The plantar plate is a strong ligament that is a thickening of the joint capsule that surround the metatasophalangeal joints in the ball of the foot. A strain or even a partial tear of that ligament is a reasonable common problem. The pain is typically under the metatarsophalangeal joint and also just distal to the joint on the bottom of the foot. It typically comes on slowly and gets progressively worse if steps are not taken to alleviate it. A somewhat weird description some with a plantar plate problem is that it feels as though a sock is bunched up under the ball of the foot, but when they check, its not. The diagnosis of a plantar plate tear is typically done by an expert clinician based on a series of clinical tests. Sometimes a diagnostic ultrasound is used to confirm the diagnosis.
My advice for a plantar plate tear
- first of all reduce activity to levels that can be tolerates (and gradually increase as symptoms reduce)
- use ice after exercise for the swelling and pain
- use strapping to hold the toe down in a plantar flexed position and to limit dorsiflexion
- use a rocker style or type shoe to help further prevent strain on the joint
- if this does not give you a steady improvement in symptoms, then consult a podiatrist