With the spring racing carnival now in full swing and the Melbourne Cup less than a week away thousands of people will pour through the gates of Flemington race course. Unfortunately, unlike the winning horses that come galloping home powerfully down the home straight, many of those thousands of people will limp towards the finish line at the end of the day with some very sore feet.
The metarsophalangeal joint and the plantar plate
After a long day in heels (or even thin, hard soled dress shoes for the men), one of the most common areas for foot pain are the balls of the feet. The balls of the feet, also known as the metatarsophalangeal joints, are important joints that allow your toes to bend upwards and downwards.
There is an important structure underneath the balls of the feet, known as the ‘plantar plate’. This is a ligament structure that is located underneath the joint. The role of this ligament is to help stabilise the joint and protect it from excessive pressure and hyperextension of our toes (which can occur during trauma or wearing poor shoes).
Plantar plate injuries
Plantar plate ligament injury is one of the most common presentations for pain under the ball of the foot. It can present as a tear or a full rupture and most commonly affects the 2nd or 3rd toe. It is frequently caused/exacerbated by long periods of time on feet in shoes (such as high heels) and trauma like stubbing a toe. It tends to present as a dull constant ache under the ball of the foot.
Plantar plate injuries can be triggered after one or multiple long days in poor footwear and can last for weeks to months in the event that it becomes chronic. Foot types prone to this injury include excessively high or flat arched feet, those with a longer 2nd metatarsal bone, or current hammer/claw toe deformities.
Plantar plate injuries lead to instability
Long term plantar plate injuries, if left untreated, causes instability of the toe, usually resulting in deviation of the toe. The poor alignment and instabilty of the joint increases the risk of future arthritis. This will cause excess swelling and inflammation to the area, which may cause other future problems such as bursitis or morton’s neuroma.
Treatment of plantar plate injuries
Our Melbourne podiatrists know how to diagnose plantar plate injuries and how to differentiate them from similar foot problems like neuromas and metatarsalgia. Treatment at our Melbourne foot clinic focuses on reducing symptoms in the acute phase, which may involve padding and strapping. Once symptoms have settled long term treatment is aimed at strengthening the joint and stabilising the toe. Custom orthotics can often assist in stabilising the foot and toes following a plantar plate injury.
If your feet are causing you pain, (especially after the spring racing carnival) then make an appointment with one of our friendly Melbourne podiatrists today! Early diagnosis and treatment is the key to helping reduce pain and preventing acute cases developing into chronic.