Plantar Plate Tear
The plantar plate is a cartilage based structure lying underneath the metatarsal heads of the 2nd to 5th metatarsals. The structure functions like the sesamoids of the first metatarsophalangeal joint to increase mobility. The plantar plate is responsible for handling a large amount of force during walking and physical activities due to the ground reaction force. Plantar plate tears are common, but symptomatic plantar plate tears are rare. The majority of plantar plate tears occur under the 2nd metatarsophalangeal joint.
- Tenderness and swelling underneath the forefoot
- Pain in the forefoot during physical activity
- Instability of the metatarsophalangeal joints
To confirm a diagnosis, a clinician will perform a physical examination of the forefoot and possibly order imaging studies to evaluate the cause and severity of the condition.
NSAIDs, icing and rest may reduce symptoms of pain and swelling. Orthotics, braces and physical therapy may be useful in further alleviating pain and correcting the biomechanics of the foot. Surgical treatment is also an available possibility to restructure the anatomy of the foot, support the plantar plate and restructure the way forces act on the foot.