Plantar Plate Repair for Toe Pain Relief

What You Need To Know

Understanding plantar plate tears, symptoms to watch for, and how we diagnose them.

Understanding Plantar Plate Tears

The plantar plate is a structure located on the ball of the foot and provides stability to the toes. An injury to the plantar plate affects the ligaments of a toe joint, most often the second toe. Without treatment, a plantar plate tear can become a serious condition where a joint becomes dislocated. Nonsurgical and surgical treatment options are available, depending on the severity of the tear.

If your life is being negatively impacted by toe pain or misalignment (a toe leaning one way or the other and/or a hammertoe), you may be suffering from a plantar plate tear. While it can affect any toe, it most often affects the second toe. Patients often describe the pain like they are walking on a stone or on their bones and can even have nerve pain. Without treatment, degenerative joint disease or arthritis can develop.

Symptoms may include sharp pain or a dull ache in the ball of the foot, the feeling like you are walking on a stone, toe misalignment where a toe drifts toward or away from the big toe, swelling or redness, hammertoes or claw toes, a tearing sensation, nerve pain or numbness, and limited flexibility in the affected toe.

To properly diagnose a plantar plate tear, X-rays are taken in a weight-bearing position. In some instances, a specific MRI is necessary to find the tear. If you are experiencing these symptoms, it is time to schedule an appointment with one of our board-certified podiatrists, who will explain the diagnosis process during your initial visit.

Treatment, Recovery, and Prevention

Once a board-certified podiatrist has diagnosed the severity of your plantar plate tear, it is time to discuss treatment options. If caught early enough, a plantar plate tear may be treated with rest, physical therapy, and ice therapy. Strengthening exercises can help prevent the tear from worsening, and shoe gear modifications and custom orthotics are highly recommended to relieve pressure, hold the plantar plate in place, and promote proper foot alignment.

All of our orthotics are made from electronically scanned images or physical impressions of your foot to ensure accuracy (less than 1mm) and prompt service. Anti-inflammatory medication may also be part of a nonsurgical care plan.

Often, surgery is necessary in severe cases to alleviate pain and realign the affected toe. Multiple techniques may be needed if other issues, such as hammertoe or bunion deformities, also need to be corrected. To repair a torn plantar plate surgically, an incision is made on the top of the toe or the ball of the foot. If the tear cannot be repaired, a tendon transfer may be discussed.

Wearing proper shoes is important in preventing plantar plate tears, and custom orthotics support proper foot structure. After any injury, evaluate your toes for signs of change, including swelling, redness, or pain. Recovery can take several weeks or months, and on average, most patients see the affected foot return to normal within four to eight weeks after appropriate treatment.