Have you ever had pain in the ball of your foot that increases with walking? Do you notice that your second toe is elevated above the ground when standing? Is your second toe becoming crooked? These symptoms can can all occur by injuring a ligament called the plantar plate. A plantar plate sprain or rupture can happen to any of the toes but the second toe is the most common. This is because of the unique structure of the 2nd toe and surrounding bones. A typical person will have a long second toe because the long bone behind the toe is the largest. This long bone is called the second metatarsal. The elongated nature of the second toe also can cause jamming as the toe hits the tip of the shoe when walking. This jamming of the toe joint can result in stress to the ligaments at the bottom of the toe joint which can lead to the sprain/rupture of the ligament.
The main treatment for this condition when caught early is conservative therapy. Icing, padding resting, NSAIDs, and decreased activity can all help with the symptoms. Custom orthotics can be used to evenly distribute the pressures on the foot so that the second metatarsal joint is not being overused. A strapping or metatarsal pad could also be used in conjunction with the custom inserts to help offload the painful area of the foot. The doctor may also tape the toe in a downward position so that the elevation of the toe can be corrected. This taping of the toe also helps to decreased pressure to the second metatarsal bone. Choosing the right shoes is also an important treatment option. Choosing a shoe with a minimal heel will result in decreased pressure to the ball of the foot resulting in decreased symptoms.
Surgery is an option for extreme cases and is only utilized if it is really needed. The goal of the surgery would be to correct the rupture of the ligament that connects the toe to the metatarsal head. This surgery can be performed under light sedation at a surgery center or hospital. Recovery from this surgery is up to six weeks in a walking boot and transitioning to a regular shoe by week eight. MRI will be utilized prior to surgery to ensure the extent of damage to the ligament. This also helps to ensure that the doctor rules out any other diagnoses that could be adding to the symptoms. Surgery is definitely avoided unless the pain is unrelenting and the MRI shows an injury to the ligament.
If you or a loved one suffer from ball of foot pain please feel free to make an appointment to see the doctors of Advanced Podiatry. Our doctors will exhaust all conservative measures and get you on the road to recovery. Call 813-875-0555 today to make an appointment.