If you’re an athlete, you’ve likely heard about people who’ve torn their plantar plate. You may have wondered, what is this foot structure? The plantar plate is an important ligament in the ball of the foot that keeps your joints stable, protects the bones from too much pressure, and stops your toes from spreading out or bending too far.
When this ligament gets overstressed or strained, it can tear. While these injuries are common in sports, they can also occur from too much force such as a fall or other factors.
What causes a plantar plate tear?
While a tear can happen to any joint in the ball of your foot, it most often affects the second toe. That’s because it’s the longest joint in the foot and takes on the most force, making it more likely to get injured.
Earlier I mentioned that falls and participation in sports can cause a plantar plate tear. Most often high-impact sports like running, jumping, dancing. and gymnastics are to blame.
Other factors that can increase your risk are:
- Flat feet, low arches and overpronation.
- Having a longer 2nd toe or a Morton’s toe—that’s because when the 2nd toe is longer more force is applied to that area during sports activity.
- Having bunions or hammertoes can also add more stress on the 2nd toe joint.
- Tight calf muscles can cause overpronation.
- Joints that are too flexible
- Wearing unsupportive shoes on and off the field
Symptoms of a plantar plate tear
While you won’t know for sure until you’ve seen a podiatrist, you’ll likely experience one of the following symptoms.
- Pain and swelling in the ball of your foot, especially around the affected toe joint.
- More pain when you’re on your feet, barefoot, or wearing flexible shoes
- The toe is sticking up with swelling or redness on the top of your foot.
- Toes that start to separate and look like a Victory sign with the second toe moving toward the big toe. This is called a Churchill sign.
- Feeling like you’re walking on the bones of your foot.
At-home treatment for a plantar plate tear
- Avoid any activities that cause your foot pain or make it worse.
- Use the RICE protocol for the first 48 hours. This stands for rest, apply ice, compression, and elevation to the affected foot.
- Avoid walking barefoot. Consider using Oofos or another sandal or slipper with arch support.
- Ask your doctor about taking anti-inflammatory medications.
How podiatrists treat a plantar plate tear
- Plantar flexion taping – this is a special taping of the toes to take pressure off the injured joint.
- A walking boot to limit your movement.
- Metatarsal pads to reduce stress on the joint.
- We may offer custom orthotics once your inflammation is down and your foot has healed. These are effective for patients with poor biomechanics to help prevent future tears and other foot problems.
- For patients with tight calf muscles, I recommend using an Achilles splint during the day for 30 minutes.
- Finally, if we do suspect a rupture, an ultrasound and MRI may be ordered. If a rupture is confirmed, a plantar plate surgical repair is indicated. There is a newer procedure called “brace’ that has been very successful in replacing the torn plate. This procedure will resolve the pain and return you to your previous sports activities.
You can prevent a plantar plate injury by taking the following steps:
- Avoid wearing high heels, flip-flops, and other flexible shoes. Instead, wear a supportive athletic shoe with a rocker sole like Hoka. Here's a video about how to test shoes before you buy them.
- Wear your orthotics consistently if your podiatrist has prescribed them.
- Before participating in sports, warm up with dynamic stretches and regular calf stretches afterward. I’ve put some links in the video above.
- Use an Achilles splint daily if your calves are tight. Looser calf muscles will help reduce overpronation.
By taking these simple steps, you can keep your feet healthy and strong—and avoid dealing with a painful plantar plate tear!
