Quite often, our podiatry team see people walk through our doors complaining of pain in the ball of their foot. There are many different diagnoses regarding this kind of pain, however, it is common a plantar plate injury has occurred. The plantar plate is a thick fibrocartilaginous ligament that spans across the bottom of the forefoot. It is responsible for preventing excessive extension of the toes and stabilising them from compressive stress that occurs with walking.
What to look for?
Injury to the plantar plate usually presents with symptoms such as sensation of “walking on a marble” or “walking on the bones of the ball of your foot.” An obvious plantar plate injury can be seen when one of the smaller toes appears to be lifted of the ground or crosses over other toes (most commonly the big toe) whilst standing.
Due to its mechanical role, excessively high and abnormal pressures under the forefoot are the main culprit. Plantar plate injuries commonly occur intrinsically with bunion formation, as the long bone of the first digit moves away from the long bone of the second digit causing excessive stretch of the ligament. This structure can only expand so much before it tears.
Alternatively, a rapid increase or change in physical activity levels; changes in footwear or excessive wear of high heeled shoes; increases in body weight; all increase the pressure and stress on plantar plate.
What can podiatrists do to help?
Treatment of a plantar plate injury is focused at addressing the current pain and symptoms along with preventing progression of the injury.
There are many treatment options available and an assessment by a podiatrist will help to determine which is appropriate for you. Taping techniques, splinting devices, orthotics, footwear modifications, routine strengthening and stretching exercises can all help to heal a plantar plate injury.
A plantar plate injury is a common yet treatable condition. If you or somebody you know is experiencing pain in this region, it is best to have it thoroughly assessed so that it receives appropriate treatment.