15 Feb Why Runners Are Prone To Plantar Plate Injuries
- Are you a runner that’s now getting pain beneath the ball of your foot when you run?
- Is the pain coming on when you walk, too?
- Have you noticed a gap that looks like a ‘V’ between two of your toes?
- Does it hurt when you bend your toes upwards?
If any of the above sounds familiar, then don’t worry – your running career is far from over. This is only a temporary setback that can be effectively managed, and it’s called a plantar plate injury. As our podiatry team at Masterton Foot Clinic regularly see and treat these injuries, we thought we’d share why these injuries occur, how they’re treated, and why runners are particularly vulnerable to this pain at the ball of the foot.
Plantar plate injuries: What are they?
To understand plantar plate injuries, let’s start with what the plantar plate is. Each of the joints at the balls of your feet is surrounded and protected by a joint capsule. The plantar plate is a thick tissue that sits at the bottom of each joint. It starts just before the joint (towards the midfoot) and connects to the joint, where it’s the thickest, and then up to the toes. Due to its location here, pressure is placed on it with every step you take, both during walking and running.
The plantar plate helps you in many ways. It:
- Helps prevent your toes from being pushed too far upwards (hyperextending)
- Stabilises the toes
- Helps prevent toe deformities like hammertoes
- Helps you push up off the ground during walking and running
- Helps the fat pad beneath the ball of your feet absorb the compressive forces you incur when you walk, run or jump
- Helps prevent our toes from separating too far from one another (which would negatively impact the way we walk and make us more vulnerable to pain
So, how did you injure your plantar plate?
Simply put, you overloaded your forefoot, meaning you placed more pressure and strain on the joints and hence the plantar plate than it could safely handle, and so it became damaged, and perhaps sustained a tear. The second toe is the most common site for this, though any toe can be affected.
If you’re a runner, the most common mechanism for injuries is going for an extra long run without preparing and conditioning your body for it, changing from jogging to sprinting when your body isn’t used to the extra pressure from more time on the front of the foot during sprints, and having a flat foot posture or other biomechanical problems which are exacerbated during running.
You don’t have to be a runner to sustain a plantar plate injury. You can also develop this problem from:
- Physical activities where you spend more time on the balls of your feet like dancing
- A job or activity where you’re regularly climbing stairs
- The effects on your feet from having a bunion or other toe deformities (claw toes, hammertoes, mallet toes)
- Walking for prolonged periods on hard surfaces like concrete, or in hard, unsupportive footwear
- Having a longer second toe, or a shorter big toe
How do you know if it’s your plantar plate or something else?
The only way to truly tell is to have an assessment from a podiatry team that is familiar with plantar plate injuries. It’s very important to accurately differentiate these injuries from others that may have similar symptoms, like capsulitis, as this greatly influences the treatment you receive and how quickly the healing process can begin. Until you can see your podiatrist, signs to look for include:
- Pain and swelling directly beneath a joint at the ball of the foot
- Worsening pain when the toe is pushed upwards (dorsiflexed) towards the sky
- A ‘V’ sign (toe separation) between the affected toe and the one next to it
- The feeling of walking on the bones of the feet
Treating plantar plate injuries in runners
As a runner, you know that the more downtime you have, the harder it is to get back to the pace you’re at. Our goal is for you to have minimal downtime so you can get back to being active and doing the things you love as quickly as possible.
We start by working to relieve your painful symptoms, then helping to repair the damage, and finally, we put the right measures in place to reduce the likelihood of another tear occurring in the future.
This may involve:
- Strapping the affected toes to help relieve pain
- Padding to offload the damaged joint
- Using custom foot orthotic to help correct any biomechanical or alignment issues that may have contributed to the injury, like supporting flat feet or other foot postural issues
- Using shockwave treatment to support healing and repair of the plantar plate
- Ensuring your shoes are helping your recovery and not making it worse
- Using a strengthening and stretching rehab program
- For severe cases, using a splint or boot
Trusted by Masterton and the Wairarapa for over 20 years
If you’re experiencing foot pain or discomfort, we’re here to help. We’ve been proudly caring for our community’s foot and leg health for over 20 years. You can book an appointment with us online here or call us on 06 370 4057
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