#890 Ankle exercises for plantar plate? - DOC

#890 Ankle exercises for plantar plate?

Do I need to do ankle exercises if I had a plantar plate sprain? That is a great question and that is what we’re talking about today on the Doc On The Run Podcast.



This morning, I was on a call with a runner, and he has had a long history of plantar plate trouble. He had a whole bunch of different treatments, done time in a fracture walking boot and then got worse when he started running a number of different types. So, he was very frustrated.

Over the last month since we started working together, he has been doing significantly better than he ever has in a year and a half and I had him do a couple of things over the last week. It made a huge difference for him that he noticed right away. The truth is, I will tell you if you are off of your foot for a year or year and a half, you are going to be super weak and it’s going to be really easy to make a lot of real solid improvement real fast because you are so weak. So, a little bit of exercise goes a long way when you are really weak.

One of the things I did was I tested him to see how stable he was with respect to his ankle and this thing we call proprioception like where you tell your foot underneath you in position in space, and he was really unstable, and you have really horrible proprioception. The reason that is a problem is that one of the things I worry about the most with plantar plate injuries when somebody starts running is not that they are going to just like grind it into the ground, but they are going to wobble and sway and load the plantar plate ligament and twist the toe asymmetrically in a way that can reinjure it really easily.

The best way to make sure that that is not going to happen is to make sure that you have good proprioception, that your ankle is strong and stable. And so, I had him do some very specific exercises to strengthen the ankle and improve that balance in less than a week. He could tell it was a huge improvement. That is really important.

He was a little confused. Truthfully, when I assigned this task to him, I said, “Look, this is what you really got to do and I want you to focus on this right now because we really need to get you running. But before you run, we need to make sure that we decrease some of the risk of you re-injuring it on even a short run, because the plantar plate has been so damaged and it’s so weak already.” If you are going to move in a schedule, you want to strengthen everything else that can help protect that one injured part so that you can get back to running sooner.

That is just some of the stuff I talked about in the plantar plate masterclass. The plantar plate masterclass is long, but it takes a deep dive into the exact strategies I use and the way that I think about it with runners and the strategies I teach to physicians at medical conferences when I get invited to lecture on running injuries, in particular things like the plantar plate ligament. Go check it out. It’s the plantar plate masterclass. You can get it for free at www.docontherun.com/plantarplatemasterclass, and I’ll see you in the training.