The plantar plate is a thick ligament that goes down the ball of your foot and connects to the joints. The plantar plate is intended to protect the head of the metatarsal (the long bones of the foot) from excessive pressure, preventing our toes from spreading too far apart causing overextension.
What causes a plantar plate tear?
A tear can form when the plantar plate is overworked or strained. Because your second metatarsal is usually the longest, plantar plate tears most commonly occur at the second toe.
Potential causes
- A tendency to over-pronate (roll the feet inwards)
- Having a bunion or hammer toe
- Having a long second metatarsal bone
- Activities that impose excessive pressure on the ball of the foot, such as dancing, running, and climbing stairs
Diagnosis
A physical evaluation by a healthcare practitioner is usually required to diagnose a plantar plate tear. During the exam, the doctor will look for soreness, edema, and instability in the foot. Imaging tests, such as an X-ray or an MRI, may also be used to confirm the diagnosis and assess the severity of the injury.
Recovery
A plantar plate tear can take a long time to heal and may necessitate a combination of rest, physical therapy, and other therapies. The following are some steps that can aid in recovery:
- Rest
To allow the ligament to mend properly, the foot should be rested as much as possible. Limiting physical activities and avoiding weight-bearing exercises that put pressure on the affected foot may be necessary.
- Ice
Applying ice to the affected area might help alleviate discomfort and swelling. Wrap an ice pack in a towel and apply it to the foot many times a day for 15-20 minutes at a time.
- Compression
Wearing a compression band or stocking might help reduce swelling and provide foot support. Wrap the foot tightly but not too tightly, as this can limit blood flow.
- Elevation
Raising the foot above the level of the heart can also help reduce edema and promote recovery. While sitting or lying down, use pillows or a footrest to prop up the foot.
- Therapy for the body
Physical therapy may be recommended after the initial discomfort and edema have passed to help strengthen the foot and improve range of motion. This could include exercises like toe curls, ankle rotations, and stretches.
- Medication
It's possible that your doctor will prescribe over-the-counter pain relievers like ibuprofen or acetaminophen to help you manage the discomfort and inflammation associated with your condition. In certain cases, a reduction in inflammation can be achieved with the use of corticosteroid injections.
- Operation
In more serious cases, an operation to repair the ruptured ligament can be necessary. This may involve reattaching the ligament to the bone or strengthening the ligament with a graft. Alternatively, the ligament may be strengthened using a graft.
Prevention
Avoidance is always preferable to treatment. Preventing plantar plate injuries requires minimizing aberrant pressures on the plantar plates of the foot and promoting optimal foot function.
Is it safe to walk on a torn plantar plate?
Depending on the degree of the tear, your doctor may urge you to avoid walking barefoot in order to avoid aggravating the rip more.
Are plantar plate rips caused by bunions?
Bunions are a common cause of plantar plate rips. Bunions increase pressure on the plantar plate, which can lead to dislocation due to ligament weakening and stretching.
How can one tear their plantar plate?
Overpronation (rolling your feet inward), bunions, hammertoes, and activities that put a lot of pressure on your feet's balls (running, dancing, climbing stairs) all contribute to plantar plate tears.
How long does it take for a plantar plate tear to heal?
It can take months to recover from a plantar plate tear. The majority of patients report being pain-free within 3-4 months of having the plantar plate restored.