The ligament located along the bottom of the foot that provides stability for the toes is called the plantar plate. It’s where the plantar fascia attaches and is responsible for preventing the toes from overextending or moving out of place.
When the plantar plate sustains a tear, there are a number of other injuries that may be diagnosed, like hammertoe, predislocation syndrome, crossover toe deformity, and others. But these conditions are almost always due to a tear in the plate, which can be treated by a foot specialist in The Woodlands, TX. Here’s what you need to know about this condition and how it can be treated.
Causes of Tears
Plantar plate tears usually develop over a long period of time because of the repetitive use of the ligament that causes deterioration, although they can sometimes be caused by an acute injury like stubbing the toes. One cause of a tear is biomechanical abnormalities like when the first toe is unusually elevated or short. Longer second or third toes can also cause the plantar plate to be under constant pressure that causes the ligament to degenerate more quickly than normal.
Bunions can also increase pressure on the plantar plate and if the bunions cause the toes to over or under-lap the toes will eventually become dislocated. The dislocation occurs when the pressure from the bunion stretches and thins out the plantar plate. People undergoing steroid injections in the ball of the foot might develop problems with the toes when the injections cause the plantar plate to become thinner and weaker.
Symptoms to Watch For
There are a number of symptoms that indicate a plantar plate tear, the most obvious being pain and swelling under the ball of the foot. The pain can be sharp or dull, but most often it feels like there’s simply not enough cushioning in the bottom of the foot. A more gradual symptom that happens as the tear worsens is the shifting of the toe, usually the second or third toe. One or both of these toes will move towards the big toe, and the toe that’s shifting will eventually not touch the ground when the foot is placed flat on the ground.
The more the toe shifts, the more the pain increases, as more pressure gets placed on the head of the metatarsal. An advanced, chronic plantar plate injury will cause greater deformity and pain as arthritis develops due to deteriorating cartilage. The toe may even become completely dislocated as the plantar plate becomes even more damaged.
Treating Plantar Plate Tears
Treatment for plantar plate tears varies depending on the severity of the tear and how the tear occurred. An acute injury tear might be treated by taping the foot or casting might be necessary. A chronic injury is often treated using arch supports, modifying footwear for more support and more toe room, or custom foot orthotics. Toe splints, pads, and taping can help realign the toes as well.
Pain may be treated using anti-inflammatory medications or with cortisone injections. Surgery may be required for either acute or chronic tears. A foot doctor in The Woodlands, TX, can surgically repair the tear and put the ligament back in the proper position. There may be additional procedures necessary to balance the toe to prevent future dislocation. For more information on treatments for plantar plate tears, contact Ankle & Foot Specialists of Conroe, The Woodlands today.