Plantar Plate
Injury Treatment
at Foot Foundation
A plantar plate injury is one of the most common causes of persistent forefoot pain and toe instability, especially beneath the second toe joint. If left untreated, it can progress into deformities like crossover toe or hammer toe, making walking and footwear increasingly difficult.
At Foot Foundation, our podiatrists specialise in diagnosing and treating plantar plate injuries early. Using orthotics, footwear strategies, targeted rehabilitation, and advanced therapies, we reduce pain, restore stability, and help patients avoid long-term deformity.
What is a Plantar Plate Injury?
The plantar plate is a strong ligament-like structure that sits under the metatarsophalangeal (MTP) joints, connecting the base of the toes to the forefoot bones. It stabilises the toes and prevents excessive upward bending (dorsiflexion).
A plantar plate injury occurs when this structure becomes stretched, torn, or ruptured. This is most common at the second toe joint, leading to pain, swelling, and progressive toe deformity (often crossover toe or hammer toe). If left untreated, plantar plate injuries may lead to chronic forefoot pain, instability, and difficulty with footwear.
At Foot Foundation, we specialise in early diagnosis and management of plantar plate injuries, helping patients avoid long-term deformity.
Causes & Risk Factors
Direct trauma – stubbing the toe on furniture or curbs
Crush injuries – heavy objects falling on the foot, workplace accidents
Sports injuries – football, rugby, netball, martial arts
Repetitive stress – overuse fractures in runners, dancers, or military recruits
Footwear factors – unsupportive or protective shoes increasing vulnerability
Bone health – osteoporosis, metabolic bone disease, or previous fracture history
Treatment at Foot Foundation
Custom orthotics – redistribute pressure, offload the plantar plate, and reduce strain
Footwear advice – supportive shoes with cushioning and wide toe boxes
Padding & taping – metatarsal pads, offloading pads, and strapping to stabilise the toe
Exercise therapy – strengthening intrinsic foot muscles, calf mobility, and stability work
Manual therapy & mobilisation – maintain joint range and reduce stiffness
Shockwave therapy – may aid healing in chronic plantar plate pain
Corn and callus care – managing secondary lesions from altered pressure
Referral for surgery – in severe cases with advanced toe drift or rupture, surgical repair or toe realignment may be required
Symptoms
Pain under the ball of the foot, usually beneath the second toe
Swelling or tenderness at the base of the affected toe
Feeling of instability or “giving way” at the toe joint
Development of a hammer toe or crossover toe deformity over time
Pain when wearing tight or narrow shoes
Difficulty pushing off during walking or running
In advanced cases: visible toe drift or dislocation
Diagnosis
At Foot Foundation, diagnosis includes:
History & symptom assessment – location, onset, activity triggers
Clinical tests:
Drawer test – upward movement of the toe indicating plantar plate laxity
Toe alignment checks – detecting early drift or crossover deformity
Gait and biomechanical analysis – assessing forefoot overload and contributing factors
Imaging:
Ultrasound – can detect partial or full-thickness tears
MRI – gold standard for visualising plantar plate damage and joint instability
Plantar Plate Injury – FAQs
It is a tear or degeneration of the plantar plate ligament beneath the toe joint, most commonly affecting the second toe.
They are caused by forefoot overload, bunions, trauma, or repetitive stress on the toe joint.
Pain under the ball of the foot, swelling, and a sense of toe instability. Over time, the toe may start to drift or overlap.
Diagnosis involves clinical drawer tests and imaging such as ultrasound or MRI.
Yes. Early injuries can be managed with orthotics, footwear changes, padding, and exercise therapy. Advanced tears with severe deformity may need surgery.
Yes. Orthotics with metatarsal offloading and support significantly reduce stress on the plantar plate and allow healing.
Supportive shoes with cushioning, firm midsoles, and wide toe boxes. Avoid narrow or high-heeled shoes that increase forefoot load.
Yes. Untreated injuries often progress to crossover toe, hammer toe, or dislocation.
No. Most cases respond to conservative care if treated early. Surgery is reserved for advanced deformities or full ruptures.
If you have persistent ball of foot pain, toe instability, or a drifting second toe, seek podiatry care early to prevent progression.
Why Choose Foot Foundation?
Foot Foundation provides specialist plantar plate injury management, focusing on early diagnosis, orthotics, footwear optimisation, and exercise rehabilitation. We aim to restore stability, reduce pain, and prevent long-term deformity, coordinating surgical referral when required.
With clinics in Rosedale, Takapuna, Remuera, Botany, Hamilton, and Tauranga, expert forefoot care is available across New Zealand.
