#865 3 mistakes runners make that lead to plantar plate surgery - DOC

#865 3 mistakes runners make that lead to plantar plate surgery

What are the three big mistakes runners make that lead to plantar plate surgery? Well, that’s what we’re talking about today on the Doc On The Run Podcast.



I know that you don’t want surgery, but if your plantar plate ligament doesn’t repair itself or you don’t let it repair itself or your doctor doesn’t help it repair itself, you might get tucked into surgery. If you have surgery, you are definitely going to spend a lot less time running over the next several weeks following that surgery because you have to let it heal.

Now, there’s really three mistakes that I see runners make when they’ve had a plantar plate injury, they kind of ignored it for a while and it’s kind of gotten worse and they’re getting really frustrated. And hopefully this episode will help you avoid some of those.

The first thing is that the biggest one for sure is that you’re running enough that you’re still getting swelling. You don’t always have to stop running, but you have to do something to allow it to calm down. If you have notable swelling in your foot and you can see it when you compare one foot to the other and you look closely and you’re looking at the skin tension lines, you’re looking at the extensor tendons, where the tendons stick out when you pull your toes up and you compare the right versus left and you have notable swelling and you’re ignoring that and you’re continuing to run and it’s still swelling, you’re getting a lot of inflammatory fluid that’s actually going to slow down the healing and it can actually degrade the collagen in the plantar plate ligament and make it weaker and hen it can even get worse after that. That’s the first thing is running enough that you’re actually still getting swelling.

The second thing is not removing enough of the stress and strain on the plantar plate ligament itself. So, you have to remember, it’s a really small ligament. Every time your heel comes off the ground and the toes bend, you’re stretching the plantar plate ligament on the bottom of your foot. You have to make sure that you’re reducing the pressure, which is what I think of as the stress and the strain, which is basically the stretch of that ligament when you’re exercising.

There’s lots of ways to do that but you need to think hard about what it is that you’re doin because if you’re if you got a plantar plate injury, and you’re not getting better, something’s not working, and you need to figure out what. Is it that you have too much pressure there? You had too much stretching to the ligament? What is the thing that’s actually causing the trouble?

This is a separate issue, but I see a lot of people who stopped running when they have this again on elliptical trainer and the heels coming up every backswing is bending the toes and it’s really aggravating the plantar plate ligament. I just don’t think it’s running, and they don’t think it’s as fun, so they think it doesn’t count, but it’s still irritating the plantar plate ligament.

The third thing is that you’re not strengthening everything else. If you really think about this, the ligament itself is one little strap of tissue on the bottom of the toe that actually helps hold the toe down. Well, you also have muscles that actually move the toes and if you strengthen the right muscles, they can actually support that plantar plate ligament because they’re actively moving instead of statically sitting there like a strap of tissue just holding it in place. And so that’s the first thing is that you don’t really strengthen the intrinsic muscles around the plantar plate ligament that could sort of take a little stress off of it itself.

But the bigger thing is that you just stop running, stop exercising, stop training that you don’t strengthen everything else in your system, in your body that’s going to actually need to be stronger, so that you can run with better form, wobble less, weigh less, put less stress on that ligament when you actually return to running.

That’s the thing that you have to pay really close attention to because most of the time the advice is just stop exercising, leave it alone, don’t do anything. Well, you shouldn’t do anything that’s aggravating the ligament, but you should do everything that you can that will strengthen everything else without aggravating the ligament. 

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