Plantar Plate Repair for Toe Pain Relief

What You Need To Know

Understanding plantar plate tears and how we diagnose and treat them.

Understanding Plantar Plate Tears

The plantar plate is a structure located on the ball of the foot and provides stability to the toes. An injury to the plantar plate affects the ligaments of a toe joint, most often the second toe. Without treatment, a plantar plate tear can become a serious condition where a joint becomes dislocated.

If your life is being negatively impacted by toe pain or misalignment (a toe leaning one way or the other and/or a hammertoe), you may be suffering from a plantar plate tear. Patients often describe the pain like they are walking on a stone or on their bones and can even have nerve pain associated with it. Without treatment, degenerative joint disease or arthritis can also develop.

Common symptoms include a sharp pain or dull ache in the ball of the foot, the feeling of walking on a stone, toe misalignment where a toe drifts toward or away from the big toe, swelling or redness, hammertoes or claw toes, a tearing sensation, nerve pain or numbness, and limited flexibility or weakness in the affected toe.

To properly diagnose a plantar plate tear, X-rays will be taken in a weight-bearing position. In some instances, a specific MRI is necessary for further evaluation to find the tear. If you are experiencing any of these symptoms, it is time to schedule an appointment with one of our board-certified podiatrists so we can explain the diagnosis process and guide you through your options.

Treatment, Recovery, and Prevention

Once a board-certified podiatrist has diagnosed the severity of your plantar plate tear, it is time to discuss treatment options. If caught early enough, a plantar plate tear may be treated with rest, physical therapy, and ice therapy. Strengthening exercises can help prevent the tear from worsening.

Shoe gear modifications and custom orthotics are also highly recommended, as they can help relieve the pressure, hold the plantar plate in place, and promote proper foot alignment. All our orthotics are made from electronically scanned images or physical impressions of your foot to ensure accuracy (less than 1mm) and expedite handling.

Often, surgery is necessary in severe cases to alleviate the pain and realign the affected toe. Multiple techniques may be needed if there are other issues to correct, such as hammertoe or bunion deformities. To fix a torn plantar plate surgically, an incision is made on the top of your toe or the ball of your foot. If the tear cannot be repaired, a tendon transfer will be discussed between your podiatrist and you.

Prevention starts with wearing proper shoes and using custom orthotics to support proper foot structure. After any injury or trauma, evaluate your toes for signs of swelling, redness, or pain. Recovery can take several weeks or months, with most patients returning to normal activity after four to eight weeks.