How to manage a plantar plate tear?

Around each joint in the body is what is called a joint capsule. This kind of capsule is what supports the bones each side of the joint together and keep the fluid in the joint which lubricates it in position. Regions of this joint capsule tend to be thicker and stronger. These thicker and stronger areas would be the ligaments that give stability to the joint. In the joints at the base of the toes in the feet, the metatarsophalangeal joints, the thickened bottom part of that joint capsule is typically known as the plantar plate. This is required to be thicker and stronger as we place a whole lot of force through it when walking and running and it has to be able to take it. In some cases that force can be so high it can strain that plantar plate or ligament and it will become damaged. When this occurs, the medical term is plantar plate dysfunction and sometimes it may progress to a small tear in the plate, therefore will get called a plantar plate tear.

Often the signs and symptoms for this are pain under the joint whenever walking or on palpation, with the pain being more common in the direction of the front side of the joint. It frequently only impacts one joint but in some cases several may be affected. The toe may be slightly elevated as the plantar plate is not able to secure the toe down because of the damage to its integrity with the strain or rupture. Usually the diagnosis is evident, however, if not an ultrasound evaluation is usually carried out to determine it. The treatment typically includes taping the toe to keep it in a plantarflexed position so the plantar plate is rested so it can have an opportunity to get better. A metatarsal pad could also be used in the footwear to keep weightbearing off the affected region. If these types of procedures don't help, then a surgical repair of the plantar plate tear are usually necesary.