate tears on the ball of the foot and toe joints.
Temporary arch supports or custom molded orthotics will also give pressure relief and is arguably the best solution for long-term treatment with or without surgical intervention.
Anti-inflammatory medication can help with the chronic pain, but is not much help with the acute pain that comes with plantar plate tears.
Taping the toes in an ‘interweaving’ fashion can either temporarily keep the toe and joint in the correct position, or help it heal if the tear is partial and not a full ligament rupture.
One of the best ways to treat Plantar Plate Injures with or with our surgery is with a orthotic device that places the pressure into the archway and off of the ball of the foot. If manufactured and molded correctly, they can keep the tension off the injury and pressure when standing and walking.
The plantar plate can be easily repaired with sophisticated surgical equipment, such as the Arthrex CPR. Digital surgery may be necessary to straighten a deformity (such as Hammertoe) caused by joint dislocation, or other deformities caused by a torn plantar plate.
The surgery is performed in an outpatient setting, and patients are non-weight bearing for 4-6 weeks followed by 3-4 weeks of physical therapy.
The plantar plate is not a tendon, but a broad ligament at the bottom of the metatarsal phalangeal joints.
A plantar plate tear takes longer to heal than most injuries because of the force of the entire body’s weight on it during normal walking. Non-weight bearing for 6-8 weeks is the optimal treatment for a plantar plate tear.
The symptoms of a plantar plate tear include pain at the ball of the foot, and the toe (most commonly the second toe) elevated above the others and not touching the floor when standing.
A plantar plate tear can heal without surgery if it is a partial tear. An MRI is essential for confirming where it is a partial vs. complete plantar plate tear. Non-weight bearing in a CAM walker for 6-8 weeks is the best treatment for a plantar plate tear.
A plantar plate tear is very serious. If left untreated the metatarsal phalangeal joint can become completely dislocated and with time progress to DJD or degenerative joint disease.
Plantar plate degeneration is the weakening of this structure under the metatarsal phalangeal joint. The most common causes are a ‘dorsiflexion’ injury, repetitive force on the ball of the foot, and elongated metatarsal.
Moore Ankle and Foot Specialists can help if you’re dealing with painful plantar plate tears. Contact us today and let’s go over your options for treatment.
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