Plantar Plate Injury

Plantar Plate Injury

What is a Plantar Plate Injury?

A plantar plate injury or plantar plate tear is a condition that causes foot pain around the ball of the foot, most commonly around the second or third toe. A plantar plate is a piece of fibrocartilage that holds our toe joint (metatarsophalangeal joint) together and provides structural stability. It originates at the head of the metatarsal bone and attaches to the base of the proximal phalanx bone.

Plantar plate injury is commonly called “floating toe syndrome” as it causes the affected toe to retract off the ground when standing. Patients with this condition will normally report pain and a “stepping on a pebble” sensation, especially when walking barefoot.

Plantar Plate Injury Explained

Causes of Plantar Plate Injury

Plantar plate injury occurs when there is a tear or thickening of the plantar plate, causing pain when pressure is applied. There are 3 typical causes of plantar plate injury – acute trauma, biomechanical factors and chronic degeneration

Acute trauma is incidents that result in either sudden traction (pulling) or direct impact on the plantar plate:

  • Fall from height or hard landing from jumps
  • High-impact barefoot training
  • Stubbing the toe
  • Hyperextending the toe

 

Biomechanical factors are structural issues that cause the overloading of pressure on the plantar plate:

  • Excessive pronation
  • Prominent metatarsal heads
  • Long second metatarsal bone
  • Short first metatarsal bone
  • Malfunctional first toe joint

 

Chronic degeneration is related to the ageing process, often associated with arthritis of the toe joint.

Risk Factors of Plantar Plate Injury

Risk factors of plantar plate injury include:

plantar plate injury symptoms

Signs and Symptoms of Plantar Plate Injury

Signs and symptoms of plantar plate injury include:

  • Sharp or aching pain, “stepping on pebble” sensation
  • Swelling at the ball of the ball
  • “V” shape sign (Churchill sign), commonly between the second and third toe
  • “Floating” toe (retracted)

Plantar Plate Injury Treatment

Treatment for plantar plate injury involves stimulating tissue repair of the plantar plate and addressing the factors causing the injury.

Treatment options for plantar plate injury include:

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