Dr Information

Summary – The plantar plate is a tough, rectangular, fibrocartilaginous structure that overlies the plantar aspect of the Metatarsal phalangeal joints. Its function is to reduce load on the plantar aspect of the metatarsal heads and stabilise the digits into alignment.  The plantar plate is subject to severe extension forces on toe-off of the foot, this force can cause the plantar plate to become strained or torn. This can be an acute injury (common when running or jumping) or due to biomechanical imbalance. Plantar plate injuries are very painful when toeing off or the digit is dorsiflexed. Commonly occur on the 2nd or 3rd digits.

Literature

Diagnostic tip – Pain on dorsiflexion of effected digit . Pain on palpation distal to joint (pressure under cleft of digit)

Testing or imagery – ultrasound of plantar plate, however if inconclusive MRI is recommended.

Referrals

Podiatrist – Strapping and padding to reduce pressure and immobilise digit. In severe cases a Moonboot maybe required to prevent dorsiflexion of digits (combined with taping and padding). Once acute injury has resolved biomechanical analysis would be undertaken to establish possible recurrence

Orthopaedic surgeon – If plantar plate is fully ruptured surgical opinion may be required.

Patient Information

Summary – The Plantar plate is a thick fibrous structure that connects the digits together and runs across the ball of the foot. It is put under extreme pressure just before our toes leave the ground

How does this occur? – This injury can be due to an acute injury, ie when running, jumping or even walking, the plantar plate becomes under strain and a digit starts to pull away from the plantar plate and can tear or rupture. This injury can also occur due to repetitive strain due to biomechanical imbalance.

How can this be helped? – immobilisation is required to reduce toe-off and to prevent further tear of the area. Rest, Ice, Compression and elevation will assist the inflammation and pain. Anti-inflammatories can help to reduce inflammation (check with GP prior to undertaking)

Who can help? – A podiatrist can assist with immobilisation through strapping and padding to reduce pain and allow the injury to heal as quickly as possible.