A plantar plate tear causes pain in the ball of the foot. It can feel like a deep bruise or sharp pain. It can also cause swelling and a stiff toe.

It is important to treat a plantar plate tear early, especially in severe cases. This will help reduce the risk of long-term deformity and pain.

Causes

The plantar plate functions to support and stabilise the lesser toe metatarsophalangeal joints during walking and activity. However, the plantar plate is prone to injury and can become damaged from overuse or trauma. This condition often occurs as a result of activities that put the foot under excessive stress, like running, jumping and climbing stairs. It also is commonly seen in sports where the toes are bent upward, such as gymnastics or dancing. The 2nd toe joint in particular is more prone to this type of injury as it bears the most load.

Initially, symptoms of a plantar plate tear range from dull to sharp pain under the ball of the foot. This pain may feel like a deep bruise and is usually most intense with weight bearing activity, such as walking or running. Over time, the injury may lead to changes in sensation such as tingling or numbness. Additionally, the toe may drift upward or become crooked.

If left untreated, a plantar plate tear can progress and lead to a crossover toe deformity where the toe moves up over the big toe. This is why early intervention and treatment of the problem is important to prevent further damage. If conservative treatments fail, surgery is usually required to repair the plantar plate. This may include ligament repair and metatarsal shortening osteotomies, which realign bones to reduce pressure on the foot.

Symptoms

The plantar plate is a tough ligament-like structure that supports the metatarsophalangeal (MTP) joints where your lesser toe bones connect to the ball of your foot. This crucial component distributes forces evenly when you walk, run and engage in other weight-bearing activities, helping to protect the joints from excessive stress.

Repetitive stress and pressure gradually damage the plantar plate over time, often without noticeable symptoms. Sudden trauma, like stubbing your toe or dropping a heavy object on the foot, may also cause a plantar plate injury. Pre-existing foot conditions, like bunions and hammertoes, may place additional stress on the plantar plate, increasing your risk of developing an injury.

Symptoms of a plantar plate injury include pain underneath the ball of your foot that is most prominent when you step down or rise from sitting. You may notice swelling of the affected toe joint, a feeling that your toe is loose or disconnected from the rest of your foot, or changes in other toes as they compensate for the injured toe.

With prompt evaluation and treatment from an experienced podiatrist, you can reduce your risk of complications like a hammertoe or other chronic pain in the forefoot. Our expert physicians are trained in a variety of surgical techniques to repair your plantar plate tear, correct your toe deformity and relieve pain.

Treatment

A plantar plate injury can be quite painful, especially in its early stages. Your foot and ankle surgeon will recommend treatment that may include rest, icing and taping (or using a stiff-soled shoe) to prevent excessive pressure on the affected metatarsal head. Some over-the-counter pain medications and physical therapy are also often recommended to control symptoms and speed up the healing process.

The plantar plate is designed to keep your toes in place and prevent them from drifting sideways. If you tear the plantar plate, the toe will feel unstable and it can become dislocated over time. If left untreated a dislocated toe can lead to permanent changes to the alignment of your foot.

Whether you have a mild or severe plantar plate tear, you should seek medical attention right away to avoid long-term problems. Your doctor will diagnose the injury by examining your feet and looking at advanced imaging such as an ultrasound or MRI.

If conservative methods fail to alleviate your pain, surgery is usually necessary. This can range from ligament repair to metatarsal shortening osteotomies that realign bones to reduce pressure. Several surgical techniques are available, and your foot and ankle surgeon will choose the one that best addresses your needs and circumstances.

Prevention

The plantar plate is an important foot structure in the ball of your foot that helps stabilize and support the metatarsophalangeal (MTP) joints where your toes connect to your feet. The plate distributes the force of walking and running evenly among your toes and prevents them from over-extending or bending too far when you place weight on your feet. When the plate becomes damaged, it can become unstable and your toes may start to drift or flex out of alignment, eventually developing into a hammer toe.

Plantar plate injuries can be caused by repetitive stress that gradually increases pressure on the feet or sudden trauma such as stubbing your toe or dropping something on your foot. Certain foot conditions like hammertoes and bunions can also cause the plate to be more susceptible to injury by altering the way the pressure is distributed through your feet.

Proper footwear and custom soft full-length orthotics are vital in preventing plantar plate tears. Changing the way you walk or run to reduce impact forces on your feet is important as well. Strengthening the foot muscles and improving flexibility in the calf muscles and Achilles tendon can also help prevent this type of injury. Prompt diagnosis and treatment is essential for a speedy recovery. A foot and ankle specialist can accurately assess your condition and recommend the best treatment approach for you.