What is it? This painful condition is a tearing of the strong ligaments that holds the toe joints together. It is most common in the second digit, under the ball of the foot. It occurs, most often, in middle aged women but can occur in any foot that over-pronates or rolls in excessively. It is often accompanied by a bunion, hammer toes and splayed toes.

 

What is the plantar plate? The plantar plate is a strong ligament-type structure which holds the little toe bones to the larger metatarsals. This band of tissue is designed to protect the metatarsal head and prevent over-extension of the joint. 

Symptoms:

  • Pain and swelling in the ball of the foot- particularly under the second toe
  • Pain when walking or standing
  • Feels like you are walking on the ‘bones of the foot’
  • Splaying of the toes
  • Hammer toes and bunions may also be present

 

Treatment:

Treatment can be difficult due to anatomy, genetics and because the condition is often caused or aggravated by complex biomechanical problems. Your podiatrist will probably send you for an ultra-sound and treatment will often depend on the severity of the condition as confirmed with diagnostics. Treatment will probably involve pain management with analgesics and anti-inflammatories, rest and shoe-wear advice. Thereafter, treatment will involve supporting the anatomy of the foot and ensuring the transverse arches are sound; preventing further over-extension of the joint. Often, orthoses are prescribed to maintain all the above. In severe cases, surgery may be required to repair the plantar plate or a resection osteotomy may be necessary in chronic cases.

SPLAYING OF THE TOES – NOTE THE STRANGE POSITION OF THE SECOND DIGIT