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plantar plate

What is plantar plate dysfunction?

There is a bizarre feeling that can happen beneath the forefoot that is frequently described as a feeling that the sock is scrunched up beneath the toes, but if you checked it it is fine. The sense is frequently referred to and is typically confusing. Most probably the actual sensation is a result of a problem with a ligament at the base of one or more of the metatarsophalangeal (toe) joints of the foot called plantar plate dysfunction. About every joint, there's a strong covering known as the joint capsule. Parts of each joint capsule are thicker which are the ligaments that secure and stabilise the joints. Underneath the bottom of the metatarsophalangeal joints, that joint capsule is thicker to make what is known as the plantar plate. It is possible to strain and even get a small tear in that plantar plate, which in turn produces that experience of a sock that seems like its bunched up under the toes.

Pain usually commences slowly and gradually under the ball of the foot and can be preceded by that weird scrunched sock feeling. The most common characteristic of plantar plate dysfunction is soreness on palpation in the vicinity of the plantar plate. A skilled clinician will be able to slowly move the joint in a way to detect when the plantar plate is damaged. A conclusive diagnosis can be performed with a diagnostic ultrasound, but it can be fairly evident to a competent clinician on assessment. Usually the first treatment is strapping to hold the toe pointing down to relieve the force on the plantar plate. A metatarsal pad is also frequently used to help in reducing the strain on the plantar plate. This often helps many cases of plantar plate dysfunction and get rid of that peculiar experience of a bunched up sock beneath the ball of the foot. In the event that those conservative treatments do not help, surgical repair of a partial or complete tear of the plantar plate is often carried out.

How useful is taping a plantar plate tear?

A plantar plate tear is a tiny tear or strain to the ligament which is underneath the lessor toe joints in the foot. It is usually related to too much use, particularly in exercises that need the toes to be bent up or dorsiflexed. The pain is commonly just over the location distal to the joint on the bottom of the foot. Since this issue is due to the toe bending to far backwards or upwards (dorsiflexing) when walking, strapping is a great way to limit that movement.

An effective way for taping a plantar plate tear is to loop some strapping across the toe to pull the toe downwards in a plantarflexed placement. The ends of the tape go under the ball of the foot and by looping across the toe it should hold it straight down. The reasoning being is that when we walk, and the heel comes up off the floor and the toe flexes there is less force on the plantar plate because the toe is hindered from bending up. This way the plantar plate tear taping could actually help the damage recover. This can easily require some time however is by and large successful. Additional strategies could be used to help prevent the dorsiflexion across the joint that is painful, for example with a more rigid sole footwear which is not flexible as this can prevent an excessive amount of motion at the joints. Additionally, there are stiff plates which can be used as shoe inserts to help make the shoe firmer. A foot support device that features a hole over the uncomfortable region could also be used to get weight off the painful spot will likely allow it to be much more comfortable to walk on. These kinds of strategies are likely to be quite helpful, particularly that strapping. Nevertheless, as we still have to walk about on the feet and not get complete rest, it will take several months of this method in order to get a result. Sometimes it will not really work out that way or the problem is particularly distressing. In these cases, surgery to mend the tear can be indicated.