Plantar Plate Tear

Most commonly experienced by middle aged women who's feet have a tendency to overpronate or roll in, a plantar plate tear is often a cause of persistent pain and swelling in the ball of the foot. It is also commonly associated with a bunion and a hammer toe. The plantar plate is a thick ligament type structure with attachments which inserts into the base of our phalanges (toe bones) in the area of the ball of the foot. The plantar plate is designed to protect the head of the metatarsal from pressure and prevent over extension of our toes. It also plays a role in preventing our toes from spreading or splaying.

Symptoms

Persistant pain and swelling under the ball of the foot and extending towards the toes (most commonly the 2nd). Some swelling may be visable on the top of the foot along with redness. Often a sensation of 'walking on the bones for the foot' will be described, and there is a positive Lachman's test. Often a tear will result in the toes splaying (daylight sign) and clawing.

Management

Diagnosis of a plantar plate tear can often be challenging due to the complex nature of the anatomy of the foot. Careful history taking and an examination of the area of pain is required to determine the extent and cause of the tear. If necessary, further investigations such as x-rays or diagnostic ultrasound may be ordered by your podiatrist to help evaluate the severity of the problem.

Conservative Treatment

Initial treatment of the tear will focus on symptom relief. This may involve the use of anti-inflammatory medications, strapping of the toe, off-loading padding, altered footwear and activity modification. low level light therapy

When pain reduction has been achieved if may be necessary to focus on the underlying causes of the problem, such as flat feet, bunions and hammer toes. Your podiatrist will perform a thorough biomechanical assessment to determine the best course of action to offload the forefoot and decrease the mechanical stress on the area. This injury usually occurs gradually and is best treated in the early stages. Often a customised soft full length orthotic and footwear modifications can prevent the problem from progressing.

Surgery

Occasionally when all conservative methods have been applied it may be necessary to refer you for further investigation by your G.P. if necessary our Podiatrist can arrange further treatment via NHS or Private healthcare provider. As our podiatrist is a registered healthcare professional with a degree in podiatric medicine, and is HCPC registered.

Our podiatrist has several years experience in treating Plantar Plate Tears, book in now for an appointment call us on: 01698 267389 or text appointment to: 07985 687 770