plantar plate Archives - DOC

#646 Should I run with a pad for plantar plate sprain?

Today’s episode actually comes from a question sent in by Melissa.

She signed up for the Plantar Plate Masterclass and she asked a very specific question.

She asked:

Should I run with a pad for a plantar plate sprain?

Great question! And that’s what we’re talking about today on the Doc On The Run Podcast.

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#637 Capsulitis vs. Plantar Plate Sprain. What is the difference?

If you’re a runner and you have pain in the ball of the foot, especially around your second toe joint where the toe attaches to the foot, you may be suffering from a plantar plate sprain.

Many years ago, if you had this kind of pain, it would probably have just been called “capsulitis” by your doctor.

But a plantar plate injury is something that has become more recognized as a distinct pathology in the last 10 or 20 years. Plantar plate injuries do not get misdiagnosed nor ignored as often as before.

Plantar plate injuries are very difficult to heal in runners because the ligament gets stretched and strained every time you stand on your foot or bend your toe.

But the joint capsule can also get injured. Joint capsule injuries and plantar plate injuries are not the same.

Capsulitis vs. plantar plate sprain. What’s the difference?

Well, that’s what we’re talking about today on the Doc On The Run Podcast.

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#636 Plantar Plate Imaging: MRI vs. Ultrasound

Every time a runner calls me who has a plantar plate sprain, they’re trying to figure out how they can know for sure they actually do have a plantar plate sprain. They often also want to know how bad the plantar plate injury really is.

When you’re a runner, the problem with plantar plate sprains is that many doctors will offer a standardized cookie cutter approach.

I most often help runners get better without surgery.

That’s not because I’m a better doctor. It is because I really put a lot of attention into educating injured runners about how to do all of the additional things to get the injury to heal quickly…so that they can skip the surgery.

One way to start healing faster is by imaging the plantar plate to determine the extent of tissue injury.

Plantar plate imaging, MRI vs. Ultrasound.

That’s what we’re talking about today on the Doc On The Run Podcast.

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#612 Dry Needling vs PRP injection in Runners

Today’s episode comes from a great question I got during one of the Runners Aid station calls.

This was someone who had a plantar plate sprain and had talked to a doctor about a couple of different procedures that might actually, potentially, speed up the healing.

He wanted to know about the difference between these two things called dry needling or a PRP injection.

Today on the Doc On The Run podcast, we’re talking about dry needling versus PRP in runners.

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#593 Is inflammation good or bad for plantar plate sprain

I was just on a call with a runner suffering from a plantar plate sprain.

He had a great question:

Is inflammation really bad or is it good when you have a plantar plate sprain?

Physicians commonly prescribe anti-inflammatories. There are many approaches used by injured runners to manage inflammation, reduce inflammation, and hopefully make your foot feel better.

If inflammation is bad for the plantar plate ligament, part of your recovery plan should include some sort of anti-inflammatory treatment.

But if the inflammation is good for the plantar plate, you should not try to interfere with the inflammatory response.

Is inflammation good or bad for a plantar plate sprain?

Well, that’s what we’re talking about today on the Doc On The Run podcast.

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#578 Did my doctor do the wrong plantar plate injection?

If you get a plantar plate sprain, the first thing you may notice is pain and irritation at the ball of the foot, right where the second toe attaches to the foot. If the foot feels swollen, puffy or sore in that spot, it could be a plantar plate sprain.

A one common injection performed for plantar plate ligament sprains is a corticosteroid injection.

I just spoke with a runner who thought the doctor did the injection in the wrong part of the foot.

She saw a podiatrist, and the doctor did a corticosteroid injection for the plantar plate sprain. She was confused afterward and asked me if the doctor did the injection with the right or wrong technique. I’ll explain why she was confused.

I think my doctor did the wrong injection for the plantar plate ligament.

Well, that’s what we’re talking about today on the Doc On The Run podcast.

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#576 Does a mild plantar plate sprain always hurt?

I was just speaking with a woman who has a suspected mild plantar plate sprain. What was interesting is the fact that she doesn’t really have a whole lot of pain.

I was explaining how important it is that she actually figures out her baseline “pain” numbers. I was explaining that even if you don’t call it “pain” you have to rate the level of discomfort so you can track it.

How bad is it when walking with or without running shoes, or simple things like walking up and downstairs.

Now, the problem is that she said, “well, it’s not really painful so I can’t put a pain number on it.”

I understand it may not really be painful. Particularly if you’re an athlete with a high pain tolerance.

When you have a mild plantar plate sprain you must figure out what it is that you call discomfort or pain. You have to track it.

Does a mild plantar plate sprain always hurt?

Well, that’s a great question and that’s what we’re talking about today on the Doc On The Run podcast.

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#574 Best exercise for plantar plate sprain in runners

The plantar plate ligament is a little ligament on the bottom of the ball of the foot, right where the toe attaches to the foot. The function of the plantar plate ligament is to reinforce the joint and support the toe by helping to hold it down against the ground.

Anatomically, the plantar plate ligament resists the motion doctors call “dorsiflexion,” where the toe gets pulled up away from the ground.

Even though the plantar plate ligament is really small, its funcion is vital.

Doing exercises to help support the plantar plate, can help to decrease some load on the ligament.

Today on the Doc On The Run Podcast, we’re talking about the single most effective exercise to support the plantar plate in runners.

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#570 Should I stretch the toe with plantar plate sprain?

Yesterday I saw a runner with a plantar plate sprain. She wanted to know if stretching the toe would help the plantar plate ligament heal faster.

Plantar plate sprains happen because the plantar plate ligament gets overstretched, and strained.

When you get a plantar plate injury, the fastest way to allow healing is to reduce the stress and strain on that injured ligament.

If you’re thinking about whether or not to stretch the toe or do something to try to help the condition improve faster, you really need to think about the mechanics that are actually involved when you have a plantar plate injury.

Should you stretch the toe that has a plantar plate sprain?

Well, that’s what we’re talking about today on the Doc On The Run podcast.

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#559 Does a crooked toe mean plantar plate surgery in a runner?

A great question I got from someone recently who had a plantar plate injury and the toe was a little bit crooked. His question was, “Do I really need to have surgery if my toe is crooked? Is that a good indicator of whether or not I need plantar plate surgery just because the toe is sitting out of position a little bit?” I thought it might be helpful to explain when it might actually be necessary to have surgery and when it might not be necessary to have surgery. Does a crooked toe mean you have to have surgery for a plantar plate injury? That’s what we’re talking about today on the Doc On The Run podcast.

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