Plantar Plate Repair for Toe Pain Relief

What You Need To Know

Understanding plantar plate tears and how our team diagnoses and treats them.

Understanding Plantar Plate Repair

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. Nonsurgical and surgical treatment options are available, depending on the severity of the tear.

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 may indicate a plantar plate tear include:

Sharp pain or dull ache in the ball of the foot; the feeling like you are walking on a stone or on your bones; toe misalignment, where a toe is visually moving towards the big toe or away from the big toe; swelling or redness to the ball of the foot; hammertoes or claw toes; pain like a tearing sensation; nerve pain or numbness; and limited flexibility or weakness with 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 Weil Foot and Ankle Institute’s board-certified podiatrists.

Treatment, History, and Recovery

If caught early enough, a plantar plate 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 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 (under 1mm) and expedite handling.

Often, surgery is necessary in severe cases to alleviate the pain and realign the affected toe. Depending on the severity of your tear, various surgical options are available. Multiple techniques may be needed if there are other issues to correct, such as hammertoe or bunion deformities. If the tear cannot be repaired, a tendon transfer will be discussed between your podiatrist and you.

Weil Foot and Ankle Institute is the leader in the diagnosis and management of plantar plate pathology. In 2006, Dr. Lowell Weil, Jr. pioneered a combined Weil Osteotomy and plantar plate repair from one incisional approach from the top of the foot, avoiding a more painful scar on the bottom of the foot.

Depending on the severity of your tear, recovery can take several weeks or months. On average, most people’s affected foot will return to normal after four to eight weeks, and proper shoes and orthotics help support long-term foot health.