A 53-year-old runner with plantar plate sprain asked me for some generic advice. That’s what we’re talking about today on the Doc On The Run Podcast.
Today’s episode actually comes from a comment posted on a video on the Doc On The Run YouTube channel. That specific video was entitled Best Exercise for Plantar Plate Sprain in Runners.
So, this guy is watching the video, and he is a 53-year-old runner, but he seemed to have been some of the videos and he posted a comment asking me for a little bit of advice, which I do not ever do over social media, I will tell you that. For several reasons, I will try to explain some of that here.
He said, Hi Doc, awesome help in all these plantar plate videos. I have been told by my podiatrist that I have a grade one possible border lane, whatever that means, grade two sprain/tear, and I am struggling to get it to heal while I keep running.
Okay. So, number one, he has a podiatrist. Number two, he’s been diagnosed with some severity, which I’m not sure exactly what that severity means because I don’t know what grading scale he’s using and he’s trying to keep running and he’s struggling. It’s not getting better. So, he continues after watching one of your other videos, I’ll be cutting out calf raises and lunges to take pressure off of the area. But I got a couple of questions.
Okay, so we also know that he is doing calf raises. He’s probably doing some other exercises and based on that comment, I assume that those things are maybe contributed to it, not getting better. But I don’t know because he hasn’t told me anything about his pain, his discomfort, his swelling, anything else on what his foot actually looks like.
He says, I have been experimenting with what are the best types of shoes to wear with running maximum cushioning or plated shoes and it seems plated shoes with the rigidity seems to help best, but I now have flared up a bit of plantar fasciitis. After the part of plantar fasciitis had a couple of sad teary faces on there. So, I guess he’s bummed out about the plantar fasciitis. I would be too.
He says I’m being conservative with training. Okay. Well, maybe if you’re being conservative training, great, but you’re not being conservative enough because you’ve got another condition, and your plantar plate does not seem like it’s healing. I’m avoiding too much speed work, just doing easy, moderate sessions, but would value a little input from an expert in running.
This is a good question. There’s a lot of questions in here, but most of them I can’t answer for several reasons. Also wants to know, do you have any advice on calf or exercises that would be friendly to the plantar plate? Well, I made a bunch of other episodes on this. So, I’m not going to talk about which exercises you should never do with a plantar plate sprain, but he says that he needs to know because he’s doing S plus C is something I do twice a week. I don’t even know what that is and I can work all other areas, but calf is tricky without that flexion.
I have made videos specifically about what exercises are the worst ones for plantar plate injuries. I would watch that and I would never, ever do those things ever, no matter what, no matter what your doctor says, your coach says, or anything else.
He says, I’m in the UK. So, I coming for a visit is not an option. Well, I do webcam consultations every single day with people all over the world. So not sure why that’s a problem. Thanks in advance. Heart, heart PS I’m 53.
Okay. So, a couple of things. Number one, I can’t give anybody any advice at all over social media comments and I don’t, and it says so on the YouTube channel description, right. When you open it up, if you look at the channel description.
But I understand that he’s 53, I understand he wants to train and understand he wants to work out. I understand he wants to maintain his running fitness for many reasons and that makes complete and total sense to me. But I cannot provide any advice if I don’t understand your situation, I would never in a million years, give you advice based on some podiatrist who has given you advice and you haven’t gotten better. Either the assessment was wrong or the advice you’re getting is not helping, but a couple of things I can comment on.
Number one, what are the best shoes. Well, that depends on your foot type and specifically your injury. Cushioning decreases stress and strain by reducing strain on the plantar plate. However, it also increases the stress by increasing movement potentially in general, if it is stiffer, it prevents the toes from bending, but going into all the biomechanics on those two things are completely beyond the scope of this one video, but you have to think about what is going to help the most with the thing that is causing the stress and strain in the plantar plate.
In terms of exercises that you should avoid. Are there any exercises that I would avoid? Yes, anything that will make it worse. So clearly, I don’t know if it’s the speed where you say you’re not doing speed work too much. I’m not doing too much calf exercise. I’m not doing these other things. What’s going to make it better? Well, the planter place course teaches you that, and you don’t need to sign up for that, but I would go back and ask your doctor these exact same questions or I would get a second opinion from somebody in the UK, if that’s what you want to do, or I would find somebody who can do it for you online, or I would check out the plantar plate masterclass.
The bottom line is that if you go through the plantar plate masterclass, you will see clearly that somebody that has these kinds of questions who is training and not getting better is making a tremendous mistake. The longer you have a plantar plate injury, the weaker it is going to get because of the enzymes in the inflammatory fluid that degrade collagen. The plantar plate is made up of collagen, and it will get weaker. It will get attenuated or stretched out, or it will tear more if it already has a tear in it.
You have to make sure that you’re doing everything possible to reduce the stress and strain on that injured ligament so that it can begin to heal. And if you’ve been training and doing all these other things, you have to systematically figure out how bad it is, what the severity is, not based on this arbitrary grade one strain that you were told. You need to figure out exactly how bad it is and how you can monitor it on a day-to-day basis so that you can start systematically adding exercises that won’t stress it. That’s what you need to do.
The specific techniques, the tips and tricks, and all those things I use with athletes, that’s all in the plantar plate course and I’m not going to, in one comment, put in this course that I have produced and put it on YouTube as a comment, but it is there if you want to get it.
The plantar plate masterclass, though, teaches you the exact principles I use when, if somebody like this called me from the UK and asked me a question on exactly what I do, it shows the exact strategy I would use in the plantar plate masterclass. That you can get for free, by the way, if you go to www.docontherun.com/plantarplatemasterclass. You can get it, you can view it, and I’ll see you in the training.
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