Are you starting to notice your second toe rising up and crossing over your big toe? If so, you may be suffering from a plantar plate injury or pre-dislocation syndrome. This usually occurs with a bunion deformity in which the big toe sways over and points torward the lesser toes. The second toe has no where to go so it begins to rise up and cross over the big toe. This can also occur without a bunion deformity if there is injury to the plantar plate.
The plantar plate is a thick ligament on the bottom of your foot that connects the toe to the ball of the foot. You can develop micro tears in the plantar plate from injury or abnormal foot biomechanics. If you develop a small tear on portion of the ligament that is closer to the 3rd toe, the opposite portion of the ligament is now tighter and pulls the toe toward the big toe.
If you have a plantar plate tear, it will most likely be painful at the ball of the foot beneath the 2nd toe and will probably be worse with increased activity or walking barefoot. After a thorough lower extremity physical exam, an X-ray will be taken to ensure there is no bony pathology to the area. Sometimes when the plantar plate tears, it takes a small portion of bone that it was attached to with it.
Treatment of plantar plate tears begins conservatively and varies with orthotics, Non-Steroidal Anti-Inflammatory Drugs (NSAIDS such as Advil, Aleve) , walking boots, Injections and a special device to wear that holds your toe pointed downward to help faster healing. If conservative treatment fails and the area is still painful, the plantar plate may need to be surgically repaired. This is performed outpatient at a surgery center.
At Advanced Foot & Ankle Center, all of our providers have extensive experience with this condition. If you are experiencing this issue or any other foot or ankle disorder, please call us at 972-542-2155.