How does chronic synovitis lead to plantar plate injury? Well, that’s what we’re talking about today on the Doc On The Run Podcast.
I was recently talking with a runner who had a plantar plate injury. One of the things we were talking about was managing the inflammation in the joint where you have the plantar plate ligament. That joint is is the second metatarsal phalangeal joint which is located right at the base of the second toe.
If you ended up getting pain right at the plantar plate ligament, it will usually ache on the bottom of the foot right at the base of the second toe under that joint. “Synovitis” is medical term that means inflammation and irritation of the lining of the joint that makes the synovial fluid that lubricates the inside of the joint and nourishes the cartilage. And if you get a chronic inflammation of the joint that leads to degeneration of structures made of collagen. The plantar plate ligament is basically a thickened plate of collagen that helps hold the toe down against the ground and reinforces the bottom of that joint capsule.
So, when you get synovitis, if you ignore it, if you run with it if it aches and hurts, (but you think it’s really not that bad because you’re tough and you’re a runner, over time the chronic inflammatory fluid surrounding the plantar plate ligament is going to degrade the collagen in the ligament and make it more prone to stretching out, getting little tears little ruptures and damaging the plantar plate ligament potentially irreparably.
You do not want to do that! If you do it the plantar plate injury can become very difficult to heal. If you’ve had a plantar plate injury and you’ve been dealing with it for months, you’re probably really frustrated. That may be because you keep ignoring the symptoms, the pain, the swelling, the discomfort when you’re running, and you’re not really calming it down completely.
Now the idea of synovitis related to the plantar plate ligament was described really well in a medical journal article that was published in the Clinics of Rheumatology in 2012. We’ll put the reference in the in the show notes at DocOnTheRun.com under this podcast episode. The title of the article was “MRI identifies plantar plate pathology in the forefoot of patients with rheumatoid arthritis.”
Why does this matter?
Well, rheumatoid arthritis basically leads to chronic inflammation in the joints, not just around the plantar plate but all the joints . The hands so people with rheumatoid arthritis typically in a very swollen joints around their knuckles. It’s very painful for them to even like open a jar or tie their shoes when they first wake up in the morning because of the swelling within the joints.
That chronic inflammation the chronic swelling in the joint degrades that plantar plate and makes the plantar plate ligament more prone to tears and ruptures and stretching out that can lead to chronic problems in runners. So control the synovitis, reduce the inflammation in the joint, and that will help you get back to running quicker.
If you want to learn more about the plantar plate ligament as it relates to runners and the strategies that I use specifically with runners, you can join me in the Plantar Plate Masterclass. It is a deep dive into all the strategies I use with runners trying to heal with plantar plate injuries You get it for free www.docontherun.com/plantarplatemasterclass. Go sign up and I’ll see you in the training!
References:
Siddle HJ, Hodgson RJ, Redmond AC, Grainger AJ, Wakefield RJ, Pickles DA, Hensor EM, Helliwell PS. MRI identifies plantar plate pathology in the forefoot of patients with rheumatoid arthritis. Clin Rheumatol. 2012;31(4):621–9.
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