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 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:
Biomechanical factors are structural issues that cause the overloading of pressure on the plantar plate:
Chronic degeneration is related to the ageing process, often associated with arthritis of the toe joint.
Risk factors of plantar plate injury include:
Signs and symptoms of plantar plate injury include:
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: