Plantar Plate: Not Something To Eat Off

Do you notice that your toe is lifting up off the ground all of a sudden?  Do you have pain under the ball of the foot?  This may indicate a problem with the plantar palate.  The plantar plate is a ligamentous like structure which is located under the metatarsal phalangeal joint, (MPJ.)  If this structure gets injured or tears, the stability of the MP joint is compromised.  This can allow the toe to move medially (inward) or laterally (outward) on the metatarsal head.  It can also allow the toe bone to lose its stability at the joint and starts to move upwards off the ground.

You can tell if you have this problem by palpating the area.  If the plantar plate is injured, you will have pain on the underside of the toe near the ball of the foot.   A tuning fork can reveal pain in this area.

The podiatrist may try a maneuver to move the toe up and down to evaluate the looseness in the area.  This may cause pain indicating a tear in the plantar plate.

Treatment can be started conservatively with many patients getting better.  Splinting the toe down to relieve stress, using pads to the area, and functional orthotics has been successful for many patients.  Surgery can be done if the above measures fail.  Seeing your podiatrist early for a definitive diagnosis is very important.  X-rays, ultrasonography can be used to help diagnose the problem. 

 

Dr. Harvey Danciger
Dr. Harvey Danciger is a podiatrist and foot surgeon in Palm Desert, CA specializing in the foot and ankle
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