#576 Does a mild plantar plate sprain always hurt? - DOC

#576 Does a mild plantar plate sprain always hurt?

Does a mild plantar plate sprain always hurt? Well, that’s a great question and that’s what we’re talking about today on the Doc On The Run podcast.



I was just talking with a woman who has a suspected mild plantar plate sprain and we were talking about the fact that she doesn’t really have a whole lot of pain. I was explaining to her about how important it is that she actually figures out what her baseline numbers are, how much discomfort she has when she’s walking around her home barefoot, how much discomfort she has when she’s doing yoga, how much discomfort she has when she’s walking with or without running shoes, or just simple things like walking up and downstairs.

Now, the problem is that she said, “well, it’s not really pain.” I understand it may not really be pain because when you have a mild plantar plate sprain, it might not really be painful, particularly if you are an athlete. Obviously to become an athlete, you have to develop a high pain threshold. You have to get used to doing hill repeats and mile repeats and long runs and not quitting when you want to quit. That’s part of becoming a runner, but that works against you when you have an injury like this because if you have a really mild sprain of a tiny little ligament in your foot, it might not actually hurt that much. But you’ve got to figure out what it is that you call discomfort or pain, that’s really the thing.

What she was saying is that it really felt like a tightness or a fullness and I get runners who have these early on sort of very low level sprains of the plantar plate ligaments. The thing that they’ll tell me is that it feels painful sometimes. Maybe it felt painful before, but as they’re recovering from the injury, what they’ll describe that confuses them is they’ll say, ‘well, it just feels like some tightness on the bottom of the foot, right where the toe attaches at the joint” or “it feels like this fullness in the ball of the foot when I’m walking or a little bit of stiffness when I change direction and step out of bed.” Sometimes they’ll say “it just feels a little bit lumpy right in that area” or maybe even kind of squishy, but not consistently and a lot of people say that “it just feels like there’s some tension in that area at the ball of the foot.”

Some people say “it actually feels kind of fat” and that’s because of the swelling that’s in there or again, that they feel this fullness in the tissue, that’s very hard to describe or quantify because it doesn’t really hurt you the way you think of pain classically. But the thing is you’ve got to really think about the details of how much it actually bothers you, how full it feels, how tight it feels, how stiff it feels. You’ve got to put a number on it on a scale of one to 10 or you can’t tell whether or not it’s safe for you to do the activities that you’re adding in as you’re regaining your running fitness and actually returning to running.

That’s why it’s so important to be able to pin this down. I mean, the first step to figuring out whether or not you really have a bad plantar plate injury or a mild plantar plate injury, or whether or not it’s okay for you to actually run is to figure out where you are. Is it really mild? Do you have a torn plantar plate? Is it just a capsulitis or inflammation within the joint and the plantar plate itself is not actually injured? You’ve got to understand the difference between these things.

Now there’s something I made for you that you might find helpful. It’s the Plantar Plate Master Class and this training will help you understand the difference between those different levels of that condition that all are related to the plantar plate and what to do about it, to figure out whether or not you can run and what you have to do to maintain your running fitness.

It can be really helpful for you. If you think you have a plantar plate sprain and you just can’t figure out whether you can run right now or if your doctor told you to stop running. I’m going to help you understand some strategies to use to make sure that you don’t lose all your running fitness while you’re just waiting for this ligament to heal. Because plantar plate ligaments can take a very long time to “heal” and you can’t afford to wait that long or you’re going to lose all your running fitness.

So, come check it out. It’s a free web class about half an hour, going to a deep dive in all these topics to help runners understand the things they’ve really got to know about what to do to get back to running as quickly as possible with a plantar plate injury. You can get it for free at docontherun.com/plantarplatemasterclass. So, go sign up and I’ll see you in the training.