Curling Second Toe – Plantar Plate Injury

Does your second toe seem to be looking out of place? Moving away from another toe like a ‘V’ shape? You might have a plantar plate tear!   If you can feel pain and swelling particularly beneath the second toe joint at the ball of your foot (also known as your second metatarsophalangeal joint), then there’s a fair chance you could have done some damage to your plantar plate. After all, it is thought of as being the most common cause of pain beneath this joint – though a plantar plate injury can affect any of the toes! So what is a plantar plate? A plantar plate is a thickened ligament band/structure that runs across the bottom of the toe joints at the ball of the foot, connecting the toes together. Because of this connection, it works to:

• Stabilise these joints (called the metatarsophalangeal joints)
• Resist abnormal spreading of the toes
• Resist hyperextending the joints
• Take on the loads we bear when walking so there is less pressure on the ends of the metatarsal bones themselves

  And what causes the plantar plate to get injured? The cause of a plantar plate injury can vary but is often associated with increased pressure that overloads the joints at the ball of the foot. This causes the plantar plate to be disrupted at that joint, leaving the toe to ‘pop up’ or move away from the others. Causes can include increased pressure from abnormal foot biomechanics such as flat feet, bunions or a long 2^nd metatarsal bone, among others. Non-biomechanical causes may include pressure from ill-fitting footwear or high heels and as a result of trauma. So what are the symptoms? Symptoms of a plantar plate tear may include:

• A ‘V’ shape between two toes (often the 2^nd and 3^rd toes)
• Pain at the affected toe joint
• Swelling
• The feeling that you’re walking on the bone
• Clawing of the toes

And the treatment? Treatment is specific to the degree of injury and begins by reducing the initial painful symptoms (pain, swelling). The focus is then on effectively healing and repairing the injury, stopping it from progressing to a tear of the plantar plate and minimising the risk of the injury happening again in the future! At Perform Podiatry, we are expert in foot biomechanics and sports medicine. We conduct a thorough biomechanical analysis to get a complete picture of what’s going on with your feet and the best solution going forward to ensure this doesn’t happen again! We understand that in this fast paced world we can’t stop everything when we get injured so tailor all treatments to meet your life. Give us a call and chat to our friendly team today!

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