Today on the Doc On The Run Podcast, we’re talking about the good and bad, or the risk vs benefits of massage with a plantar plate sprain.
The only way to run and still heal a plantar plate sprain is by decreasing the stress and strain on the plantar plate ligament enough so that the ligament can withstand the stress of running without getting re-injured.
Waiting is one way strategy. Action and applied effort on your part is the other way.
Doctors say they are really only 2 types of treatment “Conservative Treatment” vs. “Non Conservative” Treatment. What that really means is Non-surgical vs Surgical….and most doctors think only doctors should do all of them.
Most of the runners listening to this will recognize that There are 2 types of treatments for plantar plate injuries DIY treatments vs -Doctor-administered treatments.
You may not be able to do your own surgery, but you can do a lot on your own.
On of the oldest treatments for musculoskeletal injury is massage.
And a runner on webcam just asked me whether or not it might help her plantar plate injury recover faster. The goal of course is to resume training and get back to running faster.
How does massage really help when you have an injury? There are a couple of ways.
Lets talk about the good and bad (OR) Risk vs Benefits of massage with a plantar plate sprain.
Massaging breaks up scar tissue that can be be holding the toe in the wrong position
Massage, especially gentle increases blood flow in the tissues. This is the type of massage that generally feels good. It is soothing. This is like a gentle foot rub. Anyone can do it.
The other type of massage is a little more complicated, but perhaps more important. Think sports massage, or deep tissue massage. The goal with this massage is break unhealthy adhesions in the tissue.
You have 4 distinct layers of muscles on the bottom of the foot. If the foot is held still long enough you can “adhesion” which is really a fancy term for “scar tissue” or indiscriminate collage tethering muscles together.
If that scar tissue is preventing the intrinsic muscles in the foot from pulling the toe down naturally, the plantar plate can have more stress applied to it, because the little muscles are restricted by the scar tissue. The goal then of course would be to break it up.
Firm deep-tissue massage can accomplish that. But you have to make sure that you only break up “bad” scar tissue and not “good” scar tissue.
Good scar tissue is bridging the gap or tear in the plantar plate itself.
Bad scar tissue is preventing the muscles from moving in a way that supports the plantar plate.
Without sending you to massage therapy school the main points are that you:
1) Never massage the foot in a way that causes any pain in or around the plantar plate ligament.
2) Never bend the toe upward away from the ground (in dorsiflexion) when massaging the foot.
Massage the muscles, without stretching the plantar tendons or ligaments.
So, can massage help a plantar plate in a runner…yes.
Is massaging the foot to help a plantar plate injury tricky…yes, but it can be done.
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