The plantar plates are a fibrous thickening of the joint capsule under the ball of the foot. Injuries of the plantar plates include partial tears through to complete rupture.
Plantar plate injuries typically occur as a result of overuse. The plantar plates are thickened ligament on the plantar (underside) aspect of the metatarsophalangeal joint (the joint connecting the toes to the foot). When high loads are placed through the forefoot, it places more load through the plantar plates. Increased load through the forefoot can result from poor biomechanics or incorrect shoes (such as high heels).
Plantar plate injuries cause pain under the ball of the foot (forefoot). Typically, the pain is restricted to an area no bigger than the size of a 20 cent coin. The pain will generally get worse the longer you stand on your feet and feel better when you rest. You may notice some swelling under or on top of the forefoot. Sometimes this swelling can impinge on nerves causing a numb sensation in the forefoot. You may even notice your toe deviating slightly.
If you have pain under the forefoot, you shouldn’t ignore the problem. If you do not seek treatment, it is likely to get worse and possibly progress to a complete rupture.
Plantar plate injuries do not produce any long-term effects, as long as it is properly diagnosed and appropriately treated. However, the condition can worsen unless causative factors are not addressed.
The assistance of a podiatrist is important in the treatment of plantar plate injuries. Initially, they can assist in diagnosing the problem and establishing its severity. From this, an appropriate treatment plan will be developed. This may involve initial activity modification, icing, anti-inflammatory medications, taping and the correction of biomechanical abnormalities using orthoses. A podiatrist will also be able to assess and determine why you developed a plantar plate injury and address this during your recovery to prevent a re-occurrence when you return to full participation.