The Center for Podiatric Care and Sports Medicine

Do You Have These Symptoms? Four Signs You Have a Plantar Plate Tear

Posted by on Wednesday, October 31st, 2012

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Remember when we talked about how Washington Redskins wide receiver Pierre Garcon was out with a sprained toe capsule? Yeah, that was fun. Not so fun, though, is the new diagnosis Garcon received after seeing a foot specialist: he has a plantar plate tear that may require season-ending surgery

Now I bet you may be thinking to yourself, “Who cares? I’m not a highly paid football player, I don’t need to know about plantar whatevers.” Au contraire, my friend! Actually, a plantar plate tear is something that is just as likely to happen to you just as a highly paid football player. Let’s find out what it is and how to recognize it.

Where can I get these plantar plates? My friend is getting married and this sounds like a lovely gift. Well, a plantar plate is part of the structure of your toe, so a) your friend already has about ten of them and probably does not want your old ones and b) you need yours.

The plantar plate is a ligament that runs from the base of your toe, under your toe joint, and into your metatarsal head (metatarsals are the long bones that run from your midfoot to your toe joint). The plantar plate holds the toe in place and helps it move straight up as you roll through a step. It makes sure the toe doesn’t bend too far back, though, and also acts as a protector for the metatarsal head.

What could I ever do to tear it? In the case of Garcon, it probably was a traumatic injury, where his toe was yanked back too far. Most people, though, suffer plantar plate tears as a result of repetitive stress, meaning there is something about the way they walk that puts an unusual amount of pressure on the metatarsal head. Plantar plate tears can happen to any of the four smaller toes, but usually occurs in the second toe. This injury is common in people who overpronate, or have bunions or hammertoes.

How do I know if I have a plantar plate tear? Does it send some kind of message? Not a text, if that’s what you were hoping for, but it does let you know something is wrong. Now this is an injury where the earlier you catch it, the better, so it’s important to pay attention to symptoms. Here are some signs that you have a plantar plate tear:

  • Pain on the ball of your foot, under your toe (again, most likely under your second toe).
  • A feeling like you are walking directly on a bone (specifically your metatarsal head).
  • Possible swelling and redness on the top of your foot around your second toe.
  • In more advanced cases, the toe may shift to one side or begin to point upwards.

These symptoms could be related to other toe ailments, though, so it’s important to see a podiatrist at The Center for Podiatric Care and Sports Medicine ( 212.996.1900 ) for an accurate diagnosis and treatment plan.

Didn’t you say it was important to recognize these symptoms early to make treatment easier? What is that treatment, anyway? Okay, let’s say we caught it early. The main thing is to stop your toe from moving around so the ligament can heal; your podiatrist may choose to strap the toe downward if your toe is moving upwards. If it’s been shifting to one side, it can be taped to the toe on the opposite side. You may also be given anti-inflammatories for pain or have padding put under that toe to give it a rest. You also will be advised to take a break from activities that put pressure on that toe  (yes, that likely means running, jumping, dancing).

Toe strapped downward
Image: Runnersworld.com

The next step is to solve the problem that caused your plantar plate to tear so it doesn’t happen again. Your podiatrist will likely fit you with custom orthotics that can take pressure off the toe and advise you to stay away from shoes that can stress your toe (yes, stilettos…).

If the injury is too advanced, surgery may be required. You’d probably be in a walking boot for about six weeks, and it may take some time after that to fully return to normal activities. As foot surgeries go, this one isn’t too complicated, but it’s still surgery, and not really a good time for anyone.

So again, keep an eye on your toes, and avoid the surgery. I know you don’t want to go to a doctor and feel like you’re a hypochondriac, fussing about little things like a micromanaging boss. But when it comes to your health, it’s good to be a micromanager so you can avoid having a small problem turn into a big one. If your second toe is showing any symptoms of a plantar plate tear, don’t just sit and admire it, see your podiatrist!

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If you have any foot problems or pain, contact The Center for Podiatric Care and Sports MedicineDr. Josef J. GeldwertDr. Katherine Lai, Dr. Ryan Minara and Dr. Mariola Rivera have helped thousands of people get back on their feet. Unfortunately, we cannot give diagnoses or treatment advice online. Please make an appointment to see us if you live in the NY metropolitan area or seek out a podiatrist in your area.