#785 When should I start working out with a plantar plate sprain? - DOC

#785 When should I start working out with a plantar plate sprain?

When can I start working out if I have a plantar plate sprain? Well, that’s what we’re talking about today on the Doc On The Run Podcast.



Plantar plate injuries are one of the most difficult injuries for runners to deal with. The reason for that is that they can take a very long time to get better. Every time you take a step, you’re basically applying direct pressure to the plantar plate ligament. Every time your heel comes up off the ground and you take a step and you bend the toes, you’re stretching the plantar plate ligament. And the plantar plate ligament doesn’t really have a great blood supply and they can take a very long time to heal, and they can be extremely frustrating. And I know, I actually had one myself.

I was actually doing a run on the Dipsea Trail, which is this trail that goes basically over Mount Tam from Stinson Beach to Mill Valley. On that trail, there are hundreds of wooden steps cut in the hillside as it goes through the forest. I was running down those steps and skipping steps like three steps at a time and hit the edge of one of those steps with some shoes that were just a little bit too flexible, truthfully, to be doing that kind of run at that kind of speed, and I sprained my plantar plate ligament.

So, of course I knew exactly what this was. I was very careful about treating it correctly immediately. Yet, I was very cautious with returning to running on a trail. So, I took a few days off. I did a whole lot of stuff to decrease the stress and strain to the ligament. I reduced the inflammation. I did all the stuff that I thought would work right away and then I very carefully tested things out. So, I was running on flat ground. I was doing all the same strategies to take the stress and strain off of it, and I was trying to really make sure that I didn’t make it worse.

But the thing you have to think about in terms of when you’re actually running, is how much stress and strain can you decrease to the plantar plate like what can you do to do that. And also, if you see your doctor and you tell them, “Look, it’s really important that I train, that I work out.” Don’t just ask, “Can I run?” Always ask them, “What can I do to reduce the risk that I’m going to disrupt the healing if I do this workout? What is it that I can do to reduce the stress and strain on the tissue if I’m going to go to the gym? What exactly can I do at the gym that couldn’t possibly hurt my plantar plate ligament?”

You’ve got to understand that it’s not just about waiting to heal. It’s about really talking to your doctor and having meaningful conversations that drive home the point to your doctor that you need to work out, you need to maintain your running fitness, and you need to do all of that while you don’t mess up the healing process.

Padding can take some pressure off of the plantar plate ligament. Taping can reduce some strain on the plantar plate ligament. And making sure that you’re doing all the same stuff you would do to heal after hard work workouts in terms of your nutrition, hydration, and sleep and stress reduction, those things also help the healing, which move it along even faster.

If you want to check out more about plantar plate sprains, you should check out the Plantar Plate Masterclass. You can get that for free at docontherun.com/plantarplatemasterclass. But remember, if you’ve got a plantar plate injury, the point is to make sure your doctor understands why you need to work out. And then talk to your doctor to figure out what you can do to work out while you still heal your plantar plate sprain. If you do that, you will get back to running a lot faster.

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