It’s very common for an athlete to suffer a Plantar Plate injury due to the stress placed on their feet and the frequent over extension of their toes.
The plantar plate is a thick ligament on the underside (plantar) of your foot, running along the first joint of each toe. Its purpose is to act like a support cable and protect the head of the metatarsal (toe bone) from pressure and injury and to prevent the over extension of the toe by hindering the joint from bending upward beyond the normal range of motion. It also keeps each toe stabilized to prevent them from drifting out of their normal alignment, which is referred to as a “splayed toe”. The plantar plate is also called the volar plate, volar ligament, or plantar ligament.
During walking or running, your toes naturally flex upward. At the same time, your body weight – all of it – is supported by the bones in this part of the foot and the plantar plate. The plantar ligament is a relatively small structure, so you can see how easily it might be damaged.
Injury to the plantar plate is usually caused by overuse, such as from running; obesity, which puts too much body weight on the ligament; or wearing high heeled shoes too often which locks the forefoot into a flexed position and requires the plantar plate to carry all of your body weight.
Damage to the plantar plate can be chronic and include a lengthening or partial tear of the ligament. The most serious form of plantar plate injury is a total rupture of the plate, when the ligament tears completely and leaves no link between the foot bones (metatarsals) and toe bones (phalanges). Severe damage to the Plantar Plate is frequent in professional sports, as seen most recently by Pierre Garcon of the Washington Redskins.
Symptoms of Plantar Plate injury
If you’ve damaged your plantar plate, you may experience mild to severe pain and swelling under the ball of the foot, extending toward the toes (most commonly the 2nd or 3rd). Some swelling and redness may be visible on the top of your foot, and one or more of your toes may be splayed or clawed. You may also have a sensation of numbness or “burning pain” in your toes, or a feeling like you’re walking on the bones of your foot.
Treatment of Plantar Plate injury
Fortunately, the most common injuries of the plantar plate can be resolved without surgery, and one or more of the following will be suggested by your podiatrist:
- Icing the injured area
- Anti inflammatory medications like aleve or advil to reduce pain and inflammation
- Strapping the toe into a downward position to align it in order to help the tendon heal
- Custom orthotics
- Off-loading body weight via felt padding in shoes
- Footwear modifications
- If your case is severe, a special boot or shoe to keep weight completely off the ball of your foot