Plantar Plate Repair for Toe Stability

What You Need To Know

Understanding plantar plate tears and how the Foot Care Center approaches treatment.

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. Degenerative joint disease or arthritis can also happen without medical intervention.

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. Patients often describe the pain like they are walking on a stone or on their bones and can even have nerve pain associated with it.

Symptoms that indicate a plantar plate tear 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 visually moves towards or away from the big toe, swelling or redness to the ball of the foot, hammertoe or claw toes, a tearing sensation, nerve pain or numbness, and limited flexibility or weakness in the affected toe.

To properly diagnose a plantar plate tear, X-rays will be taken in a weight-bearing position. In some instances, a specific MRI is necessary for further evaluation to find the tear. If you are experiencing any of these symptoms, it is time to make an appointment with one of our board-certified podiatrists so we can explain the diagnosis process and outline your treatment options.

Treatment, Recovery, and Prevention

Nonsurgical and surgical treatment options are available, depending on the severity of the plantar plate tear. If caught early enough, a tear may be treated with rest, physical therapy, and/or ice therapy. Strengthening exercises can help prevent the tear from worsening. Shoe gear modifications and custom orthotics are also highly recommended, as they can help relieve pressure, hold the plantar plate in place, and promote proper foot alignment. All our orthotics are electronically scanned images or physical impressions of your foot to ensure accuracy (<1mm accuracy) and expedite handling.

Often, surgery is necessary in severe cases to alleviate pain and realign the affected toe. Various surgical options are available, and multiple techniques may be needed if there are other issues to correct, such as hammertoe or bunion deformities. To fix 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 will be discussed between your podiatrist and you.

Wearing proper shoes is important in preventing plantar plate tears, and custom orthotics play a vital role in supporting proper foot structure. After any injury or trauma, evaluate your toes for signs of change, including swelling, redness, or pain.

Recovery can take several weeks or months depending on severity. On average, most patients’ affected foot returns to normal after four to eight weeks following the treatment plan set by your podiatrist.