Health and Fitness

What is plantar plate dysfunction?

There is a strange feeling that might happen beneath the forefoot that is frequently described as a feeling that a sock is bunched up under the toes, but when you looked at it, it is not. The feeling is frequently referred to and it is frequently perplexing. Most probably the feeling is caused by an issue with a ligament on the base of one or more of the metatarsophalangeal (toe) joints of the feet termed plantar plate dysfunction. Around every joint, there is a strong covering called the joint capsule. Parts of each joint capsule are thicker and these are the ligaments which guard and stabilise the joints. Under the base of the metatarsophalangeal joints, that joint capsule is thicker to make what is called the plantar plate. It's possible to strain and even get a minor tear in that plantar plate, that creates that sensation of a sock that feels like its bunched up beneath the toes.

The symptoms usually commences little by little under the ball of the foot and can be preceded with that strange bunched sock sensation. The most common sign of plantar plate dysfunction is soreness on palpation of the region of the plantar plate. A skilled clinician will slowly move the joint in such a way to detect when the plantar plate is impaired. A conclusive diagnosis may be possible with a diagnostic ultrasound, however it is pretty obvious to a experienced clinician on examination. Normally the first treatment methods are taping to hold the toe directed down to ease the force on the plantar plate. A metatarsal pad is also often used to lessen the stress on the ligament. This usually will help most all cases of plantar plate dysfunction and get rid of that peculiar experience of a bunched up sock below the ball of the foot. In the event that those conservative measures don't help, surgical repair of a partial or complete split of the ligament is commonly performed.

Doug Parks