Today on the Doc On The Run Podcast we’re talking about three callus patterns I often see that can suggest you have a risk for getting a plantar plate sprain if you are a runner.
If you are a runner and you actually get pain in the ball of the foot, particularly at the base of the second toe right here. It could be a plantar plate sprain. And whenever I see runners on webcam or in person who have this pain that is suggestive of a plantar plate sprain, the first thing I do is look for any callus pattern in the skin that suggest they have too much pressure and friction at that area that could injure the ligament underneath the skin.
I think this episode will be helpful. I think it’ll help you understand a little bit about what to look for if you’re looking at your own feet.
The plantar plate ligament is actually a little ligament right here at the base of the second metatarsal phalangeal joint, doesn’t matter what that is, but it’s just where the metatarsal bone in the ball of the foot connects to the base of the second toe. So, when you get too much pressure and friction, too much stress and strain on the ligament, that’s where it can get injured.
The first thing is obviously, if this is where the problem is, a thick callus right here covering that area, then you are more likely to have too much pressure and friction there. What that does is when you look at the foot cross section this way, where we’re looking through cross section like right at the second toe then basically if your metatarsal bone, let’s say sticks down more than the other neighboring metatarsal bones, then there’s too much pressure there. That can actually create too much friction, too much pressure and the skin gets thicker here and you get this callus. That’s number one.
Number two is where you have a lot of motion where that metatarsal isn’t really moving but the first metatarsal next to it, this one is actually moving up. In that case what you’ll get is a thick callus that looks like a crescent shaped ridge right on the edge of that metatarsal. And so, if you look at your foot, you have this line of callus, it’s like a hard ridge right there. That is suggestive of too much friction because this bone is moving up out of the way and it’s suddenly shifting forces that way on to that second metatarsal which you know is going to actually stress the plantar plate. So, this one is actually sorted by number one and this one is kind of number two.
Number three is where you get a callus on the big toe itself. So, the first metatarsal bone that is bigger and then in your big toe, you only have two bones in there. This joint right here is called the interphalangeal joint and sometimes you actually get a big callus right here on the side of the big toe joint. And when we look at that from the side view, this is your big toe and you’re looking at the side, the callus that you get here is right here, all down here.
That thick callus is a pinch callus that you’re getting specifically because you’re rolling and twisting off of the big toe joint and that actually pulls as you twist and roll off it there, it pushes the metatarsal out of the way and then loads the forces against the second metatarsal in a similar way to what I described here.
So, if you see a pinch callus on the big toe, if you see a crescent callus shaped like kind of curved right along the edge of the metatarsal or a big round callus right under the second metatarsal head of the ball of the foot, those three things are really suggestive of having an increased risk for getting a plantar plate sprain.
If you want to learn more about plantar plate sprain, come check out the plantar plate masterclass that I created for you. It’s free. You can get it at www.docontherun.com/plantarplatemasterclass. So, come check it out and I’ll see you in the training.
