Today on the Doc On The Run podcast, we’re talking about 3 ways a runner can confirm a self diagnosis of plantar plate sprain.
In this lesson we are going to discuss the 3 ways to confirm you have a plantar plate sprain.
If you are a runner and you have some pain, and maybe a little bit of swelling, in the ball of the foot, you might be concerned you have a plantar plate sprain. Maybe you were diagnosed with “metatarsalgia.” Maybe you thought you had a metatarsal stress fracture.
But maybe after listening to one of these talks I’ve been giving on plantar plate injuries, you started to think you might have plantar plate sprain instead.
Obviously if you are treating the wrong condition, you are not likely to improve very quickly. If you want to maintain your running fitness and get back to running as quickly as possible you have to have the correct diagnosis and start getting better.
In the simplest sense, there are basically three ways to tell for sure whether or not you have plantar plate sprain. Let’s talk about the three approaches runners use.
1. Do your own self diagnosis.
The first and simplest way is to push on the injured ligament and see if it hurts. This is a relatively simple step but one many injured runners skip.
It’s really not complicated. If you have injured the plantar plate ligament 
and you press on it, it will hurt. If you stretch plantar plate ligament, if you load the plantar plate ligament or stretch plantar plate ligament, it will also hurt.
It’s a little bit difficult to explain in text or audio exactly how we do this. But that’s part of what I have put in the plantar plate sprain course for runners. I created a number of video lessons with 3D animations that show you exactly how to test the plantar plate ligament so you can tell whether or not you actually do have a plantar plate injury.
So if you have been diagnosed with a plantar plate sprain by a doctor and you’re confident in your doctor’s diagnosis, you can obviously skip this step.
If you push around on your foot and you poke and prod around the plantar plate ligament but you can’t really tell with 100% certainty whether or not the ligament t is injured, you can’t really reproduce the tenderness you feel when you run, it may just be a really mild injury.
In that case, you have two other ways to confirm whether or not you have a plantar plate sprain injury.
2. Make the injury worse.
Believe it or not, this is a technique and a method you can use to tell for sure whether or not you have a plantar plate sprain injury.
Of course, this method is violating one of the Cardinal rules of medicine:
First Do No Harm!
So don’t blame me if you deliberately try to make the injury worse and you screw up your foot in the process.
So this is your official warning and disclaimer: don’t try this at home!
Now with that disclaimer, for educational and entertainment value only, I’ll explain the method.
The assumption is that you could have a plantar plate sprain that is so minor it doesn’t even hurt when you push on it, load the ligament or stress the plantar plate ligament.
If you can’t tell whether or not it hurts, it’s hard to make a diagnosis.
So the idea is that you do some particular activity that you know will flare it up and make it more angry. It will then be more tender.
When the plantar plate is injured and tender it’s very easy to tell that you have discomfort when you push on it or stretch the plantar plate ligament.
So if you then do box jumps, run stairs, do a bunch of lunges barefoot or otherwise engage in activities that you know will hurt, it will likely flare it up.
Once the plantar plate ligament is a bit more irritable it’s easier to palpate, push on ligament, stretch the ligament and feel tenderness associated with that self-exam that confirms you have a plantar plate sprain.
3. Treat it like a plantar plate sprain and see if it improves.
The third method assumes you have a plantar plate sprain that is minor and you attempt to treat it.
If you choose the treatments that will definitely help the plantar plate sprain it will start to improve.
As your foot starts to improve, your pain goes down and you start to feel better, you have by default confirmed your diagnosis of a plantar plate injury.
So with this method, all you do is decrease the stress on the ligament, decrease the inflammation around the plantar plate ligament and joint capsule and see if the plantar plate ligament starts to heal.
Obviously, trying to make the plantar plate sprain better is a much more sensible approach than deliberately trying to make it worse.
The plantar plate sprain course for runners shows you exactly how to decrease stress to the plantar plate. The plantar plate sprain course also shows you how to decrease the inflammation that can damage the plantar plate ligament and prevent healing.
Of course we also show you how to get back to running as quickly as possible without putting yourself at risk of an additional injury and another setback.
Remember, it’s not really that complicated. When you have a plantar plate sprain and you want to get back to running, you need to confirm you have the right diagnosis.
You need to decrease some stress and strain to the plantar plate ligament, decrease the inflammation around the joint and then follow a very structured return to running that will allow you to retain your aerobic fitness, rebuild your running fitness and prevent you from getting another overtraining injury.
But if you do that, you can heal the plantar plate ligament and keep running!
Pain is the best tool to help an injured runner decide when run. You don’t have to figure out what to write down. We made a simple Pain Journal PDF for you.
To print out your copy of the pain journal, Download here:
If you have a question that you would like answered as a future addition of the Doc On The Run Podcast, send it to me PodcastQuestion@docontherun.com. And then make sure you join me for the next edition of the Doc On The Run Podcast!
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