What casues a tear in the plantar plate?

There's a peculiar feeling which may happen under the forefoot that is commonly described as a feeling that the sock is bunched up beneath the toes, but when you checked it it is good. The sensation is commonly referred to and it is often confusing. Most likely the sensation is because of a problem with a ligament on the base of one or more of the metatarsophalangeal (toe) joints of the foot known as plantar plate dysfunction. Around each joint, there's a strong covering called the joint capsule. Parts of each joint capsule are thicker and these are the ligaments that secure and stabilise the joints. Under the bottom of the metatarsophalangeal joints, that joint capsule is thicker to create what is called the plantar plate. It is possible to strain or even get a small tear in that plantar plate, which in turn causes that sensation of a sock that seems like its bunched up below the toes.

Pain usually begins gradually below the ball of the foot and may be preceded with that weird bunched sock feeling. The typical manifestation of plantar plate dysfunction is soreness on palpation in the region of the plantar plate. An experienced clinician will move the joint in such a way to detect if the plantar plate is impaired. A definitive diagnosis may be accomplished with a diagnostic ultrasound, but it can be fairly evident to a experienced clinician on assessment. Usually the initial treatment solutions are strapping to hold the toe pointing down to ease the strain on the ligament. A metatarsal pad can be often used to help reduce the stress on the ligament. This often assists most cases of plantar plate dysfunction and get rid of that unusual experience of a bunched up sock below the ball of the foot. When those conservative measures will not help, surgical repair of a partial or complete rip of the plantar plate is commonly undertaken.

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