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Plantar plate tears are extremely uncomfortable and very painful foot injuries. One treatment that is commonly used for plantar plate injuries is to tape your affected toes.

Here is what you need to know about a plantar plate injury and treatment.

What is the Plantar Plate?

The plantar plate is a type of ligament in the ball of your foot. Sitting under the metatarsophalangeal (MTP) joint where your toe connects to your foot, it pulls the toe downwards toward the floor. Each one of your toes except the big one has a plantar plate, and each plate is connected to the ones adjacent to it with a ligament.

Together, these ligaments provide crucial stability to your feet and toes.

What is a Plantar Plate Tear?

The plantar plate can tear, generally under excessive pressure or use. The tear is a fraying of the ligament under the metatarsophalangeal joint. If left unchecked or untreated, the tear can get worse until the ligament is completely torn apart or results in a plantar plate rupture.

Letting a partial plantar plate tear progress until the ligament is completely torn will make the symptoms significantly worse and treatment much more difficult.

However, even if it is completely torn, the plantar plate will heal on its own. It will just take more time and treatment.

Symptoms

The most obvious symptom of a plantar plate tear is a sharp pain on the underside of the foot where your toes connect to your foot, referred to as the area in front of the metatarsal head. The location is commonly referred to as along the ball of your foot. The exact location of the pain will depend on which plantar plate is tearing: If the plantar plate for the fifth metatarsophalangeal is affected, then the pain will be at the base of your little, “pinky” toe. If the plate for the second metatarsophalangeal joint is tearing, as is most common, the pain will be at the base of your second toe.

The pain that you feel can vary from a sharp, stabbing pain to a throbbing ache. At its onset, it is generally slight and only gradually gets worse. It is typically at its worst during activity, like walking or running.

Some people with a plantar plate tear may actually feel the tear happen. This often happens during an instant of trauma to the foot, though it can also happen during regular day-to-day activities. Sometimes, this includes a sensation of the toe dislocating before immediately popping back into place.

There may also be:

  • Toe misalignments, hammertoe, claw toe, or even toes crossing over one another, are strong indications that the ligament has become severely or completely torn
  • Swelling in the bottom of the foot
  • Inflammation
  • The feeling that you are walking on marbles underneath the ball of your foot

As soon as you begin to suffer these symptoms, you should consult your doctor. Continued use will only make the condition worse. Furthermore, the pain can lead to other complications as you, whether consciously or not, adjust your walking gait to avoid or at least mitigate the pain. This can lead to a limp or to knee, hip, or back pain, or other compensatory injuries.

Causes

Typically, plantar plate tearing is caused by too much pressure on the plate. However, there are numerous different reasons for why there would be too much pressure on the plate.

Overuse is a common cause of pressure and tearing. High-impact sports or sports that require lots of toe strain, like volleyball or basketball, can lead to plantar plate tears.

Poor biomechanics, like inefficient muscle work or abnormal weight handling, can increase the pressure on the plantar plate and speed up the deterioration of the plate. This is especially common if your gait does not put the proper weight on the first metatarsal and your big toe. By deflecting this strain to the smaller metatarsals and toes, it can increase the odds that the plantar plates supporting them tear. This can happen if your feet pronate inwards too far when you walk or run.

Other foot conditions like bunions or hammertoes put additional stress on the plantar plate, contributing to the tearing. In more severe cases, they can lead to chronic plantar plate injuries. A chronic plantar plate injury may even require plantar plate surgery for correction of the toe deformity and plantar plate repair.

Wearing shoes that fit poorly can also make things worse. They can squeeze your feet and put more pressure on their undersides where the plantar plate is.

Finally, plantar plate tears can be the result of a sudden trauma or injury. This may also be the result of an activity that finally strains the plantar plate too much after years of its slow deterioration.

How Do You Fix a Plantar Plate Tear at Home?

Plantar plate tears are only treated with surgery as a last resort. Conservative treatments at home are nearly always sufficient for making a full recovery.

One of the most important aspects of home care is rest. Ligament tears like plantar plate tears recover over time, so temporarily stepping away from the activity that is causing the pain can let the body go through the necessary healing process. If you cannot or do not want to step away completely, then adding more days of rest into your athletic routine can still make enough of a difference that you make a recovery.

Icing your feet when they begin to hurt or after strenuous activity can help with the healing process, as well.

You can also change or adapt your footwear with orthotics or a pad that provides additional support to your plantar plates.

Physical therapy that strengthens your foot muscles is another common home remedy for plantar plate tearing, particularly after other treatments have alleviated the pain and allowed the tear to heal. These exercises can build more strength in the muscles of the foot which can take strain off the metatarsals and planter plate during use, and reduce the odds that you suffer another tear.

Taping your toe can also be an effective part of a conservative treatment plan.

How Do You Tape a Plantar Plate Tear?

There are a couple of different ways that you can use strapping tape to stabilize the toe that is affected by a plantar plate tear, though the differences between the methods are minute.

Using a ten- to twelve-inch long, half-inch wide strip of tape, stick the middle of the strip to the top of the affected toe and manipulate the ends of the tape so they dangle under either side of the toe. Pull the end that is closer to the outside of your foot diagonally downwards and inwards, towards the arch of your foot, and stick it to your skin when it starts to get taut or tense. Then pull the other end of the tape diagonally downwards and outwards, sticking it to your skin when it starts to get taut.

You may need to repeat this step or tighten the tape if it does not sufficiently pull the toe downwards. If you do repeat this step, make sure the tape is about half on the prior strip and half on your skin for maximum support.

From the underside of your foot, the pattern will look like a cancer ribbon, with your toe in the loop of the ribbon.

Finally, take a single, inch-wide strip and tape down the ends of the strips that are on the underside of your foot.

By taping the toe downwards, it replicates the mechanism of the plantar plate and holds the toe in the proper place while the plate tear heals. This speeds up the healing process and ensures that the toe will be correctly aligned after recovery. Together with other at-home treatments, taping the toe affected by the plantar plate tear can be one of the most effective ways to make a full recovery.

Should You Massage a Plantar Plate Tear?

Yes, massaging your plantar plate can speed up the recovery time, so long as it is done together with other forms of treatment.

Do You Need to Wear a Boot for a Plantar Plate Tear?

You will typically only need to wear a boot if you have suffered a severe or complete plantar plate tear. The boot would stabilize the joint and reduce motion through the joint. This can help the plate recover functionality after a severe tear.

Consult a Healthcare Professional

Plantar plate tears are painful and can be debilitating. However, they can also be difficult to diagnose, as the symptoms of a plate tear are similar to other foot injuries, such as foot bursitis or metatarsalgia. Talk to your doctor before starting any at-home treatments for a plantar plate tear.