Plantar Plate Tear & Injury: Best Taping, Shoes, Treatment & Repair 2019
A plantar plate tear can be a BIG injury: Find out the 100% best taping, shoes and conservative treatments before plantar plate surgery repair!
Plantar Plate Injury Overview:
Plantar plate ligament:
- A plantar plate tear or a plantar plate injury refers to the ligaments that holds your metatarsal phalangeal joint together.
- This is located in the ball of your foot or the metatarsalgia region.
- The plantar plate is a very thick structure that stabilizes the attachment of your toe joints. It is at the bottom of the foot.
- The most common joint involved is the second toe in the second metatarsal phalangeal joint. But the other toes can be affected as well.
Plantar plate tear symptoms:
- There can be an acute injury or a chronic injury.
- An acute injury happens with one accident, whereas chronic injury slowly develops over time with repetitive use. Most injuries are chronic.
The symptoms of an acute plantar plate tear are similar to something called turf toe injury. This is when your toe gets suddenly and excessively bent upward.
- This type of motion can strain the ligaments on the bottom of your metatarsal phalangeal joint.
- Some people can feel a pop or a tearing sensation.
- The token even dislocate, and popped back into place with walking.
- In severe plantar plate tear is there could be bruising, and it can also cause the toe to be unstable.
- If untreated. This can lead to a crossover toe, or a dislocated toe.
Chronic plantar plate tear:
This is much more slowly developing than one accident like the acute injury.
- Here there is microscopic tears that stretch out over time. Chronic injury can occur from trauma, where the initial plantar plate was undiagnosed.
- This is a very difficult condition to heal and will take many months of conservative treatment and offloading. It can also be surgically treated in some cases.
Untreated Torn Plantar Plate rupture:
- A chronic plantar plate tear can still be treated with conservative therapy, but if left untreated it can lead to and hammer toe.
- This can be thought of as ball of the foot pain or metatarsalgia pain.
- This can also be called a crossover toe.
Diagnosis of a plantar plate rupture:
- Most of the injuries we see are very subtle.
- This means that the toe is usually not obviously dislocated.
- Some studies show that the pain can radiate to the bottom of the foot, rather than just in the ball of the foot.
- This is because the plantar plate tear occurs close to where the ligament attaches the bone to the toe.
Lachman test (Plantar Plate Tear Test):
- There is a test where you could grab the joint attempt to dislocated, if the toe lifts superiorly. This does mean the ligament is torn. But in most cases there is a mild to moderate tear, not gross dislocation.
- An x-ray has its uses, but plantar plate ligaments can be visualized on x-ray imaging alone.
- This will tell us if there is a dislocation or a broken bone. Which can be very common.
Magnetic resonance imaging(MRI):
- This can be very helpful with plantar plate injuries. There is minimal radiation and there is low risk.
- The downside is an MRI is very difficult and expensive in today’s insurance climate. It could also miss small or minor tears.
- This is an invasive test where radiographic dyes injected into the joint.
- This is not as commonly done anymore.
Plantar plate tear treatment
Plantar plate tear conservative treatment:
- Conservative treatment options for plantar plate injuries are very effective.
- As long as a complete dislocation care has not occurred.
- Although this can happen in chronic injuries.
Acute Injury Conservative Treatment:
This is where plantar plate taping can be very effective. Here we show a video about how to tape a plantar plate injury.
Plantar Plate Tear Taping:
Taping and splinting usually needs to be done for about 6 to 8 weeks, although in some cases 3 to 4 months may be necessary for the patient.
Chronic injury Conservative treatment:
A chronic plantar plate injury is treated similar to a hammertoe, where good orthotics and good good shoe gear is utilized to keep pressure off chronic plantar plate injury.
These treatments include:
- Good supportive shoes.
- Good orthotics:
- Shoes with white toe box.
- Modify activities to decrease running and walking, focus more on biking and swimming.
- Stretching for your Achilles tendon and hamstring muscles.
- Podiatric care for calluses in the ball of your foot.
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